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Malignant Bone Neoplasm

Malignant Bone Tumors


Presentation

  • Occasionally binucleated cells are present.[pedorthpath.com]
  • Patients clinically present with night pain that may or may not be relieved with salicylates.[podiatrytoday.com]
  • Clinical presentationpresent as a localized painful mass • with systemic symptoms such as fever, malaise, weight loss, and • an increased erythrocyte sedimentation rate. • These systemic symptoms may lead to an erroneous diagnosis of osteomyelitis.[slideshare.net]
  • Core Tested Community Questions (5) Sorry, this question is for PEAK Premium Subscribers only Sorry, this question is for PEAK Premium Subscribers only Sorry, this question is for PEAK Premium Subscribers only (M1.ON.4723) A 12-year-old Caucasian male presents[medbullets.com]
Fever
  • (after osteosarcoma) medullary cavity, usually of long bones in the lower extremities  Femur most common  pelvis  upper limb  spine and ribs sacrococcygeal region SYMPTOMS Age 5-15 yrs localized pain and swelling Additional symptoms may include Fever[slideshare.net]
  • Some tumors can also cause fevers and night sweats. Many patients will not experience any symptoms, but will instead note a painless mass. Medical history and physical exam: Tell the doctor your complete medical history.[health.uconn.edu]
  • Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia, which is a low level of red blood cells. If you are concerned about any changes you experience, please talk with your doctor.[cancer.net]
  • . • Fever, anemia, leukocytosis and increased sedimentation rate are often seen.[pedorthpath.com]
Weight Loss
  • Clinical presentation • present as a localized painful mass • with systemic symptoms such as fever, malaise, weight loss, and • an increased erythrocyte sedimentation rate. • These systemic symptoms may lead to an erroneous diagnosis of osteomyelitis.[slideshare.net]
  • Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia, which is a low level of red blood cells. If you are concerned about any changes you experience, please talk with your doctor.[cancer.net]
  • Some other symptoms can be weight loss, fatigue and or anemia. The first step in diagnosing primary bone cancer is a complete medical history and physical examination performed by a physician.[sarcomaalliance.org]
  • In addition, swelling and weight loss can also occur.[podiatrytoday.com]
Fatigue
  • Some other symptoms can be weight loss, fatigue and or anemia. The first step in diagnosing primary bone cancer is a complete medical history and physical examination performed by a physician.[sarcomaalliance.org]
  • Additional symptoms may include fatigue, fever, weight loss, anemia, and unexplained bone fractures. Many patients will not experience any symptoms, except for a painless mass.[en.wikipedia.org]
  • The side effects of chemotherapy include: nausea irritability hair loss extreme fatigue Cryosurgery Cryosurgery is another treatment possibility. This treatment involves killing cancer cells by freezing them with liquid nitrogen.[healthline.com]
Intravenous Drugs
  • It may be ingested via a pill or a needle inserted into a vein for intravenous drug therapy. Radiation therapy: This therapy uses high-energy rays to kill cancer cells and shrink tumors.[my.clevelandclinic.org]
Rectal Bleeding
  • Clinical Findings Low back pain Constipation or fecal incontinence Rectal bleeding Sciatica from nerve root compression Frequency, urgency, straining on micturition CHORDOMA 37.[slideshare.net]
Fecal Incontinence
  • Clinical Findings Low back pain Constipation or fecal incontinence Rectal bleeding Sciatica from nerve root compression Frequency, urgency, straining on micturition CHORDOMA 37.[slideshare.net]
Hirsutism
  • . • It consists of polyneuropathy (P), organomegaly (O), particularly of the liver and the spleen, endocrine disturbances (E) such as amenorrhea and gynecomastia, monoclonal gammopathy (M), and skin changes (S) such as hyperpigmentation and hirsutism,[slideshare.net]
Osteoporosis
  • . • Multiple myeloma may present in a variety of radiographic patterns Particularly in the spine, • it may be seen only as diffuse osteoporosis with no clearly identifiable lesion; multiple compression fractures of the vertebral bodies may also be evident[slideshare.net]
Low Back Pain
  • Clinical Findings Low back pain Constipation or fecal incontinence Rectal bleeding Sciatica from nerve root compression Frequency, urgency, straining on micturition CHORDOMA 37.[slideshare.net]
Elbow Pain
  • pain shows a pathologic fracture through the markedly eroded ulna and extensive cortical breakthrough.[slideshare.net]
Sciatica
  • Clinical Findings Low back pain Constipation or fecal incontinence Rectal bleeding Sciatica from nerve root compression Frequency, urgency, straining on micturition CHORDOMA 37.[slideshare.net]

Workup

  • Workup Laboratory studies may include measuring serum calcium, phosphorous, and alkaline phosphatase levels to assess for possible bony metastasis.[emedicine.medscape.com]
  • Since not every benign tumor can be reliably diagnosed as benign on an x-ray, it is important to do a complete diagnostic workup until the dignity (benign / malignant) of the vertebral finding can be confirmed.[harms-spinesurgery.com]

Treatment

  • However, the choice of treatment depends upon the location, size, and stage of cancer, the patient’s age and general health, and how the tumor responds to treatment.[my.clevelandclinic.org]
  • There remains uncertainly as to the best treatment of this disease and how to improve its prognosis.[ncbi.nlm.nih.gov]
  • Sometimes your doctor may recommend removing the tumor (excision) or using other treatment techniques to reduce the risk of fracture and disability. Some tumors may come back–even repeatedly–after appropriate treatment.[health.uconn.edu]
  • The choice of chemotherapy scheme will depend on the treatment-free interval and the initial treatment received by the patient.[link.springer.com]

Prognosis

  • There remains uncertainly as to the best treatment of this disease and how to improve its prognosis.[ncbi.nlm.nih.gov]
  • Prognosis: • Better prognosis than conventional osteosarcoma, but still have tendency to recur and metastasize. • Medullary involvement of the bone may have poorer prognosis. • About 70% recurrence rate after excision. • Rate of metastasis has been reported[pedorthpath.com]
  • […] appearance of the periosteum Laboratory findings: ESR, LDH, leukocytosis Biopsy Anaplastic small-blue-round-cell malignancy Cells contain glycogen accumulations and are usually CD99-positive Chromosomal translocation t(11 ; 22) (q24;q12) ; Treatment Prognosis[amboss.com]
  • The impact on prognosis of the pathologic response to denosumab in GCTB is yet to be determined.[link.springer.com]

Etiology

  • ] [19] Differential diagnosis of primary malignant bone tumors Secondary malignancies of the bone (bone metastasis) Description Definition : secondary bone tumors due to metastasis (predominantly hematogenous) of primary malignancies of other organs Etiology[amboss.com]
  • Consider the anatomic structures surrounding the lesion and possible etiologies for the mass. Next, palpate the lesion. Determine the size, shape, and contour.[emedicine.medscape.com]
  • Common benign bone tumors may be neoplastic, developmental, traumatic, infectious, or inflammatory in etiology. Some benign tumors are not true neoplasms, but rather, represent hamartomas, namely the osteochondroma.[en.wikipedia.org]

Epidemiology

  • Ewing sarcoma Description : : highly malignant bone tumor arising from neuroectodermal cells ; ; associated with various chromosomal translocations of the EWSR1 gene ( chromosome 22 ) Epidemiology Incidence : peak at 10–15 years Sex: Ethnicity: primarily[amboss.com]
  • Epidemiology: • Accounts for less than 1% of primary bone tumors and only 1-2% of all osteosarcomas. • Males and females are equally affected. • The peak incidence is in 2nd-3rd decades of life.[pedorthpath.com]
  • Osteoblastoma: Epidemiology: Usually appears between the ages of 10 and 35. Clinical features: Osteoblastoma usually is observed in long bones and posterior spine.[pedclerk.bsd.uchicago.edu]
  • Epidemiology Primary bone tumors are the sixth most common neoplasm occurring in children and constitute approximately 6% of all childhood malignancies.[pedsinreview.aappublications.org]
  • Eyre R, Feltbower RG, James PW, et al ; The epidemiology of bone cancer in 0 - 39 year olds in northern England, 1981 - BMC Cancer. 2010 Jul 610:357.[patient.info]
Sex distribution
Age distribution

Prevention

  • Treatment focuses on the underlying malignancy and additional management of pain and prevention of fractures related to the metastases.[amboss.com]
  • Radiotherapy works by damaging the DNA inside the tumor cells, preventing them from reproducing.[medicalnewstoday.com]
  • Stabilization of long bones is often necessary to prevent pathologic fracture. Amputation is indicated only rarely, when function is lost because of pathologic fracture or extensive soft-tissue involvement that cannot be managed otherwise.[merckmanuals.com]
  • Is It Possible to Prevent Bone Cancer? At this time, there are no specific methods of prevention of bone cancer. What Is the Prognosis for Bone Cancer? The outlook for patients with bone cancer is improving.[emedicinehealth.com]
  • Is it possible to prevent bone cancer? Since the exact cause of bone cancer is poorly understood, there are no lifestyle changes or habits that can prevent these uncommon cancers.[medicinenet.com]

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