Bone swelling
Bone tumor is a collective term for a group of malignant and benign formations of bone or cartilage tissue. Speaking about bone tumors, specialists most often mean primary neoplasms. They account for about 1% of all malignant human oncopathologies. Most often, bone tumors are diagnosed in the male population at a young or middle age - from 15 to 40 years. As for localization, it is mainly the tubular bones of the extremities and the pelvic bones that are affected.
Some scientists use the phrase "bone tumor" to refer to secondary tumors, that is, those neoplasms that have arisen as a result of malignancy of exostoses, deforming chondromatosis and other benign pathologies of bone tissue. Also, secondary bone tumors include those that have arisen as a result of metastasis of malignant neoplasms located in other organs.
The most commonly diagnosed tumors affecting bone tissue are osteosarcomas, chondrosarcomas, and fibrosarcomas. At a young age, patients are mainly diagnosed with Ewing's sarcoma. More than 30 types of bone tumors are known to modern science.
Outgrowths can be formed from bone or cartilaginous tissue, it is possible to detect giant cell neoplasms and bone marrow tumors. An intermediate type is malignant osteoblastoma.
Content:
- Causes of bone tumors
- Bone tumor symptoms
- Diagnosis of bone tumors
- Bone tumor treatment
Causes of bone tumors
The causes of malignant bone tumors are still unclear.
Scientists suggest that the following factors are capable of provoking the development of oncopathology of bone tissue:
- Bone trauma. Despite the absence of a 100% evidence base, most authors agree on the assumption that various injuries play a leading role in the development of primary neoplasms. It was found that more than 50% of all patients with malignant bone tumors indicate that they previously received bruises of soft tissues, extremities or joints;
- Genetic predisposition. Also, one should not reject the fact of a hereditary predisposition to this oncopathology. The risk of developing the disease in blood relatives is higher if there are already cases of bone tumors in the family history;
-
Paget's disease. Another reason that, according to scientists, can aggravate the risk of a malignant tumor in humans is inflammatory bone diseases. In particular, we are talking about Paget's disease. People with such a diagnosis have a relatively high probability of developing osteosarcoma in adulthood and old age;
- Metastasis of primary tumors and malignancy of benign ones. Secondary bone tumors are formed as a result of malignant degeneration of benign neoplasms, or become the result of metastasis of primary tumors from other organs.
Bone tumor symptoms
The main symptoms of bone tumors are represented by the classic triad:
- Pain. In the presence of a malignant neoplasm on the bone, a person experiences progressive pain of a persistent nature. They tend to get worse at night. It is very difficult to relieve such pain with pain relievers. If the sensations diminish, it is very slight. It is pain that is the earliest sign of bone tumor, with the exception of Ewing's sarcoma. With this pathology, a tumor first appears, and pains manifest a little later;
- The presence of a tumor-like outgrowth on the affected bone. It can be felt even when the neoplasm begins to increase in size. The tumor is most often represented by a dense, painless and immobile conglomerate, prone to constant rapid growth. While bone tumors of a benign nature grow much more slowly;
- Dysfunction of the joint located next to the tumor.
The symptoms of all malignant bone tumors should be considered separately:
- Ewing's sarcoma symptoms. An increase in body temperature is characteristic, which is noted by up to 50% of patients. Sometimes it rises to a very impressive 39 ° C. The vascular pattern on the skin becomes more pronounced, when a person tries to touch the affected area, pain occurs. The limb increases in volume. Symptoms most often increase rapidly, sometimes a fulminant course of the disease is noted, although periods of remission and exacerbation are not excluded;
- Symptoms of osteosarcoma. Statistics indicate that this tumor is the most common and accounts for about 60% of all malignant neoplasms of bone tissue. It manifests itself in progressive pain. Most often, it affects the long tubular bones above and below the knee joint. Characterized by increased vascular pattern, local increase in body temperature. Muscles located below the level of the pathological process are prone to atrophy. Joints that are nearby often have limited mobility. For patients with a similar neoplasm, pathological fractures are characteristic;
-
Chondrosarcoma symptoms. Chondrosarcoma, as a rule, progresses slowly, developing over 10 years or more. The symptoms of the disease are blurred. Most often, this is pain and the appearance of a tumor-like outgrowth located on the bone. The pains tend to intensify with increasing intensity. The skin over the affected area of the bone is characterized by a higher temperature, the saphenous veins are dilated. This tumor is most often diagnosed in older men;
- Fibrosarcoma symptoms. With fibrosarcoma, the pain intensifies at night, progresses slowly and over a long time is not so intense that a person seeks medical help. Most often, more than six months pass from the manifestation of oncopathology to the first visit to the doctor. This period for malignant neoplasms of bone tissue is quite long. As for the outgrowth itself, it often provokes a change in the contour of the joint located next to it. Fibrosarcoma is always motionless relative to the bone;
- Symptoms of histiocytoma. Malignant fibrous histiocytoma, which is very rare, is characterized by severe pain and the presence of a tumor-like subcutaneous neoplasm that sits tightly on the bone.
Secondary malignant neoplasms of bone or cartilage tissue are most often formed against the background of tumors of the prostate, breast and thyroid glands, as well as of the kidneys, lungs and uterus. They are characterized by the above-described triad of symptoms.
Benign bone tumors
Benign bone tumors include osteomas, osteoid osteomas, osteoblastomas, osteochondromas, chondromas. Most often, benign tumors develop asymptomatically and do not manifest themselves for a long time. Pain, if it does occur, is of low intensity (with the exception of osteoblastoma).
Diagnosis of bone tumors
Diagnosis of a bone tumor almost always begins with an X-ray examination performed in two projections. It is also possible to prescribe additional procedures, such as angiography, tomography, CT.
Bone scintigraphy is a very sensitive method, which makes it possible not only to detect the primary tumor, but also provides information on the prevalence of the oncological process.
Aspiration biopsy, open biopsy, or trepanobiopsy are performed to select a method for treating patients with malignant bone tumors. This type of research is decisive in terms of making a diagnosis.
Bone tumor treatment
The treatment of bone tumors is based on surgery. If the disease was detected at an early stage of development, then preference is given to organ-preserving operations. When the size of the neoplasm is impressive, then amputation or disarticulation of the bone is indicated. Often this method is the only way to keep a person alive.
In addition to surgery, patients are usually prescribed chemotherapy and radiation therapy. When deciding on the choice of a particular method of treatment, the doctor takes into account the sensitivity of the detected type of tumor to various types of exposure. So, cartilaginous tumors can be removed only with the help of surgery. Ewing's sarcoma responds well to radiation and chemotherapy, and surgery is in this case an additional method of treatment, which is not possible in every case.
Surgical interventions can be radical and conserving. The first type includes amputation and disarticulation, and the second - resection. However, in any case, the tumor must be removed together with the musculo-fascial sheath, and the limb must be crossed above the place where the damaged segment is.
An action plan is drawn up depending on the type of bone tumor:
- Treatment of osteosarcoma. The tumor is removed promptly. If in previous years amputation was used, now more and more often they resort to organ-preserving surgery followed by chemotherapy, which is carried out before surgery. The cut bone fragment is replaced with a metal or plastic implant. The prognosis is most often favorable and the five-year survival rate of patients is about 70% (in more detail: osteosarcoma);
- Chondrosarcoma treatment. The approach to this type of tumor is predominantly complex. Chemotherapy is used in combination with a radiosurgical technique to remove the neoplasm. The prognosis after performing radical surgery is most often favorable, the use of only radiation therapy gives a temporary effect, reduces pain and allows you to prolong the life of patients;
- Treatment of Ewing's sarcoma involves multicomponent chemotherapy followed by radiation therapy. If there is such an opportunity, then the bone itself and the surrounding soft tissues are subject to removal. They refuse radical intervention only if there are contraindications to its implementation. Radiation therapy and chemotherapy are given both before and after surgery. As for the prognosis, the five-year survival rate does not exceed 50% (more: Ewing's sarcoma).
All patients who have undergone treatment for malignant bone tumors are registered with an oncologist. They are actively monitored by a doctor for the first five years after the operation. In subsequent years, it is mandatory to undergo an examination with an X-ray once every 365 days.
The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon
Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"
