What Is a Bone Neoplasm?

Bone tumors are tumors that occur in the bone or its accessory tissues. There are benign and malignant points, benign bone tumors are easy to cure, the prognosis is good, malignant bone tumors develop rapidly, the prognosis is poor, and the mortality rate is high. Malignant bone tumors are classified as primary and secondary. Malignant tumors from other tissues or organs in the body are metastatic to the bones through the blood circulation and lymphatic system and are secondary malignant bone tumors. There is also a class of lesions called tumor-like lesions. The tissues of tumor-like lesions do not have the characteristics of tumor cell morphology, but their ecology and behavior are destructive to tumors. They are generally limited and easy to cure.

Basic Information

English name: bone neoplasms
Visiting department: Orthopedics, Oncology
Common locations: skeleton

Common causes: Related to chronic irritation, viral infection, endocrine, genetics, etc.
Common symptoms: Pain, swelling or lumps, dysfunction, etc.
Contagious: no

Causes of Bone Tumors

The pathogenesis of bone tumors is complex, and there is no exact etiology at present. Internal causes include quality theory, genetic theory, endocrine theory, etc .; external factors include chemical element substances, internal and external radiation chronic stimulation theory, and virus infection theory. Some multiple osteochondroma and fibroid proliferative diseases are related to family inheritance. Benign tumors of bone can be malignant: multiple osteochondromas can become malignant chondrosarcomas.

Clinical manifestations of bone tumors

Pain

It is the main symptom that appears early in bone tumors. It is relatively mild at the beginning of the disease and is intermittent. With the progress of the disease, pain can gradually increase and develop into persistent. Most patients experience increased pain at night that affects sleep. Its pain can radiate far away.

2. Swelling or lumps

Tumors that are subcutaneous or superficial appear earlier and can touch bone expansion and deformation. If the tumor penetrates out of the bone, it can produce a fixed soft tissue mass with a smooth or uneven surface.

3. dysfunction

In the later stage of bone tumor, due to pain and swelling, the function of the affected part will be impaired, which may be accompanied by muscle atrophy in the corresponding part.

4. Compression symptoms

Tumors growing into the cranial cavity and nasal cavity can compress the brain and nasal tissues, resulting in craniocerebral compression and poor breathing; pelvic tumors can compress the rectum and bladder, resulting in difficulty in defecation and urination; spinal tumors can compress the spinal cord and Paralyzed.

5. deformity

Due to tumors affecting the development and solidity of the limbs and bones, the deformity is complicated, and the lower limbs are obvious.

6. Pathological fracture

As long as the tumor site has a slight external force, it is easy to cause fractures. The fracture site is swollen and painful. Pathological fractures of the spine are often associated with paraplegia.

7. Systemic symptoms

In the later stage of bone tumors, due to tumor consumption, toxin stimulation, and painful torture, a series of systemic symptoms can occur, such as insomnia, irritability, loss of appetite, depression, pale, progressive weight loss, anemia, cachexia, and so on.

Bone tumor examination

Radiological examination

It can provide valuable information for clarifying the nature, type, scope and treatment of bone tumors, and is an important examination method for bone tumors. The morphology of benign bone tumors is regular, with clear boundaries between the surrounding normal bone tissue. The hardened edge is the boundary. The cortex is thinned due to swelling, but it remains intact. There is no periosteal reaction. Bone phenomenon is more obvious, bone destruction, thinning, fracture, loss, primary malignant tumors often have periosteal reactions, and their shapes can be sun-radiated, onion skin-like and Codman triangle.

2. Pathological examination

Histopathological examination is considered to be the most accurate diagnostic method, but if the material is not taken properly, it can also cause diagnostic errors. Therefore, the pathological examination must be combined with clinical and x-ray examinations. Commonly used materials and inspection methods include needle aspiration biopsy, incision biopsy, frozen section, paraffin section and so on.

3. Radionuclide inspection

It can be used for early diagnosis of bone metastases.

4.CT and magnetic resonance

Early detection of diseased tissues with high accuracy.

5. Other

When osteosarcoma accelerates blood sedimentation, alkaline phosphatase of osteoblastic metastatic bone tumors can increase.

Bone tumor diagnosis

The diagnosis of most bone tumors is complicated, and sometimes there are certain difficulties, because different bone tumors can have similar manifestations, and benign bone tumors can undergo malignant changes; some bone tumors have histological examinations showing benign differentiation, but clinically they are highly malignant. Lung metastases often occur early. Therefore, comprehensive analysis should be combined with the above-mentioned examinations, and the final diagnosis depends on histopathological examination.

Bone Tumor Treatment

Benign tumor

Local scraping and bone grafting or resection is the main method. If it can be completely removed, it usually does not recur, and it is good after healing.

Malignant tumor

(1) Surgical resection is the main method of treatment. Amputation and joint dissection are the most common methods. However, due to the advancement of chemotherapy methods, in recent years, some scholars have begun to perform tumor resection or total femoral resection and replaced with artificial prostheses. Measures such as "extensive partial resection and functional reconstruction" with preservation of limbs combined with chemotherapy were adopted.

(2) Drugs commonly used in chemotherapy for systemic chemotherapy are doxorubicin and high-dose methotrexate, but the drug's action selectivity is not strong, and tumor cells are not synchronized during the division cycle, which affects the effect of chemotherapy.

(3) Local chemotherapy includes continuous intra-arterial chemotherapy and regional perfusion, of which regional perfusion is better.

(4) Immunotherapy cannot be widely used due to limited sources of interferon.

(5) Radiotherapy can only be used as an adjuvant therapy for bone tumors.

Bone tumor prognosis

Benign bone tumors are easy to cure, and the prognosis is good. Malignant bone tumors develop rapidly, the prognosis is poor, and the mortality rate is high. So far, there is no satisfactory treatment method.