A bone tumour is an abnormal growth of cells in the bone. Bone tumours are often benign (non-cancerous), but can be malignant (cancerous). Most commonly seen in the long bones, they may originate within the bone itself (primary tumour), or they may spread to the bone from other parts of the body (known as a secondary or metastatic tumour).
The most common benign types of tumour include non-ossifying fibroma unicameral (simple) bone cyst, osteochondroma, giant cell tumour, enchondroma and fibrous dysplasia.
The most common types of malignant tumour, alternatively, are multiple myeloma (which occurs in the bone marrow), osteosarcoma and chondrosarcoma.
The symptoms of a bone tumour will vary based on type, size and location, though most patients will experience a persistent dull pain at the tumour site, which may become worse at night or with activity as well as swelling or the development of a lump which can be sore, and warm, to the touch.
Adjunct symptoms of malignant tumour can include fatigue and weight loss, as well as fever and night sweats.
The causal factors which underlie the development bone of a bone tumour are not always clear, altlthough they may include genetic factors associated with an increased risk of tumour development, such as Li-Fraumeni syndrome and Ollier disease, as well as exposure to radiation.
In older adults, Paget’s disease may be associated with the development of Osteosarcoma in rare cases. Bone tumour development can also be associated with rapid change in bone and hormonal changes during adolescence.
Non-surgical treatment options are dictated by the type, size and location of the tumour, the aim of treatment being to remove the tumour, preserve bone integrity and minimise the risk of recurrence. Non-surgical treatment options include:
Chemotherapy and radiation therapy: chemotherapy utilises anti-cancer drugs to shrink the tumour and can be very effective when paired with radiation therapy, which uses high-energy lightwaves to destroy tumour cells.
Targeted therapies: involves the use of drugs, such as tyrosine kinase inhibitors, which inhibit cancer cells via targeted action on the proteins or genetic pathways responsible for their growth
Tumour embolisation: involves cutting blood supply to the tumour by the introduction of a physical agent via catheter.
Cryoablation and radiofrequency ablation: cryoablation involves the use of liquid nitrogen or argon gas to freeze and kill the tumour, while radiofrequency ablation utilises the heat generated by high-frequency electrical currents to the same end.
Surgical treatment options are often the most efficacious, particularly when used alongside some of those non-surgical adjuvent therapies noted above. These can include:
Curettage and bone graft: involves scraping the tumour from within the bone while leaving the affected bone segment in place. Typically, a bone graft will be used to fill-in any gaps left following removal of the tumour and restore structural integrity.
Resection: involves removing the tumour in one piece, alongside proximal healthy tissue to ensure all cancerous cells are cleared. The resected bone will typically be restored thereafter using a graft or prosthesis.
Amputation: involves the partial or total removal of the affected limb, and with it the cancerous tumour, where limb-sparing surgery is not possible.
To learn about tumour surgery, and what to expect from your surgery, please visit our tumour surgery page.
For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.
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Professor Dr Munjed Al Muderis is an orthopaedic surgeon specialising in osseointegration, hip, knee and trauma surgery. He is a clinical professor at Macquarie University and The Australian School Of Advanced Medicine, a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group.