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The tumor development in the bone tissue may be a consequence of metastasis from other organs or it may occur independently. In the second case, we are talking about primary bone tumors.
The peak incidence is observed in the 2nd and 3rd decade of life. Men are sick slightly more often than women. Primary bone tumors account for about 1,5 percent. all malignant tumors. Primary bone tumors occur in several clinical types and their location depends on this.
Imaging tests are used to diagnose primary bone tumors. First of all, review radiographs and computed tomography. The test that is performed before making a decision about treatment is also an open biopsy. MRI scans are useful in assessing inflammatory changes that develop around the tumor.
The most commonly diagnosed bone cancers include:
Osteosarcoma (Osteosarcoma) – In terms of the frequency of occurrence, it is in second place and accounts for approx. 20%. all bone sarcomas. It usually affects people between 12 and 24 years of age. years of age, more often in the male sex. About 50 percent. patients are located within the knee joint. A symptom of developing cancer is short-term pain that occurs periodically and becomes continuous as the disease progresses. Pain worsens mainly at night. The affected limb is swollen. There may also be pathological fractures.
Treatment consists of the use of induction chemotherapy, which is designed to reduce the tumor mass before surgery, then surgery, and then postoperative chemotherapy.
Five-year survival is recorded in 40-60 percent. patients.
Chondrosarcoma (Chondrosarcoma) – It usually attacks middle-aged and elderly people – mainly in the 5th and 6th decade of life, and accounts for approx. 10% all primary bone tumors. It most often develops in the bones of the trunk and the upper (proximal) sections of the humerus and femurs. The tumor grows slowly, but pain may appear months before the tumor is felt.
Surgery is the treatment of choice because this type of primary bone cancer is resistant to chemotherapy and radiation. After such treatment, 5-year survival is achieved in half of the patients.
- Fibrosarcoma (Fibrosarcoma) – The age to which it can develop is very broad. The disease appears from the 2nd to the 6th decade of life. Fibrosarcoma accounts for about 4 percent. all bone sarcomas. It usually affects the epiphyses of long bones, especially the shinbones and femurs.
The only treatment method that brings good results is surgery. Working through the use of radiotherapy is in most cases ineffective. Irradiation is recommended for inoperable tumors. The use of chemotherapy in this type of primary bone cancer is at the stage of clinical trials and it is still difficult to predict what the results will be.
Mięsak Ewinga (Sarcoma Ewing) — It is classified as a small cell tumor of unknown origin. It mainly attacks young people in the 1st and 2nd decade of their lives. It usually develops in the bones of the pelvis and legs. Treatment of this form of cancer consists of four stages: induction chemotherapy, surgery, postoperative irradiation, and postoperative chemotherapy. Aggressive treatment with the use of multiple drugs and the removal of fragments of diseased bones and irradiation brings good therapeutic results. 40-60 percent the sick can be cured.
Giant cell tumor (Osteoclastoma) – Oncologists classify it as a neoplasm with a benign but aggressive growth. It usually develops in the 3rd and 4th decade of life. Statistically, it is about 5 percent. primary bone tumors. It is assumed that the giant cell tumor does not appear in children before skeletal maturity. It usually develops in long bones, especially around the knee joint and the distal (closer to the knee) section of the radial bone.
It comes in three forms:
I – intraosseous tumor that does not reduce the cortical layer of the bone (benign form),
II – tumor causing reduction and distension of the cortical layer (active form); about 50 percent all cases of this cancer,
III – a tumor that causes perforation of the cortical layer and infiltrates soft tissues (aggressive form); concerns 25 percent cases of this cancer.
Treatment of giant cell tumors is a huge medical problem. In the case of type I and II tumors, complete mechanical removal of all bone changes and lauterization (cauterization, burning) of the resulting defects with phenol solution or liquid nitrogen is suggested. The next stage of treatment is filling the resulting cavities by transplanting solid spongy bones or filling them with bone cement. In the case of type III tumors, a complete resection (removal) of the diseased bone fragments is usually performed. Reconstruction is performed through the use of arthroplasty, i.e. joint replacement or the use of arthrodesis (surgical stiffening of the joint) or through a vascular graft. If the cancer has damaged large bone fragments and also affects soft tissues, the only solution is to amputate and then make a prosthesis that will make it easier for the patient to move around. Irradiation is often the treatment of choice for tumors that are not amenable to surgery. The decision to use it, both the doctor and the patient must carefully consider, because irradiation can lead to malignancy of the tumor.
20-50% of the octal cell tumors that have been treated topically. cases, within two years, they recover, no matter how advanced they were. When the disease recurs, another resection (removal) of the resulting lesion is performed. After such a resumption, in the case of 5-7 percent. in patients, the tumor becomes malignant. When radiotherapy is used, the risk of malignancy increases significantly.