A bone tumor is an abnormal growth of cells within a bone. A bone tumor may be cancerous (malignant) or noncancerous (benign).

Tumor - bone; Bone cancer; Primary bone tumor; Secondard bone tumor

The cause of bone tumors is unknown. They often occur in areas of rapid bone growth. Possible causes include:

• Genetic defects passed down through families
• Radiation
• Injury

In most cases, no specific cause is found.

Osteochondromas are the most common noncancerous (benign) bone tumors, and occur most often in people between the ages of 10 and 20.

Cancers that start in the bones are referred to as primary bone tumors. Cancers that start in another part of the body (such as the breast, lungs, or colon) are called secondary or metastatic bone tumors. They behave very differently from primary bone tumors. Multiple myeloma often affects or involves the bone, but is not considered a primary bone tumor.

Cancerous (malignant) bone tumors include:

• Chondrosarcoma
• Ewing's sarcoma
• Fibrosarcoma
• Osteosarcomas

The cancers that most often spread to the bone are cancers of the:

• Breast
• Kidney
• Lung
• Prostate
• Thyroid

These forms of cancer usually affect older people.

Bone cancer was once very common among people who made glow-in-the-dark dials using radium paint. The practice of using radium paint was abandoned in the mid-1900s.

Bone cancer is more common in families with familial cancer syndromes.

• Bone fracture, especially fracture from slight injury (trauma)
• Bone pain, may be worse at night
• Occasionally a mass and swelling can be felt at the tumor site

Note: Some benign tumors have no symptoms.

The doctor or nurse will perform a physical exam. Tests that may be done include:

• Alkaline phosphatase blood level
• Bone biopsy
• Bone scan
• Chest x-ray
• CT scan of the chest
• MRI of the bone and surrounding tissue
• X-ray of bone and surrounding tissue

This disease may also affect the results of the following tests:

• Alkaline phosphatase isoenzyme
• Blood calcium level
• Parathyroid hormone
• Blood phosphorus level

Some benign bone tumors go away on their own and do not require treatment. Your doctor will closely monitor you and order periodic x-rays to see if the tumor shrinks or grows.

Surgery may be needed to remove the tumor in some cases.

Treatment for cancerous bone tumors that have spread from other parts of the body depends on where the cancer started. Radiation therapy may be given to prevent a fractures or to relieve pain.

Tumors that start in the bone are rare. They require treatment at centers with experience treating such cancer. After biopsy, a combination of chemotherapy and surgery is usually necessary. Radiation therapy may be needed before or after surgery.

It may be helpful to join a support group where members share common experiences and problems. See: Cancer - support group.

How well you do depends on the type of bone tumor.

The outcome is expected to be good for people with noncancerous (benign) tumors. However, some benign bone tumors may turn to cancer.

Most patients with cancerous bone tumors that have not spread can achieve a cure. The cure rate depends on the type of cancer, location, size, and other factors. Talk to your doctor or nurse about your particular cancer.

• Pain
• Reduced function, depending on the tumor
• Side effects of chemotherapy
• Spread of the cancer to other nearby tissues (metastasis)

Call your health care provider if you have symptoms of a bone tumor.

Baker LH. Bone tumors: primary and metastatic bone lesions. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 209.

National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Bone Cancer. National Comprehensive Cancer Network; 2012. Version 2.2012.

Lerner A, Antman KH. Primary and metastatic malignant bone lesions. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 208.