What is primary bone cancer?
Bone cancer is caused by a cancerous or malignant changes in the cells that make bone. Bone tumors occur most commonly in children and adolescents and are less common in older adults.
Most causes of primary bone cancers are unknown. Previous high doses of radiation therapy increase the risk of developing primary bone cancer later. Similarly patients who have Paget’s disease of the bone have a higher risk of developing primary bone cancer later in the affected region. Patients with certain benign bone tumors may later develop malignant or primary bone cancers. Certain rare genetic syndromes increase the risk of primary bone cancer. Children with a history of a malignant eye cancer called retinoblastoma have a higher risk of primary bone cancer.
What are the different types of bone cancer?
There are many different types of bone cancer. The most common primary bone tumors include osteosarcoma, Ewing's sarcoma, chondrosarcoma, malignant fibrous histiocytoma, fibrosarcoma, and chordoma.
- Osteosarcoma is the most common primary malignant bone cancer. It most commonly affects males between 10 and 25 years old but can less commonly affect older adults. It starts in the long bones of the arms and legs at areas of rapid growth around the knees and shoulders of children. This type of cancer is often very aggressive with risk of spread to the lungs. The five-year survival rate is about 65%.
- Ewing's sarcoma is the most aggressive bone tumor and affects younger people between 4-15 years of age. It is more common in males and is very rare in people over 30 years of age. It most commonly occurs in the middle of the long bones of the arms and legs. The three-year survival rate is about 65%, but this rate is much lower if there has been spread to the lungs or other tissues of the body.
- Chondrosarcoma is the second most common bone tumor and accounts for about 25% of all malignant bone tumors. These tumors arise from the cartilage cells and can either be very aggressive or relatively slow growing. Unlike many other bone tumors, chondrosarcoma is most common in people over 40 years of age. It is slightly more common in males and can potentially spread to the lungs and lymph nodes. Chondrosarcoma most commonly affects the bones of the pelvis and hips. The five-year survival for the aggressive form is about 30%, but the survival rate for slow-growing tumors is 90%.
- Malignant fibrous histiocytoma (MFH) affects the soft tissues, including muscle, ligaments, tendons, and fat. It is the most common soft-tissue malignancy in later adult life, usually occurring in people 50-60 years of age. It most commonly affects the extremities and is about twice as common in males as females. MFH also has a wide range of severity. The overall five-year survival rate is about 35%-60%.
- Fibrosarcoma is much rarer than the other bone tumors. It is most common in people 35-55 years of age. It most commonly affects the soft tissues of the leg behind the knee. It is slightly more common in males than females.
- Chordoma is a very rare tumor with an average survival of about six years after diagnosis. It occurs in adults over 30 years of age and is about twice as common in males as females. It most commonly affects either the lower or upper end of the spinal column.
What are the different types of bone benign tumors?
In addition to bone cancer, there are various types of benign bone tumors. These include osteoid osteoma, osteoblastoma, osteochondroma, enchondroma, chondromyxoid fibroma, aneurysmal bone cyst, unicameral bone cyst, and giant cell tumor (which has the potential to become malignant). As with other types of benign tumors, these are not cancerous.
There are two other relatively common types of cancer that develop in the bones: lymphoma and multiple myeloma. Lymphoma, a cancer arising from the cells of the immune system, usually begins in the lymph nodes but can begin in the bone. Multiple myeloma begins in the bones, but it is not usually considered a bone tumor because it is a tumor of the bone marrow cells and not of the major component bone cells.
Medically reviewed by Jay B. Zatzkin, MD; American Board of Internal Medicine with subspecialty in Medical Oncology
Bone tumors: Diagnosis and biopsy techniques. UptoDate.com
Osteosarcoma: Epidemiology, pathogenesis, clinical presentation, diagnosis, and histology. UptoDate.com