Bone tumorsAs in other ties, benign and malignant tumors can also develop in bone. In addition to other treatment methods, surgery may be indicated to remove them. Basically Bone tumors Subdivided into primary, i.e. tumors that have developed on the spot, and secondary, i.e. tumor tie that has migrated into the bone (metastases). The most common malignant bone tumor is osteosarcoma (apart from metastases). Overall Bone cancer but a very rare disease. Benign tumors of the bones are found comparatively more frequently. The most widespread benign bone growth is osteochondroma.
In bone tumors, no definitive cause can usually be found. Benign bone tumors can be hereditary, but the development of malignant tumors can be caused by various factors (z. B. radiation or Paget's disease, a bone disease) are promoted. But most of the time it remains unknown how a bone tumor specifically developed in a person.
Bone tumors can originate in the bone (e.g., in the bone). B. Osteosarcoma = malignant tumor of the bone tie) or of other tie parts in the surrounding area. Often, however, they are also metastases of malignant tumors of other parts of the body in the bone. Bone metastases often originate in the mammary gland, prostate, lung, thyroid gland or kidney.
In the case of bone tumors, there are often no symptoms for a long time. There is a thickening of the bone with possible pain. There may be a reduction in mobility at the respective body part. Sometimes bone fractures occur without the presence of strong force (pathological fractures). If the tumor is malignant, ingrowth and destruction of local tie may occur. Malignant tumors can also cause metastases in other parts of the body, which can also cause serious problems in this area.
The more common bone tumors, aside from metastases, include the following types.
Osteochondroma is the most common of the primary bone tumors (originating from the bone itself) and is benign. Osteochondromas can be found especially around joints in the limbs or even in the fingers. They often grow out of a bone and are partially composed of cartilaginous tie, which means that they often cannot be fully detected on X-ray. Complaints are rare in osteochondroma and occur mainly when other ties are displaced.
– A Osteosarcoma (actual bone cancer, malignant) occurs most frequently in children and adolescents between the ages of 10 and 30. and 20. Age of birth to. It usually arises in the growth plates of the bones, z. B. near the knee or on the upper arm.
– A Ewing's sarcoma occurs almost exclusively in childhood (up to the age of 15). 30. Year of life. It is also malignant. Can be located inside or outside the bones. Year of life. It is also malignant. Can be located inside or outside the bones. It is also malignant and can be located inside or outside the bones. Ewing's sarcoma occurs mainly on the arms, legs, and pelvis.
– The Chondrosarcoma is malignant and originates from the cartilage tie. Those affected with chondrosarcoma are usually older people (typically between 40 and 60 years of age). The pelvis is most frequently affected.
The patient is questioned (anamnesis) and a physical examination is performed. Changes can be seen in imaging procedures such as X-rays, scintigraphy, computed tomography (CT), or magnetic resonance imaging (MRI), and the extent can also be assessed prior to treatment. The definitive proof of what kind of tumor it is can only be provided by a fine tie examination (histology), z. B. after a sample of tie has been taken (biopsy) or after surgical removal of the tumor.
The different types of tumors that can occur on the bone must be distinguished from each other. In addition, a painful swelling must also be accompanied by an inflammation (e.g., a tumor). B. Bone inflammation = osteitis) should be considered. A bone fracture can also result in a distension (callus) or compression of the tie, which must be differentiated from a real tumor.
The choice of treatment method depends on the type and extent of the tumor, the presence of possible daughter tumors (metastases), and the patient's general condition.
In some cases, a non-surgical treatment is sufficient, e.g. B. by certain drugs (chemotherapy), by radiation therapy or hyperthermia treatment. These forms of treatment are also often combined with surgery. If a benign tumor hardly grows or does not grow at all and remains without symptoms, it may even be possible to dispense with actual treatment. However, the patient must then visit the doctor regularly for check-ups.
Surgery is often necessary to remove bone tumors. Doctors from different specialties may be involved. The procedure can be performed under general anesthesia or regional anesthesia (anesthesia of a larger area of the body).
If surgery is performed on the arm or leg, a tight cuff may be applied to temporarily stop blood flow (tourniquet). This can reduce bleeding. The view of the surgical area can be improved. A benign bone tumor is removed completely. Preserve as much surrounding tie as possible.
A malignant bone tumor must also be removed completely, whereby a safety margin must be maintained in the healthy tie. If lymph nodes in the drainage area of the tumor are thickened, these are also removed.
To remove the tumor, parts of the bone, possibly with surrounding tie, must be taken out; in particularly severe cases, amputation may be necessary.
Various measures can be taken to bridge the resulting defect. Foreign materials such as screws and plates can be incorporated to stabilize the bone. It may be necessary to apply a so-called external fixator, a connecting frame that is located outside the body.
If the defect is very extensive, it is often necessary to transfer autologous bone tie. The original material for such a bone transfer is often taken from the pelvic bone. Sometimes foreign bone or bone substitute material is used to bridge the defect. A so-called bone transfer can also be performed. For this purpose, a special fixator is used to gradually pull the bone tie from the healthy areas into the defect area.
At times, prostheses of various types may be used to restore function.
The insertion of a drainage into the surgical area can be useful to catch wound fluid. The drainage tube can be removed after a few days. A bandage is applied at the end of the procedure. A cast, splint or other additional stabilizing dressing material may also be necessary.
Possible extensions of the operation
A special plastic surgery procedure may be necessary for reconstruction or to achieve good functional and cosmetic results.
If unexpected findings or complications occur during surgery, it may be necessary to perform additional procedures that were not previously planned.
Bone surgery can cause damage to nearby structures. Especially when bone tumors are removed, a more or less large defect may remain. There may be bleeding, secondary bleeding and bruising. Infections, wound healing disorders and scarring may occur. Injury to nerves can cause sensory disturbances or paralysis, among other things. Prere damage or paralysis may be caused by a possible blood stasis cuff. Bone fracture may occur during surgery. The formation of blood clots is possible. Lymphatic accumulation with severe swelling may result. In childhood, growth problems may occur after an operation on the bones. Allergic reactions of any severity are possible. In the case of more extensive interventions, other complications may arise.
NoteThis section can only give a brief overview of the most common risks, side effects and complications and does not claim to be complete. This is not a substitute for talking to the doctor.
The prognosis of the different types of bone tumors is highly variable. It depends on how malignant the growth is, but also which area is affected and how early treatment is given.
Benign tumors can usually be removed permanently by surgery. Therapy without surgery may be sufficient, or only a repeated check that the defect has not increased significantly.
The prognosis of malignant tumors depends on the type, extent and previous metastasis (formation of daughter tumors). Often the tumor can be completely removed with surgery, possibly in combination with other treatment procedures. However, a recurrence of the findings may occur (recurrence). Likewise, at the time of removal, metastases may already exist that were not previously detected and continue to grow elsewhere in the body. Later, further operations or treatments may become necessary.
Before an operation
In many cases, medications that inhibit blood clotting, such as Marcumar® or Aspirin®, must be discontinued prior to surgery. This is always done in consultation with the doctor.
If the pain is severe, the doctor may give painkillers.
After the procedure, if affected, the leg or arm must be particularly rested for some time. Joints not involved should be moved a lot. Physiotherapy is useful. Sports and other activities involving stress on the affected bone may only be carried out when the doctor no longer considers them to be a particular risk. Depending on the location and extent of the operation, further special considerations may have to be taken into account.