BONE CANCER

RAED ISSOU
 BONE CANCER

Bone cancer is an uncommon cancer that begins in a

bone.
most commonly affects the long bones that make up the
arms and legs
20 % of pediatric bone tumors are malignant.
66% of adult bone tumors are malignant, most commonly
mets.
The most common type of bone cancer in adults is
metastatic cancer from other organs
Distribution of Common Pediatric Malignancies

Soft Tissue
6% Bone
5% Wilms' Tumor
6%
Leukemia Lymphoma
31% 14%

Eye
3%
Other Neuroblastoma
7% 7%
0% Central Nervous Germ Cell
System 3%
18%
 BONE CANCER
PRIMARY : cancer arising from the bone itself.

SECONDARY : i.e. metastasis

 PRIMARY BONE CANCER

RISK FACTORS:
1. Radiotherapy & chemotherapy
2. Paget's disease
3. Family Hx : hereditary retinoblastoma
 Signs & symptoms

Bone pain that often is nocturnal

Swelling & tenderness near the affected area
Pathological fractures
Fatigue
Unintended weight loss
Fever
Night sweats
 OSTEOSARCOMA

The most common primary bone malignancy

 Incidence: 2.8 per million
Age 10-25 years (the 8th most common form of childhood
cancer)
M >F
The most common sites are;
 Distal femur 52%
 Proximal tibia 20%
 Proximal humerus 9%
 OSTEOSARCOMA (continued)

Usually the lesions are metaphyseal

Strong genetic predisposition (chr. 13)
Metastatic spread usually is pulmonary
•
 Diagnosis

 Radiological studies :
 1. X-Ray
 2. CT-scan
 3. bone scan & MRI.
 Bone biopsy.
 X-ray findings

• 1.Lesion
• 2.Cortical destruction
• 3.Extension to the marrow or soft tissue
• 4.Codman’s triangle
• 5.Sunburst Effect
Sunburst Appearance
 TREATMENT
Surgical resection
Preoperative & postoperative chemotherapy
Clinical appearance of
a teenager who
presented with
osteosarcoma of the
proximal humerus
 Prognosis

 Aggressive tumor & The prognosis depends on the stage not the
grade.

 Without mets the 5-year survival is 70%

 If mets present the 5- year survival is 25%

 Ewing’s sarcoma

Identified in 1921 by James Ewing

The second most common bone malignancy in pediatrics.
Incidence : 0.6 per million
M>F
Age 10-20 years
The usual sites are : pelvis , long bones of the limbs & ribs
, but most commonly around the knee joint.
 Ewing’s sarcoma (continued)

Usually the lesions are diaphyseal

T(11.22).
Mets are found in 30% of cases, most commonly in the
lungs & other bones & less commonly in the bone
marrow.
 Diagnosis
 Radiological studies:
1.X-Ray
2.CT-scan
3.bone scan & MRI

 X-ray findings :
1.lytic medullary lesion
2.onion skin appearance
 TREATMENT
1- Local radiotherapy combined with systemic
chemotherapy

2- In young children amputation may be necessary

due to severe compromise of bone growth
 Prognosis

 The 5-year survival with the first approach is 50%.

 The 5-year survival with the 2nd approach is 75%.

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