Introduction
Tumours where a mass or lump develops in the pelvis or spine, or in the arms or legs – are referred to as 'musculoskeletal tumours'. Tumours that develop in the bones, joints or soft tissue are referred to as 'orthopaedic tumours'.
Nine out of ten of these tumours are 'benign', that is they are not cancerous, even though they can cause some damage to body tissue where they are located. One in ten of these tumours are 'malignant' that is they are cancerous and are capable of spreading to other parts of the body and causing cancer elsewhere via a process known as 'metastasis'.
There are two different types of musculoskeletal tumours;
Benign orthopaedic tumour
This type of bone tumour can develop in any bone in the body, but will not spread to other parts of the body. It may cause damage to the bone where it has developed, either weakening or fracturing the bone. Medical science does not understand why benign bone tumours develop and in many cases people with these types of tumour have no symptoms at all (and the tumour is often discovered during another medical examination). In other cases, a tumour may cause some pain or a noticeable lump.
Malignant orthopaedic tumour
This type of tumour can affect the bones or soft tissue and is classified as either 'primary' or 'secondary'.
Bone tumours
A primary malignant bone tumour (also called 'bone sarcoma') is one that has developed on its own in the bone itself, whereas a secondary malignant bone tumour (also called 'metastatic bone cancer') is where the cancer has developed in a primary tumour somewhere else in the body (for example in the prostate, breast, lung, kidney, thyroid gland or on / under the skin – a melanoma) and spread to the bone.
Symptoms of primary malignant bone tumours can include tenderness and/or pain and stiffness in the bone.
Symptoms of secondary bone tumours ('bone metastases') include pain in the affected bone or joint not treatable with normal pain medication, bone fracture, problems with urinary and faecal incontinence and weakness in the affected arm or leg. Other symptoms (caused by related high blood calcium levels) can include vomiting / nausea, constipation and general confusion.
Soft tissue tumours
Also called a 'soft tissue sarcoma', a soft tissue tumour is one that develops in any other body tissue (also known as 'connective tissue'), for example in synovial tissues (which surround joints), blood vessels, nerves, muscles, deep skin tissue and fat. They generally appear as lumps that do not cause any pain and common sites for them to develop include the thigh, the shoulder and in the pelvic area. Occasionally they can also develop in the abdomen or in the chest. Although they can develop at any age, they are more in people over 55.
It is not completely understood why malignant bone and soft tissue tumours develop, however a family history of cancer (and some other inherited disorders), or previous radiotherapy treatment for cancer increase the risk.
Malignant bone and soft tissue tumours are both classified as 'rare cancers'.
Tests / Diagnosis
Tests to diagnose orthopaedic tumours will generally include a number of the following:
- Biopsy (tissue sample) of bone tissue.
- Blood tests.
- Imaging, including x-rays and CT, MRI and / or PET scans.
Treatment
Treatment will be specific to the particular type of tumour and may include surgery, radiotherapy and chemotherapy, or a combination of a number of these treatments.