Sandbox: foreverbones

# Overview

# Historical Perspective

# Classification

# Pathophysiology

# Causes

# Differentiating Non Small Cell Lung Cancer from Other Diseases

# Epidemiology and Demographics

# Risk Factors

# Screening

# Natural History, Complications, and Prognosis

# Diagnosis
Staging | History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | MRI |  Ultrasound | Other Imaging Findings | Other Diagnostic Studies | Biopsy

# Overview
Tumors of the bone (also known as "Bone and cartilage tumors") are generally defined as the neoplastic growth of tissue in the bone and cartilage. Abnormal growths found in the bone or cartilage can be benign or malignant. These tumors may be classified as "primary tumors", which originate in bone or from bone-derived cells and tissues, and "secondary tumors" which originate in other sites and metastasize to the skeleton. Carcinomas of the prostate, breasts, lungs, thyroid, and kidneys are the carcinomas that most commonly metastasize to bone. Secondary malignant bone tumors are more common than primary bone cancers. The most common symptom of bone tumors is pain, which will gradually increase over time. The pain increases with the growth of the tumor. Additional symptoms may include fatigue, fever, weight loss, anemia, and/or sudden bone fractures. In some cases, bone tumors may be asymptomatic. Bone tumors may weaken the structure of the bone, causing pathologic fractures.

# Classification
According to World Health Organization, bone tumors can be divided into primary and secondary. Primitive bone tumors are classified using histo-genetic criteria and malignancy anatomic-clinical criteria. The table below summarizes the findings that differentiate bone tumors according to location, age, histological features, imaging features, and tumor origin.

## Primary tumors
- Primary tumors of bone can be divided into benign and malignant tumors.
- Common benign bone tumors, include:
- Osteoma
- Osteoid osteoma
- Osteochondroma
- Aneurysmal bone cyst
- Fibrous dysplasia.
- Common malignant bone tumors, include:
- Osteosarcoma
- Chondrosarcoma
- Ewing's sarcoma

## Secondary tumors
Secondary bone tumors include metastatic tumors which have spread from other organs (usually, adenocarcinomas). In general, metastatic tumors frequently involve the axial skeleton and the appendicular skeleton.
- Common secondary bone tumors, include:
- Breast cancer
- Lung cancer
- Prostate cancer.
For more details about each specific type of bone tumor, click on the links in blue in the table below.

# Diagnosis

## Symptoms
- Bone tumors are generally asymptomatic.
- The majority of patients may develop non-specific symptoms, such as:
- Dull pain
- Worse at nights
- Adjacent muscle soreness

## Physical Examination
Physical examination findings of bone tumors, may include:
- Painless mass
- Weight loss
- Limited range of motion
- Fever
- Tenderness
- Swelling

# Treatment
- The treatment of choice for bone tumors is dependent on the histological type of tumor.
- Chemotherapy and radiotherapy are effective in certain bone tumors (such as Ewing's sarcoma).
- Treatment for some bone tumors may involve surgery, such as:
- Limb amputation
- Limb-sparing surgery (often in combination with chemotherapy and radiation therapy).
- Limb sparing or limb salvage surgery
- Van-ness rotation or rotationplasty

## Surgery
- The mainstray of choice for the majority of bone tumors is surgery.
- Common surgical procedures may include:
- Amputations (conservative or radical)
- Radical amputation, is called hemicorporectomy (translumbar or waist amputation) which removes the legs, the pelvis, urinary system, excretory system and the genital area (penis/testes in males and vagina/vulva in females).

# Acknowledgements
The content on this page was first contributed by: Editor-In-Chief: C. Michael Gibson, M.S., M.D.