Orthopedic oncology

The exact causes of sarcomas and benign bone tumors remain unknown. Due to their rarity, extensive research on these tumors has been challenging. Most of these tumors are not inherited or passed on genetically.

A tumor is an abnormal growth in the body, consisting of cells that divide and replicate uncontrollably. Tumors can be classified as either benign (non-cancerous) or malignant (cancerous). Malignant tumors are further categorized based on the cell type they originate from, such as sarcomas (from connective tissues) or carcinomas (from epithelial cells). Some tumors may develop due to genetic alterations.

Yes, there is a difference. A bone tumor refers to any abnormal growth in or on the bone, which can be either benign (non-cancerous) or malignant (cancerous). Bone cancer specifically refers to a malignant bone tumor. This can be a primary malignant tumor, such as osteosarcoma, Ewing’s sarcoma, or chondrosarcoma, or it can be a metastatic carcinoma, where cancer from another part of the body (like the breast, lung, prostate, kidney, or thyroid) spreads to the bone. Differentiating between these types is crucial, as each type of cancer affecting the bone has its own specific treatment and prognosis.

Sarcomas and carcinomas are both types of malignant tumors, but they originate from different types of cells and have distinct growth patterns.

• Sarcomas arise from mesenchymal cells (mesodermal origin) and typically affect bones or soft tissues. They grow as “ball-like” masses, pushing aside adjacent structures such as arteries, nerves, and veins.
• Carcinomas originate from epithelial cells and tend to grow in an infiltrative manner, invading and spreading through adjacent structures like nerves, blood vessels, and muscles. Carcinomas often spread to bones and soft tissues from other primary sites, such as the lungs, liver, breast, and other organs.

Understanding these differences is crucial for determining the appropriate treatment and prognosis for each type of cancer.

Limb sparing surgery, also known as resection, is a procedure aimed at removing malignant tumors or large benign aggressive tumors while preserving the limb. This surgery is typically performed for high-grade tumors and can be applied to approximately 95% of malignant bone tumors.

During a resection, the tumor, along with the affected bone (or part of it) and usually the adjacent joint, is removed. The next step, called reconstruction, involves restoring the bone and joint, often using a metal prosthesis to replicate the removed structures.

Limb sparing surgery can also be performed for soft tissue sarcomas. In these cases, bone removal or prosthesis placement is usually not required. Instead, radiation therapy is often incorporated to eliminate any microscopic tumor cells, making it easier to remove the tumor and preserve the surrounding soft tissue. Additionally, muscle flaps may be used to repair the soft tissue, prevent infection, and ensure the limb functions properly.