Bone Tumours: Benign and Malignant

Key points

• • Bone tumours may be benign (such as osteochondroma, the commonest benign bone tumour) or malignant (primary bone cancers or, more often, secondary deposits from elsewhere).
• • In adults the commonest malignant bone lesions are metastases, especially from cancers of the breast, prostate, lung, kidney and thyroid.
• • Osteosarcoma is the commonest primary bone-forming sarcoma (multiple myeloma, a marrow cancer, is the commonest primary bone malignancy overall); it usually affects teenagers, arises around the knee, and shows a sunburst pattern and Codman triangle on imaging.
• • Ewing sarcoma affects children and young people, tends to arise in the shaft of long bones, and shows an onion-skin layering of new bone on imaging.
• • Giant cell tumour of bone arises at the ends of long bones after growth has stopped, is usually benign but locally aggressive, and shows a soap-bubble appearance.
• • The patient's age, the part of the bone involved and the imaging pattern together give strong clues to the diagnosis before biopsy confirms it.