Pediatric Conditions

Pediatric Bone Tumors

Kids with bone tumors require special attention. Luckily most musculoskeletal tumors in children are benign. Many do not require treatment and can simply be observed by a trained specialist. Conversely, sarcomas (osteosarcoma, Ewing sarcoma, rhabdomyosarcoma) comprise a much larger portion of malignancies in children than in adults, therefore vigilance is critical. These malignancies require chemotherapy, and are managed by a team that includes pediatric oncology specialists.

INDICATIONS FOR REFERRAL

  1. X-ray showing bone lucency
  2. Persistent, unexplained musculoskeletal pain and X-ray abnormality
  3. Enlarging mass in the extremities

If yes, these steps are recommended before referral:

  • X-ray
  • No biopsy

EXAMPLES OF BONE TUMORS IN CHILDREN


Simple (unicameral) bone cyst:

Benign, very common, mostly found around the shoulder and hip, recognized by sudden pain after minor fall.

Treatment: Immobilization until fracture has healed, then percutaneous bone grafting

Non-ossifying fibroma:

Benign, very common, typically an incidental finding discovered on X-ray of knee or ankle for unrelated sports injury.

Treatment: Observation

Osteosarcoma:

Most common bone sarcoma, presents with pain and destructive mineralizing lesion, most common around knee.

Treatment: Chemotherapy and surgical resection, vast majority limb sparing, with reconstruction using tumor endoprosthesis (below)

 

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