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
- X-ray showing bone lucency
- Persistent, unexplained musculoskeletal pain and X-ray abnormality
- Enlarging mass in the extremities
If yes, these steps are recommended before referral:
- 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
Benign, very common, typically an incidental finding discovered on X-ray of knee or ankle for unrelated sports injury.
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)