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Bone Tumor, Primary Malignant

Nehman Andry, MD, Juan R. Ramos Dominguez, MD, MPH and Jeff Svec, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Primary malignant bone tumors are rare (<1% of all tumors). Patients >40 years; rule out more common metastatic disease (breast, lung, prostate, thyroid, kidney).

  • Osteogenic sar...

DIAGNOSIS

HISTORY

  • Pain with weight-bearing, at rest, and at night; often dull or aching; swelling, tenderness; systemic symptoms of weight loss and fever; failure of symptoms to resolve after 2 to 3 we...

TREATMENT

MEDICATION

  • Neoadjuvant chemotherapy treats micrometastatic disease and allows time for ordering replacement prosthesis and bone graft and for in vivo assessment of response to chemotherapy. (...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • CBC for myelosuppression

  • Serial ECGs when doxorubicin is being used; granulocyte colony-stimulating factor (G-CSF) is often used to minimize neut...

REFERENCES

1
Eyre R, Feltbower RG, Mubwandarikwa E, et al. Epidemiology of bone tumours in children and young adults. Pediatr Blood Cancer.  2009;53(6):941–952. [View Abstract on OvidMedline]
2
Kryc...

ADDITIONAL READING

  • Arndt CA, Rose PS, Folpe AL, et al. Common musculoskeletal tumors of childhood and adolescence. Mayo Clin Proc.  2012;87(5):475–487. [View Abstract on OvidMedline]

  • Gorlick R, Ja...

CODES

ICD10

  • C41.9 Malignant neoplasm of bone and articular cartilage, unsp

  • C40.90 Malig neoplasm of unsp bones and artic cartlg of unsp limb

  • C41.0 Malignant neoplasm of bones of skull and face

  • C41.2 Malig...

CLINICAL PEARLS

  • Bone tumor biopsies should ideally be performed at the same institution that can provide comprehensive definitive treatment using a multispecialty approach.

  • Have a high index of suspici...

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