Bone Sarcoma

What is a bone sarcoma?

 

​Bone sarcomas are a type of malignant (cancerous) bone tumor. Bone tumors develop when cells within a bone divide uncontrollably, forming a lump or mass of abnormal tissue. They can consist of any component of bone or the surrounding tissues, including: bone itself, cartilage, connective tissue, muscle, or fat.

 

Bone sarcomas can be life-threatening and spread to other parts of the body, a process known as metastasis. Treatment requires a multidisciplinary team of specialists, including: an orthopaedic-surgeon oncologist, medical oncologist, radiologist, pathologist, and radiation oncologist.

Some common types of bone sarcomas - and related conditions - include:

  • Osteosarcoma

  • Chondrosarcoma

  • Ewing sarcoma

  • Chordoma

  • Adamantinoma

  • Undifferentiated pleomorphic sarcoma of bone

How common are bone sarcomas?

Bone sarcomas are rare and account for less than 1% of all cancer diagnoses in the United States. They are most common in children and young adults, but can occur at any age.

What causes bone sarcomas?

All cancers occur because genetic mutations in an individual cell cause that cell to multiply and grow uncontrollably. There are some inherited conditions and syndromes that predispose patients to cancer, but most patients develop cancer sporadically. Family members and children of sarcoma patients are generally not at higher risk of developing cancer in the future.

 

There is still much we do not know about sarcoma. Dr. Collier's research lab, the Indiana Musculoskeletal Oncology Lab, is working to better understand why these rare cancers occur in an effort to develop better therapies in the future.

What are symptoms of a bone sarcoma?

 

Most patients with a bone sarcoma will experience pain in the area of the tumor. This pain generally increases with activity, but can occur at rest or at night.

Although bone tumors are not caused by trauma, an injury can sometimes cause a bone that is weakened by a tumor to fracture, or break.

How do you diagnose a bone sarcoma?

 

​Infections, stress fractures, metabolic abnormalities, and other non-tumor conditions can all closely resemble a bone sarcoma. To be sure you have a bone sarcoma and to determine which type, Dr. Collier will conduct a thorough evaluation and may order a number of tests, including:

  • Medical history and physical exam

  • X-rays

  • Other imaging studies (CT, MRI, Bone scan)

  • Biopsy

    • A biopsy may be necessary to confirm the diagnosis of a bone sarcoma and guide treatment. There are two basic methods of performing a biopsy:

      • Needle biopsy - After given local anest​hetic or sedation, a needle is inserted into the tumor to remove some tissue. The tissue is then evaluated under a microscope to confirm the diagnosis. A needle biopsy is most often done by a radiologist.

      • Open biopsy - An open biopsy is performed in an operating room by a surgeon.

  • Blood and/or urine tests

How do you treat a bone sarcoma?

The first step in the treatment of bone sarcomas, after the diagnosis has been confirmed, is to determine whether the tumor has spread (or metastasized) to other parts of the body. This step is known as staging and will help guide treatment and prognosis.

Every sarcoma patient will then be discussed at a multidisciplinary tumor board of experts from IU Health and Riley Children's Hospital to recommend a treatment plan. Treatment generally involves a combination of surgery, chemotherapy, and/or radiation therapy.

 

The type of surgery performed depends on the type and location of each sarcoma. It may involve limb-sparing surgery or amputation.

  

Dr. Collier will work with you and your family to develop a personalized treatment plan for your specific tumor and location.