Introduction
It is important to consult a physician to learn more about your condition and treatment options and associated risks, and to answer any questions you may have.
Benign bone cysts and tumors 1-3
Discovering that your loved one has a bone tumor or cyst can be quite unsettling, creating anxiety and generating great concern over their health. It may help to know that most of these cysts and tumors are actually benign (i.e., not considered cancerous) and do not spread to other parts of the body. Surgical treatment can be minimally invasive or require more extensive surgery depending on the size and type of tumor involved. Sometimes benign tumors or cysts will appear when bones fracture. This is called a pathologic fracture and is due to the weakening of the bone. Often, this is the first time the abnormality is identified. Depending on the fracture, the surgeon may elect to treat the fracture, and if the cyst does not heal completely and resolve, a grafting procedure may be required.
Types of tumors 1-3
There are several different types of tumors that can occur in children and adolescents. The most common of these are the simple or unicameral bone cyst (UBC), aneurysmal bone cyst (ABC), non-ossifying fibromas, and giant cell tumors (GCT).
A UBC usually occurs in the long bones of a growing child (typically ages 6-15), most often in the shoulder and hip area. The cyst itself is a fluid-filled cavity in the bone and has a fibrous tissue lining. Some heal spontaneously, while others tend to grow and must be addressed surgically. These types of cysts can recur and sometimes multiple treatments are needed.
An ABC is typically more aggressive. It is a fibrous cyst in the bone that is filled with blood and expands, causing pain, swelling and fracture if not treated. They are more frequent during teenage years and can occur in almost any bone in the body. Because of their aggressive nature, these cysts can damage the bone and potentially cause deformity. While these cysts are typically treated surgically, they too can come back and require additional treatment.
A non-ossifying fibroma is a type of bone tumor that is composed of fibrous tissue and is one of the most common benign bone tumors in children. They are usually found in the thigh or lower leg bones, but also may occur in the arms and hands. They are typically seen as incidental findings when a bone is X-rayed for other reasons. They are usually not painful or symptomatic, and most often the surgeon will follow clinically as they usually will resolve as the child goes through skeletal maturity. However, sometimes they can grow quite large and symptomatic and require bone grafting. They can also fracture the bone and require treatment of the fracture followed by grafting, if needed.
GCTs are more aggressive bone tumors. They are very rarely seen in children, and typically occur between the ages of 20 and 40. They usually occur at the ends of the long bones in arms and legs near the joint. Treatment generally involves removal of the tumor, treatment of the bone cavity with cauterization, freezing or chemicals and then bone grafting. Surgery is usually successful but some can grow back.
Evaluating whether treatment is appropriate involves substantial discussion with a physician to adequately evaluate the risks and benefits, including discussion of any unique patient circumstances.
References:
- Mascard E, Gomez-Brouchet A, Lambot K. Bone cysts: unicameral and aneurysmal bone cyst. Orthop Traumatol Surg Res. 2015 Feb;101(1 Suppl):S119-27. doi: 10.1016/j.otsr.2014.06.031. Epub 2015 Jan 8. PMID: 25579825.
- Bowers LM, Cohen DM, Bhattacharyya I, Pettigrew JC Jr, Stavropoulos MF. The non-ossifying fibroma: a case report and review of the literature. Head Neck Pathol. 2013 Jun;7(2):203-10. doi: 10.1007/s12105-012-0399-7. Epub 2012 Sep 25. PMID: 23008139; PMCID: PMC3642261.
- Hartmann W, Harder D, Baumhoer D. Giant Cell-Rich Tumors of Bone. Surg Pathol Clin. 2021 Dec;14(4):695-706. doi: 10.1016/j.path.2021.06.010. Epub 2021 Oct 7. PMID: 34742488.
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