Tumors are growths- lumps of tissue- that are not normal and form when abnormal cells grow without the normal controls to stop them. Bone tumors start in the spine, leg bones, ribs or arm bones.

Sometimes, symptoms of a bone tumor have not surfaced, but a tumor is found when a child is getting an X-ray for some other reason. Unfortunately, the cause of bone tumors in children is unknown.

What are the types of pediatric bone tumors?

Bone tumors in children can be non-cancerous (benign) or cancerous (malignant). Both benign and malignant cancers can come back at the same site after being removed.

Benign tumors do not spread. Also called “sarcomas,” malignant tumors can spread (metastasize) to other parts of the body.

What are the types and symptoms of a benign bone tumor? Can a benign tumor become malignant?

Benign bone tumors are more common in children than malignant tumors and rarely become cancerous. Symptoms of a benign bone tumor in a child or teen include a slow growing bump and pain. Benign bone tumors can be discovered when a child has a bone fracture and requires an X-ray.

Types of benign bone tumors include:

• Nonossifying fibromas: Usually found in the long bones that are actively growing, such as the thighbone (femur)
• Exostoses or osteochondromas: Contain bone and cartilage and usually grow out from a bone
• Unicameral bone cysts: Also called simple or solitary bone cysts, holes in a bone that are filled with fluid; most common in the upper arm bone (humerus) or femur

What are the types of cancerous bone tumors and what are the symptoms?

Types of malignant bone tumors include:

• Ewing sarcoma: A common primary bone cancer in children and teens usually in the long bones of the arms or legs
• Osteosarcoma: Occurring in the knee, one of the most common forms of cancerous bone tumors in teens
• Rhabdomyosarcoma: Can develop in almost any muscle of the body and is the most common type of soft tissue sarcoma in children

Symptoms of cancerous bone tumors in children and teens include:

• Fatigue
• Poor appetite
• Recurring pain that occurs with activity or at rest and becomes more severe over time
• Swelling or presence of a palpable mass (bump)
• Unexplained fever with no symptoms
• Unexplained weight loss

What are the treatments for benign and malignant tumors?

If a bone tumor is discovered in your child, your child’s provider will request information about your child’s medical history, as well as your family’s medical history. A physical examination, X-rays and blood tests will be completed as well.

Your child’s physician will then advise if a biopsy is needed to determine if the bone tumor is benign or malignant and what specific type of bone tumor it is. If a biopsy is needed, a pediatric orthopedic oncology specialist will be added to your child’s care team and perform the biopsy.

Other tests may be ordered to determine the extent of the tumor- if it is growing or has spread to other areas of the body. These tests include:

• Bone scan: Imaging that detects bone tumors and determines other abnormalities in bones
• CT (computed tomography) scan: Primarily used to check for a bone tumor as well as tumor cells in the chest and lungs
• MRI (magnetic resonance imaging): Gives detailed images of the structure of the body and is used to determine the extent of the tumor within the bone and soft tissues
• PET (positron emission tomography) scan: An extremely sensitive imaging test to pick up abnormalities and detect tumors in the bone and surrounding tissue

Many children with bone cancers have more than one type of treatment. If the bone tumor is cancerous, your child’s treatment plan will include one or more of the following:

• Chemotherapy
• Surgery to remove as much of the cancer as possible
• Radiation therapy

Early diagnosis is important, so if your child displays concerning symptoms, schedule an appointment with their medical provider as soon as possible.