Bone Tumors

  • Carlos Rodriguez-Galindo
  • Fulgencio Baez
  • Ana Patricia Alcasabas
Chapter

Abstract

Malignant bone tumors comprise approximately 6 % of all childhood cancers and include two major categories, osteosarcoma and Ewing sarcoma. In both disease categories, patients present most commonly in the second decade of life, with large bone masses causing pain and function limitations; systemic symptoms are very rare. Osteosarcomas present typically in the metaphyses of long bones (distal femur, proximal tibia, and proximal humerus, in that order of frequency), and metastases occur in 20–30 % of the patients, usually in the lungs. Patients with localized disease are curable with radical surgery and systemic chemotherapy. Osteosarcoma is radioresistant, and thus surgery is the only option for local control. In the absence of advanced limb-salvage programs, amputation is the best curative alternative. Patients presenting with metastatic disease have a very poor outcome. Ewing sarcoma usually develops in axial bones and in the diaphysis of the long bones, and metastases, which occur in 20–30 % of the patients, usually involve lungs, bones, and bone marrow. Ewing sarcoma is a radiosensitive malignancy, and thus radical surgery is not always required. Treatment includes systemic chemotherapy and local control with surgery, radiation therapy, or a combination of both. In this chapter, a review of the presentation and treatment of these two malignancies is included, with considerations to their management in resource-limited settings.

Keywords

Leukemia Sedimentation Sarcoma Doxorubicin Methotrexate 

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Carlos Rodriguez-Galindo
    • 1
  • Fulgencio Baez
    • 2
  • Ana Patricia Alcasabas
    • 3
  1. 1.Dana-Farber/Boston Children’s Cancer and Blood Disorders Center and Harvard Medical SchoolBostonUSA
  2. 2.Hospital Infantil Manuel de Jesús Rivera “La Mascota,”ManaguaNicaragua
  3. 3.Philippines General HospitalManilaPhilippines

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