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J Korean Med Assoc > Volume 49(12); 2006 > Article
Jung and Jeong: Bone Tumors Specific in Children

Abstract

Primary bone tumors in pediatric age group are uncommon, and even when they do occur, they are usually benign. The primary malignant tumors that occur predominantly in children are two bone tumors, namely, osteosarcoma and Ewing's sarcoma. An adequate history and physical examination are the first and most important steps in evaluating a patient with a bone tumor. All suspected bone tumors should be evaluated initially with plain roentgenograms. Then the additional diagnostic studies, such as computed tomography(CT), magnetic resonance imaging(MRI) and technetium bone scan can be used, if necessary. Biopsy should be the last step in evaluation. Most of benign bone tumors usually do not require treatment other than a periodic follow-up evaluation. The optimal treatment of the malignant bone tumor often requires a combination of radiation therapy, chemotherapy, and wide surgical excision or amputation. Early detection of a malignant bone tumor not only may make the difference between life and death but also may allow successful salvage surgery rather than amputation of the limb.

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Figure 1
Different patterns of bone destruction
jkma-49-1068-g001-l.jpg
Figure 2
Different patterns of periosteal reaction
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Figure 3
Surgical margins
jkma-49-1068-g003-l.jpg
Figure 4
Osteoid soteoma(CT)
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Figure 5
Conventional osteosarcoma
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Figure 6
Conventional osteosarcoma
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Figure 7
Osteochondroma
jkma-49-1068-g007-l.jpg
Figure 8
Enchondroma
jkma-49-1068-g008-l.jpg
Figure 9
Nonossifying fibroma
jkma-49-1068-g009-l.jpg
Figure 10
Shepherd's crook deformity of right hip
jkma-49-1068-g010-l.jpg
Figure 11
Osteofibrous dysplasia
jkma-49-1068-g011-l.jpg
Figure 12
Simple bone cyst
jkma-49-1068-g012-l.jpg
Figure 13
Ewing's sarcoma
jkma-49-1068-g013-l.jpg
Table 1
Classification of pediatric bone tumors based on tissue of origin
jkma-49-1068-i001-l.jpg
Table 2
Common locations of pediatric bone tumor
jkma-49-1068-i002-l.jpg
Table 3
Staging of musculoskeletal tumors
jkma-49-1068-i003-l.jpg

From Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Othop Relat Res 1980; 153: 106



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