Children's Hospital Colorado

Bone Tumors in Children

What are the types of bone tumors?

If you suspect your child has a bone tumor, or your primary care doctor refers you to the Orthopedic Tumor Program at Children's Hospital Colorado, our first step is to determine if the tumor is benign (a non-cancerous bone tumor that does not spread) or malignant (cancerous).

Malignant bone tumors and bone cancer

Among young patients, the two most common types of bone cancer are:

  • Osteosarcoma: Most commonly found in the bones around the knee.
  • Ewing's sarcoma: More common in the upper leg, pelvis and other bones of the trunk.

Both osteosarcoma and Ewing's sarcoma usually begin during the young teenage years. Learn more about how we treat osteosarcoma and Ewing's sarcoma.

Benign bone tumors

Benign (non-cancerous) bone tumors are commonly found on X-rays when a child is being examined for another reason. Symptoms of a benign bone tumor include a slow growing bump, pain or may be found when your child has a fracture through a bone weakened by a bone cyst. In some families, there may be a history of benign bone tumors.

What are symptoms of bone tumors?

Symptoms can vary widely between patients and types of cancer. The most common bone tumor symptoms of osteosarcoma and Ewing's sarcoma include:

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

Children's Colorado also offers an Adaptive Recreation for Childhood Health program for children with cancer and other conditions. Learn how this program can help children with cancer lead a lifetime of healthy leisure and awareness.

How are bone tumors diagnosed?

When you and your child first meet with a clinician from the Orthopedic Tumor Program, he or she will discuss your child's detailed medial history and do a physical examination, in addition to imaging and/or blood tests. If a biopsy is needed to determine what type of tumor your child has, it will be performed by our orthopedic oncologist (a doctor who specializes in bone tumors).

The biopsy will help determine whether the tumor is benign (a type of tumor that is not likely to spread from the original area) or malignant (likely to spread from the original area). If a biopsy was already performed before coming to Children's Colorado, another biopsy may or may not be necessary.

Staging studies

In addition to determining whether your child's tumor is benign or malignant, the musculoskeletal tumor team may perform other tests to further classify the tumor. This series of tests is known as staging. The tests will determine the extent of the tumor, if it is continuing to grow or if it has spread to other areas of the body. The tests help give your child's care team the information they need to provide the most effective treatment for the tumor. Some of these tests will generally be performed before your child’s surgeon obtains a biopsy. Each study is listed below, along with information and instructions for how to prepare your child so the most accurate results are obtained.

Bone Scan
A bone scan is an imaging study done to detect bone tumors and determine other abnormalities in bones. Sometimes your child's doctor will order a bone scan with "contrast," a dye injected into a vein two hours before the scan is done. It is important that your child be well hydrated for this study. Your doctor will give you detailed instructions on how to prepare for this study and when to arrive at the radiology department.

PET Scan
A PET (positron emission tomography) scan is an imaging study that also detects tumors in the bone and surrounding soft tissues in the body. This is a very sensitive test that will pick up any abnormalities. To ensure accurate results, there are specific preparations for the scan, which your doctor or nurse will share with you.

CT Scan
A CT (computed tomography) scan is an imaging study that uses a combination of X-ray and computer technology to produce cross-sectional images of the body, including bones, muscles, fat and organs. CT scans are primarily used to check for a tumor in the bone as well as tumor cells in the chest and lungs.

MRI Scan
An MRI (magnetic resonance imaging) scan is a study that uses a combination of large magnets, radiofrequency and a computer to produce detailed images of structures in the body. It is used to determine the extent of the tumor within the bone and soft tissues. Your healthcare team will provide specific instructions about eating and drinking before the MRI.

Learn more about how we treat osteosarcoma and Ewing's sarcoma.

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