Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 20-44: Tumors & Tumor-Like Lesions of Bone + Key Features Download Section PDF Listen +++ ++ Persistent pain, swelling, or tenderness of a skeletal part Pathologic ("spontaneous") fractures Suspicious areas of bony enlargement, deformity, radiodensity, or radiolucency on radiograph Histologic evidence of bone neoplasm on biopsy specimen Primary tumors of bone are relatively uncommon in comparison with secondary or metastatic neoplasms Osteosarcoma, the most common malignancy of bone, typically occurs in adolescents + Clinical Findings Download Section PDF Listen +++ ++ Osteosarcoma may present as pain or swelling in a bone or joint (especially in or around the knee) When the symptoms appear following a sports-related injury, accurate diagnosis may be delayed + Diagnosis Download Section PDF Listen +++ ++ Biopsy (which is not always definitive) Differential diagnosis Benign developmental skeletal abnormalities Metastatic neoplastic disease Infections (eg, osteomyelitis) Posttraumatic bone lesions Metabolic disease of bone Osteoid osteomas Osteosarcoma Fibrosarcomas Enchondromas Chondromyxoid fibromas Chondrosarcomas Giant cell tumors (osteoclastomas) Chondroblastomas Ewing sarcoma + Treatment Download Section PDF Listen +++ ++ Chemotherapy for some Osteosarcomas: treated by resection and chemotherapy; 5-year survival rate of 60% Osteoid osteomas (seen in children and adolescents) should be surgically removed Tumors derived from cartilage treated with appropriate curettement or surgery have good prognosis Ewing sarcoma (affects children, adolescents, and young adults), has a 50% mortality rate in spite of chemotherapy, irradiation, and surgery