Orthopaedic Oncosurgery

Good-to-know facts about Malignant Bone Tumours

Bone Tumours are developed when cells within a bone divide uncontrollably, leading to a lump or mass of abnormal tissue being formed. Not all Bone Tumours are cancerous i.e. benign. Generally, Benign Tumours do not spread to other parts of the body and are not life-threatening. On the other hand, there are Bone Tumours that are cancerous, referred to as Malignant Bone Tumours. The earliest symptoms of Malignant Bone Tumour are pain and swelling in the area where the Tumour is located. The pain may come and go at first; then it can become more severe and steady later.

Malignant Bone Tumours can metastasize which means the cells can spread throughout the body. Depending upon the type of Tumour, treatment options are wide-ranging. In most cases, treatment for Malignant Tumours involves a combination of Chemotherapy, Surgery and Radiation.

An Orthopaedic Oncosurgeon assesses the individual case for feasibility of limb preserving surgery. Then the surgeon would plan and execute a biopsy and team up with a Medical Oncologist for Chemotherapy. Generally, it is advocated that the surgeon performing the fi nal limb salvage procedure should be the one performing the biopsy. The first surgeon has the best chance of cure.

During surgery the cancerous section of bone is removed, keeping nearby muscles, tendons, nerves, and blood vessels intact wherever possible. The surgeon will take out the Tumour and a portion of healthy tissue around it. From the point of view of Oncologic Principles, it is necessary to resect the bone in a manner that at least 3 cm of disease-free marrow margin and 2cm of soft tissue margin is obtained for a successful outcome. Reconstructing the Tumour defect with mechanically sound prosthesis or adequate Osteosynthesis follows. The Orthopaedic Oncosurgeon not only does the surgery but also oversees functional rehabilitation whilst planning Chemotherapy for distant metastatic control. A prosthetic limb can aid function in cases that involve amputation. The pattern of reconstructions done varies from case-to-case.

Dr. Haresh Manglani
Sr. Consultant
Orthopaedic Oncologist
Nanavati Super Speciality
Hospital, Mumbai