Cancerous tumours of the bone

A cancerous tumour of the bone can grow into and destroy nearby tissue. It can also spread (metastasize) to other parts of the body. Cancerous tumours are also called malignant tumours.

Cancer that starts in the bone (primary bone cancer) is rare. It is more common in children and young adults than in older adults. Cancer that spreads to the bone from other parts of the body (called bone metastases) is much more common in older adults.

Most bone cancers are called sarcomas. The following are sarcomas found in adults.

Chondrosarcoma

Chondrosarcoma is the most common type of primary bone cancer found in adults over the age of 50. It starts in the cartilage, which is the strong and flexible tissue that lines the joints. It is most often found in the upper arm bone (humerus) or the thigh bone (femur). But it can also be found in the ribs, pelvic bones and shoulder blade (scapula). Chondrosarcoma is usually a slow-growing cancer.

There are different subtypes of chondrosarcoma:

  • central, primary and secondary chondrosarcoma
  • peripheral chondrosarcoma
  • dedifferentiated chondrosarcoma
  • clear cell chondrosarcoma
  • mesenchymal chondrosarcoma

Osteosarcoma

Osteosarcoma is the second most common type of primary bone cancer found in adults in their 60s and 70s. It is the most common type of bone cancer found in children and young adults. While osteosarcoma can start in any bone in the body, it is most often found in the ends of the bones of the knee, shin (tibia), leg and upper arm. In older adults it is also found in the hips and jaw.

Osteosarcoma is more common in people who have a history of retinoblastoma (a type of childhood eye cancer), Paget disease of the bone or radiation therapy treatments.

There are several different subtypes of osteosarcoma:

  • low-grade central osteosarcoma
  • conventional osteosarcoma (which can be osteoblastic, chondroblastic or fibroblastic)
  • small cell osteosarcoma
  • high-grade surface osteosarcoma
  • telangiectatic osteosarcoma
  • secondary osteosarcoma (caused by radiation treatment or Paget disease of the bone)
  • parosteal osteosarcoma
  • periosteal osteosarcoma

Chordoma

Chordoma is a slow-growing cancer that is found in the base of the skull, the base of the spine (sacrum) and the other spinal bones (vertebrae). It is more common in men than women and in adults over the age of 30.

Undifferentiated high-grade pleomorphic sarcoma

Undifferentiated high-grade pleomorphic sarcoma is found in the bones of the leg, arm and jaw. It is more common in people over the age of 40. Another name for this tumour is malignant fibrous histiocytoma (MFH). Undifferentiated high-grade pleomorphic sarcoma tumours are treated like osteosarcoma tumours.

Rare bone cancers

The following primary bone cancers are rare.

Ewing sarcoma is very rare in adults over 40. It is much more common in teenagers and young adults. It most often affects the pelvic bones and the bones in the leg, arm, ribs, spine and skull. Find out more about Ewing sarcoma.

Fibrosarcoma of the bone is an aggressive type of primary bone cancer that is very rare in people under 40 and is more common in adults over 40. It is most often found inside the bones of the leg. The main treatments for fibrosarcoma of the bone are surgery and radiation therapy, but sometimes chemotherapy may be used. Fibrosarcoma can also start in the soft tissues around the bone. This type of fibrosarcoma is called soft tissue sarcoma.

Angiosarcoma of the bone is an aggressive type of primary bone cancer. It occurs in the bones of the leg and pelvis, sometimes in several places in the same bone. Surgery is the main treatment for angiosarcoma. Chemotherapy may be used for angiosarcoma that has spread to other parts of the body.

Other cancers that can start in the bones

The following cancers can start in the bones, but they are not considered to be bone cancer:

Expert review and references

  • Al Saanna G, Bovee J, Hornick J, Lazar A. A review of the WHO classification of tumours of soft tissue and bone. 2013: http://sarcomahelp.org/reviews/who-classification-sarcomas.html.
  • American Cancer Society. Bone Cancer. 2016.
  • Cancer Research UK. Types of bone cancer. Cancer Research UK; 2013.
  • Macmillan Cancer Support. Understanding Primary Bone Cancer. Macmillan Cancer Support; 2014.
  • O'Donnell RJ, Dubois SC, Hass-Kogan DA . Sarcomas of bone. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 91:1292–1313.
  • Samuel LC . Bone and soft-tissue sarcoma. Yarbro CH, Wujcik D, Holmes Gobel B (eds.). Cancer Nursing: Principles and Practice. 8th ed. Burlington, MA: Jones and Bartlett Learning; 2018: 46:1243-1277.
  • Teo HEL, Peh WCG . Primary bone tumors of adulthood. Cancer Imaging. 2004.
  • Augsburger D, Nelson PJ, Kalinski T, et al. Current diagnostics and treatment of fibrosarcoma – perspectives for future therapeutic targets and strategies. Oncotarget. 2017: 8(61):104638–104653. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5732833/pdf/oncotarget-08-104638.pdf.

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