Non-cancerous tumours of the bone

A non-cancerous (benign) tumour of the bone is a growth that does not spread (metastasize) to other parts of the body. Non-cancerous tumours are not usually life-threatening. Some non-cancerous bone tumours can grow into and destroy the surrounding bone and tissues (locally aggressive), but don’t spread outside of the bone.

Most non-cancerous bone tumours are removed with surgery or curettage and do not usually come back (recur).

Osteochondroma is the most common non-cancerous bone tumour. It starts in the tough, flexible tissue that lines the joints (cartilage). These tumours are usually found near the ends of the long bones in the legs, but can also grow in the pelvic bones or shoulder blades. Osteochondroma tumours are usually found in people up to the age of 40.

Hereditary multiple osteochondromas is a rare inherited condition where people develop many osteochondroma tumours, usually by the age of 12. People who have this condition have a greater risk of an osteochondroma tumour becoming a cancerous tumour called a chondrosarcoma tumour.

Osteoma is a non-cancerous tumour that is found in the bones of the paranasal sinuses and skull and the long bones of the legs and arms. Osteoma tumours don’t usually cause any symptoms, so they can be hard to diagnose. People who have more than one osteoma tumour may have an inherited disorder called Gardner syndrome. Surgery is offered to people who have more than one osteoma tumour, as well as people who have symptoms caused by osteoma tumours.

Osteoid osteoma is a very small non-cancerous tumour that is usually found in the bones of the leg. It is usually smaller than 1.5 cm. This type of tumour is most common in men under 40. Osteoid osteoma tumours can cause pain and swelling.

Enchondroma is a non-cancerous bone tumour that can occur at any age but is most common in children and young adults. It is found mostly in the bones of the hands and feet. If many enchondroma tumours are found, it is a condition called enchondromatosis or Ollier disease.

Most enchondroma tumours do not have to be removed with surgery unless they are causing pain, they are growing larger or there is a risk that the bone will break.

Giant cell tumours of bone are most often found in the long bones of the leg, around the knee. This tumour is more likely to be found in people between 20 and 30 years old. This tumour is sometimes called an osteoclastoma.

Giant cell tumours of bone are locally aggressive. They often cause pain as they spread through the bone and into the surrounding tissues. In rare cases, giant cell tumours may spread to the lungs, even though they are non-cancerous tumours.

These tumours often come back (recur) after being removed with surgery. To lower the risk of a giant cell tumour coming back, the surgeon may use chemicals to heat the ends of the bone where the tumour was removed or freeze the area by using extremely cold liquids like nitrogen.

Denosumab (Xgeva) is a monoclonal antibody that finds and attaches to RANKL, which is a substance on the surface of bone cells. RANKL helps break down bones. When RANKL is targeted and blocked, bones are not broken down as quickly. Denosumab may be offered as a treatment for giant cell tumours of bone, as it has been shown to slow the changes to the bone and delay the need for surgery.

Chondroblastoma and osteoblastoma are 2 types of bone tumours that are intermediate tumours. This means that they are in between being non-cancerous and cancerous. While they can grow and spread to the surrounding tissues, they very rarely spread to other parts of the body. These tumours have only a small risk of becoming cancerous.

The following non-cancerous bone tumours are rare.

• chondroma
• giant cell lesion of the small bones
• benign fibrous histiocytoma
• non-ossifying fibroma
• benign notochordal tumour
• atypical cartilaginous tumour (locally aggressive)
• chondromyxoid fibroma (locally aggressive)
• osteochondromyxoma
• bizarre parosteal osteochondromatous proliferation (BPOP or Nora lesion)
• subungual exostosis
• synovial chondromatosis