Medicine – Primary Malignant Bone Tumours

1. Osteosarcoma

Osteosarcoma is a primary malignant bone tumour that occurs predominantly in young adults. It most commonly involves the long bones, particularly around the knee, with the distal femur and proximal tibia being characteristic sites. The tumour usually demonstrates rapid and aggressive growth, and patients commonly present with progressively worsening bone pain and local swelling. Osteosarcoma has a tendency to spread through the bloodstream, particularly to the lungs, resulting in pulmonary metastases. Treatment generally consists of a combination of surgery and chemotherapy. The table gives an approximate cure rate of 40%.

2. Chondrosarcoma

Chondrosarcoma is a malignant tumour of cartilage-producing cells that is most frequently seen in adults between 35 and 60 years of age. Common sites include the pelvis, ribs, spine, and long bones. In contrast to osteosarcoma, chondrosarcoma generally shows slow and progressive enlargement. As the tumour advances, it may eventually invade nearby blood vessels and surrounding structures. Surgical removal is the principal form of treatment, as conventional chemotherapy is generally less effective for most chondrosarcomas. According to the table, the approximate cure rate is 75%.

3. Fibrosarcoma and Malignant Fibrous Histiocytoma

Fibrosarcoma and malignant fibrous histiocytoma can occur at almost any age, although their incidence peaks at approximately 30–40 years. These tumours commonly affect bones such as the femur, tibia, humerus, and pelvis. Their behaviour is characterised mainly by progressive local growth and invasion of blood vessels, allowing the tumour to extend into surrounding tissues and potentially spread to distant sites. The main treatment is surgical excision, with the aim of completely removing the malignant tissue. The table indicates an approximate cure rate of 40%.

4. Ewing’s Sarcoma

Ewing’s sarcoma is an aggressive malignant bone tumour that occurs mainly in children and teenagers. It commonly affects the long bones, pelvis, and ribs. Unlike some more slowly growing bone tumours, Ewing’s sarcoma is highly aggressive and has a significant tendency to develop widespread metastases. Because of its systemic nature and responsiveness to cytotoxic drugs, chemotherapy forms an important part of treatment, usually as part of multimodal therapy. The table lists an approximate cure rate of 10%.