What Causes Bone Lesions and How to Treat Them? | Symptoms and Prognosis of Bone Lesions

Sometimes as a result of an infection, trauma, injury, fractures, or due to development of tumors, some areas of the bones get damaged or change in their characteristics. This is what is medically referred to as Bone Lesions. In some cases, the cells within the bone start to divide uncontrollably. This is termed as bone tumors. Majority of Bone Lesions are benign and not a cause of concerns. However, in some cases these Bone Lesions become cancerous and are known as malignant bone tumors.^[1,2,3]

Bone Lesions can affect any bone of the body and can develop at any location right from the surface of the bone right down to the bone marrow. Bone Lesions have a tendency to destroy healthy tissues around it causing the bone to become weak and prone to fractures. While majority of Bone Lesions are benign, there are occasions where these lesions become malignant.^[1,2,3]

Malignant Bone Lesions are classified into two, namely primary bone cancer and secondary bone cancer. The primary bone cancer starts in the bone itself while in secondary bone cancer the primary tumor is somewhere else in the body but it has spread to the bone.^[1,2,3]

The cause and treatment options for Bone Lesions depend on whether the lesions are benign or malignant. In cases of benign bone lesions, some of the causes include medical conditions like non-ossifying fibroma, bone cyst, osteochondroma, giant cell tumor, chondroblastoma, fibrous dysplasia, and osteoid osteoma. For benign Bone Lesions, the physician may just follow a wait and watch approach with close monitoring of the lesions with radiographs.^[3]

In many cases, these lesions tend to fade away with time. If they do not then there are a variety of treatment options available in the form of medications. In rare cases, surgery may have to be done to remove the lesion to cut down the risk of fracture due to Bone Lesions. However, benign Bone Lesions have a tendency to recur and thus constant treatment may be required. In very rare cases, benign Bone Lesions may go on to become malignant.^[3]

Malignant Bone Tumors: As stated above, malignant Bone Lesions are classified into primary and secondary.

The Main Causes Of Primary Malignant Bone Lesions Include:^[3]

1. Multiple Myeloma: This condition is mostly seen in people above the age of 50 and is perhaps the most common cause of primary bone cancer. It is a cancer of the bone marrow. Any bone in the body can be affected with multiple myeloma. Experts estimate that about 6 in every 100,000 people are diagnosed with this condition every year.^[3]

   Treatment: The primary mode of treatment of multiple myeloma is by way of radiation and chemotherapy. In rare cases surgery may have to be done. With regard to the prognosis, the 5-year survival rate for multiple myeloma is about 50%.^[3]

2. Osteosarcoma: This is also one of the common causes of primary bone cancer even though it is considered to be quite rare. The most common area of this form of bone cancer is either the knee or the shins. It is seen mostly in teens and children. However, at times it can also develop in the hip or shoulder.^[3]

   Treatment: The treatment for osteosarcoma is normally chemotherapy, radiation, and surgery. The overall prognosis is fair for people with this condition of around 70% after 5 years of diagnosis.^[3]

3. Ewing Sarcoma: This is a form of bone cancer that is seen mostly in children between the age of 5 and 20. This cancer generally develops in the legs, pelvis, upper arm, and ribs. Sometimes, this cancer can also develop in the soft tissues surrounding the bone.^[3]

   Treatment: Again, the treatment for this condition is radiation, chemotherapy, and surgery. The overall 5 year survival rate for children with Ewing sarcoma is about 70% post diagnosis provided that the cancer has not spread to other parts of the body. However if the cancer has spread then the prognosis is not that good for people with Ewing sarcoma.^[3]

4. Chondrosarcoma: This is a form of bone cancer that is made up of cells that produce cartilages. This form of cancer is seen in people between the age of 40 and 70 and develops in the hip, pelvis, and shoulders.^[3]

   Treatment: This condition in most cases requires surgery and the procedure is determined by physicians depending on the health status, extent, and size of the tumor. The surgery involves removing the diseased portion of the bone and replacing it by a metal implant.^[3]

In case if the cancer has spread to affect the nerves and blood vessels in the area then the entire area needs to be amputated. Chondrosarcoma is a very slow growing cancer and at the time of diagnosis in majority of the cases the tumor is of low grade.^[3]

The Main Causes Of Secondary Malignant Bone Lesions Include:

Secondary bone cancer develops when the tumor begins at some other area of the body and spreads to the bone. Primary regions from where a person can develop secondary bone lesions include breasts, lungs, prostate, kidney, and thyroid. The treatment and prognosis of secondary malignant bone lesions depend on the type and severity of the primary tumor.^[3]

Bone Lesions can at times cause pain in the affected area. The pain will be characterized as a dull ache which tends to get worse with any form of activity. Fever and night sweats are also observed at times in cases of Bone Lesions. If the lesions are malignant, then the person can observe stiffness, swelling, and tenderness around the affected region. The pain may get better or worse at night.^[3]

However, in some cases there may be no symptoms experienced at all and the person may just observe a lump around the affected region. Bone Lesions make the bones weak and makes then prone to fracture. Thus, it is quite common for a person with Bone Lesions to break their bones without any apparent cause.^[3]

The prognosis of a person with Bone Lesions depends on the type of bone lesions he or she has. Benign Bone Lesions are completely harmless and are not a cause for worry. However if the lesions are malignant then the prognosis depends on the type of cancer that has been mentioned above and the severity of it. The prognosis for all forms of malignant bone lesions have been described in detail above.^[3]

For benign Bone Lesions, physicians just monitor the condition and look for any increase in size to suggest any malignancy. These lesions in most cases fade away with time but they have a high likelihood of returning even after successful treatment of Bone Lesions. It is vital for people with bone cancer to get checked up with their doctors on a regular basis to ensure that their cancer is in remission and to look for any sign of recurrence of Bone Lesions.^[3]

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