Yordanos Lemma presented on bone tumors (benign and malignant) at Salale University College of Health Science. The presentation covered: - Types of bone tumors including the most common benign tumors like enchondroma and osteochondroma, and malignant tumors such as multiple myeloma, osteosarcoma, Ewing's sarcoma, and chondrosarcoma. - Risk factors for bone tumors including being a child or young adult as benign tumors often affect the growing skeleton. - Diagnosis involves imaging tests and biopsies to determine if a tumor is benign or malignant. Management depends on the type and severity of the tumor, ranging from observation to surgery.

1. SALALE UNIVERSITY COLLEGE OF HEALTH SCIENCE POST
GRADUATE PROGRAM IN AHN.
PRESENTATION ON BONE TUMORS(BENIGN&MALIGNANT)
SUBMIT TO: MR. TADELE.K ( ASS’T. PROFESSOR)
SUBMIT BY: YORDANOS LEMMA (BSC, MSC STUDENT)
ID NO 195
SEP 2023
FITCHE
BY .yordanos L 1

2. Presentation outline
 Introduction
 Type of bone tumor
 Etiology
 Pathophysiology
 Epidemiology
 Classification
 Clinical Manifestation
 Risk factors
 Diagnosis
 Management and
prevention
 complication
 Summary
 Reference
BY yordanos L( MSc) 2

3. Objective of Presentation
To Understand:
 Definition of bone tumors ,risk factors.
 Etiology and classification of bone tumors.
 Their complications & their diagnoses.
 The different management/treatment
Options/Techniques/prevention.
BY yordanos L 3

4.  Definition of Bone Tumor
 Bone tumors develop when cells within a bone divide
uncontrollably, forming a lump or mass of abnormal
tissue.
 A bone tumor is an abnormal growth of cells within a
bone. Most bone tumors are benign (not cancerous).
 A bone tumor may be cancerous (malignant) or
noncancerous (benign).
BY yordanos L 4

5. Types of bone Tumors
BY Yordanos L 5

6.  Benign Bone Tumors
 Benign bone tumors are bone tumors that are not cancerous.
 Most tumors that start in our bones are benign (not cancer).
 This means that benign tumors will not spread from their
original site to a new location.
 Tumors can form in any of the bones of your skeletal system
and in any part of the bone. In general, the most common
bones involved are also some of the largest: the femur, tibia,
humerus, pelvis, spine and ribs.
By yordanos L 6

7. cont.…
BY yordanos .L 7
• Some types of tumors are most common in specific
locations, such as the spine or near the growth plates in
your hip, knee or shoulder.
 How common are benign bone tumors?
• Benign bone tumors are most common in people who
are under 30 years old. A large portion of benign bone
tumors are found in children while their skeletons are
still growing.

8. cont.…
 Many benign tumors actually stop growing once a child
reaches skeletal maturity, which is the term used to
describe the time at which bones stop growing in
length.
 Skeletal maturity usually happens between the ages of
14 to 16 in girls and between the ages of 16 to 19 in
boys.
By yordanos L 8

9.  The most common types of benign bone tumors
 Enchondroma: This type of tumor starts in the
cartilage. These tumors are found inside the bone, in
the marrow space.
• usually appears in bones of your hands and feet.
• It often has no symptoms.
• It’s the most common type of hand tumor.
By yordanos L 9

10. cont.…
By yordanos L 10
 Osteochondroma: is a most common tumor that grows in
our spine and long bones, mostly in young adults.
 This type of tumor is made up of cartilage and bone and
can get bigger while the skeleton is growing.
 These tumors grow outside the bone.

11.  Osteoid osteoma: This type of tumor usually affects the
long bones of the body and is more common in males. It
can cause significant pain at nighttime due to hormone
interaction and can be relieved with non steroidal anti-
inflammatory medications (NSAIDs).
 Chondroblastoma: This type of tumor is usually
removed because its growth affects nearby joints.
 It’s found in children and can cause significant pain.
By yordanos L 11

12. cont.…
 Osteo blastoma: This type of tumor is also more
common in males. Treatment is almost always surgery.
 Periosteal chondroma: These tumors are made up of
cartilage and are located on the surface of a bone.
Treatment is almost always surgery.
 Giant cell tumor: These tumors, though rare, grow
aggressively. Females are slightly more likely to develop
giant cell tumors. Treatment is almost always surgery.
By yordanos L 12

13.  Etiology of benign bone tumors
 Bone tumors form when bone cells divide and grow out
of control, forming a lump or a mass of cells. We don’t
know why this happens in most cases.
 Benign bone tumors occur most often in children whose
skeletons are still growing and people up to age 30.
 These tumors are often strongly affected by the
hormones that cause growth. Many benign tumors stop
growing once a child's bones do.
By yordanos L 13

14.  Pathophysiology of benign bone tumors
 Bone tumors develop when cells within a bone divide
uncontrollably, forming a lump or mass of abnormal
tissue.
 Most bone tumors are benign (not cancerous).
 Benign tumors are usually not life-threatening and, in
most cases, will not spread to other parts of the body.
BY Yordanos L 14

15.  Epidemiology of bone tumors
• According to the analysis of the Surveillance,
Epidemiology and End Results (SEER) Cancer Statistics
Review of the National Cancer Institute, it is estimated
that 2,810 men and women (1,620 men and 1,190
women) will be diagnosed with and 1,490 men and
women will die of cancer of the bones and joints in 2011
(1).
BY Yordanos L) 15

16. Cont.…
• Overall, bone sarcomas account for 0.2% of all
malignancies diagnosed in the United States, and the age
adjusted incidence rate for all bone and joint
malignancies is 0.9 per 100,000 persons per year.
• The overall 5-year relative survival for 2001–2007 was
66.3% and the age-adjusted death rate based on patients
who died in 2004–2008 in the US, was 0.4 per 100,000
men and women per year (1).
BY Yordanos L 16

17.  Clinical manifestation of benign bone tumors
By yordanos L 17
• An obvious swelling or lump.
• Pain, possibly severe, that increases in intensity.
• It may hurt even when you’re resting.
• Breaks or fractures due to bones made weaker by a
growing bone tumor.
• In most cases, these tumors have no symptoms and are
incidentally discovered on an X-ray obtained for an
injury.

18. Risk Factors
• Children whose skeletons are still growing and people up
to age 30.
• These tumors are often strongly affected by the
hormones that cause growth.
• Many benign tumors stop growing once a child's bones
do.
BY Yordanos L 18

19.  Diagnosis of benign bone tumors
 Imaging and tests: obtain X-rays.
 Different types of tumors exhibit different characteristics
on X-ray. Some dissolve bone or make a hole in the bone.
Some cause extra formation of bone. Some can result in a
mixture of these findings.
• Some tumors have characteristic findings on X-rays.
• In other cases, it may be hard to tell what kind of tumor is
involved.
By yordanos L 19

20. cont.…
By yordanos L 20

21. There are two basic methods of doing a biopsy.
 Needle biopsy: The doctor inserts a needle into the tumor
to remove some tissue.
 This may be done while you are under local anesthesia.
 Or a radiologist may do it, using an X-ray machine or
 MRI scanner to help direct the needle to the tumor.
By yordanos L 21

22. cont.…
 Open biopsy: The doctor uses surgery to remove
tissue.
 This is generally done through a small incision
while you are under general anesthesia in an
operating room.
BY yordanos L) 22

23.  Management
• In many cases, benign tumors just need to be
watched.
• Some can be treated effectively with medication.
• Some benign tumors will disappear over time; this is
particularly true for some benign tumors that occur in
children.
By yordanos L 23

24. cont.…
• Some times removing the tumor (excision) or using other
treatment techniques to reduce the risk of fracture and
disability.
• Some tumors may come back–even repeatedly–after
appropriate treatment.
BY Yordanos L) 24

25. Non-pharmacological aspect
• Just need to be watched Some benign tumors will
disappear over time; this is particularly true for some
benign tumors that occur in children.
BY Yordanos L 25

26. Prevention
 Don't use tobacco. ...
• Eat a healthy diet. ...
• Maintain a healthy weight and be physically active. ...
• Protect yourself from the sun. ...
• Get vaccinated. ...
• Eating citrus fruits such as lemons, limes, grapefruits
and oranges has been associated with a lower risk of
cancer in some studies.
• Avoid risky behaviors. ...
• Get regular medical care.
By yordanos L 26

27.  Malignant Bone Tumors
• Bone cancer is when unusual cells grow out of control in
our bone. It destroys normal bone tissue. It may start in
our bone or spread there from other parts of our body
(called metastasis)& Bone cancer is rare.
• Malignant tumors can spread cancer cells throughout the
body (metastasize).
BY yordanos L 27

28. cont.…
•This happens via the blood or lymphatic system.
 Cancer that begins in bone (primary bone cancer) is
different from cancer that begins somewhere else in the
body and spreads to bone (secondary bone cancer).
By yordanos L) 28

29.  Types of malignant bone tumors
 Depend on the origins
A, primary bone cancer(malignancy) &
B, secondary bone cancer(malignancy)
A, Primary bone cancer(malignancy): Cancer that begins
in bone.
BY yordanos .L 29

30.  The four most common types of primary bone
cancer are:
• Multiple Myeloma: the most common primary bone
cancer, is a malignant tumor of bone marrow. It affects
approximately 20 people per million people each year
• Most cases are seen in patients aged 50 to 70 years old.
Any bone can be involved.
• Osteosarcoma is the second most common bone cancer.
It occurs in two or three new people per million people
each year.
By yordanos L 30

31. Cont.…
• Most cases occur in teenagers. Most tumors occur around the
knee. Other common locations include the hip and shoulder.
• Ewing's sarcoma: most commonly occurs between age 5 and
20. The most common locations are the upper and lower leg,
pelvis, upper arm and ribs.
• Chondrosarcoma: occurs most commonly in patients 40 to 70
years of age.
• Most cases occur around the hip and pelvis or shoulder.
BY yordanos L 31

32. B, secondary bone cancer(malignancy)
 Cancer in our bones usually started else where in our
body. For example, if lung cancer has spread to our
bones, that's secondary bone cancer.
 Any cancer that moves from one part of our body to
another is called metastatic cancer.
 Cancers that commonly spread to bone include:
 Breast cancer, Prostate cancer ,Lung cancer
BY yordanos L 32

33.  Etiology of malignant bone tumors
 The causes of malignant bone tumors aren't known.
 A few possible causes are genetics, radiation treatment,
and injuries to the bones.
 Osteosarcoma has been linked to radiation treatment
(particularly high doses of radiation) and other anticancer
drugs, especially in children.
 However, a direct cause hasn't been identified.
By yordanos L 33

34.  Pathophysiology of malignant bone tumors
 Osteosarcomas arise from mesenchyme cells and are
characterized by areas of abnormal bone growth .
• The various genetic, epigenetic, and environmental factors
that drive mesenchyme stem cells to differentiate into
bone precursor cells also play a role in the development of
osteosarcoma.
By yordanos L 34

35.  Epidemologe of malignant bone tumor
 Overall, bone sarcomas account for 0.2% of all malignancies,
and the adjusted incidence rate for all bone and joint
malignancies is 0.9 per 100,000 persons per year, while the 5-
year overall survival rate is 67.9%.
 Osteosarcoma is not a common cancer. Each year, about
1,000 new cases of osteosarcoma are diagnosed in the United
States. About half of these are in children and teens.
 Most osteosarcomas occur in children, teens, and young
adults between the ages of 10 and 30.8 octo 2020
BY yordanos L 35

36.  Clinical manifestation of malignant bone tumors
• symptoms can include pain that:
Is in the area of the tumor , dull or achy
• Gets worse with activity, Wakes us at night
 Other symptoms related to malignant bone tumors include:
• Fevers ,Night sweats
• Swelling around a bone , Limping
• Fatigue
• Weight loss
BY yordanos L 36

37. Risk factors
• Genetics. Children with familial
• retinoblastoma, which is a type of eye cancer, have an
increased risk of developing osteosarcoma. ...
• Previous radiation therapy. ...
• Chemotherapy for another cancer. ...
• Benign tumors or other bone conditions.
BY Yordanos L) 37

38.  Diagnosis of malignant bone tumors
• Bones through imaging tests such as: X-rays.
• These show tumors and how big they are.
• CT scans. A computer uses X-rays to make more
detailed pictures.
• Bone scans. A technician injects a different radioactive
material into our vein. It collects in our bones, where a
scanner can see it.
BY Yordanos L) 38

39. cont...
• It might also do blood tests to look for two enzymes
that can be signs of blood cancer.
• MRI scans. These use a strong magnet to show
inside our body. Biopsy can confirm a diagnosis.
• PET scans. A technician injects radioactive glucose
(sugar) into our vein.
• A scanner then spots cancer cells, which use more
glucose than regular cells.
BY yordanos .L 39

40.  Common Management of malignant bone tumor
• Limb salvage surgery. Your doctor removes the part of
the bone with cancer but not nearby muscles, tendons, or
other tissues. They put a metallic implant in place of the
bone.
• Amputation. If a tumor is large or reaches our nerves
and blood vessels, our doctor might remove the limb.
You may get a prosthetic limb afterward.
BY Yordanos L) 40

41. Cont.…
 Radiation therapy. This kills cancer cells and shrinks
tumors with strong X-rays. Doctors often use it along with
surgery.
 Chemotherapy. This kills tumor cells with cancer drugs.
Your doctor might use it before surgery, after surgery, or
for metastatic cancer.
 Targeted therapy. This drug treatment targets certain
genetic, protein, or other changes in or around cancer.
BY yordanos L 41

42. Prevention
• Early detection offers the best chance
• To identify risk factors
BY yordanos L 42

43. complication
 The major skeletal complications associated with
bone metastases include;
 Cancer-induced pain,
 Hyperkalemia,
 pathological bone fracture , disability.
 metastatic epidural spinal cord compression and other
organs. ,cancer cachexia then death.
BY Yordanos L 43

44. Nursing care plan
• Imbalanced nutrition , less than body requirement,
related to sever pain
• Anxiety related to impending surgery and diagnosis
of cancer
• Pain related to tumor mass
BY Yordnos L 44

45. Nursing management
• Maintaining optimal nutrition
• Providing emotional support
• Relieving pain
• Monitoring and managing complication
BY Yordanos L 45

46. Summary
 Bone cancer treatments can cause problems over time
with our heart, lungs, brain, hearing, bones, or fertility.
 Your recovery from bone cancer depends on its type and
stage. Overall, more than 78% of people who have it live
at least 5 years after diagnosis.
 They have a major impact on the life of patients and their
families.
By yordanos L 46

47. References
 1.http://seer.cancer.gov/csr/1975_2008/results_single/sect_01_
table.01.pdf
 2. http://www.registri-tumori.it/cms/?q=sede_osso
 3. Hauben EI, Arends J, Vandenbroucke JP, et al. Multiple
primary malignancies in osteosarcoma patients. Incidence and
predictive value of osteosarcoma subtype for cancer
syndromes related with osteosarcoma.
 Eur J Hum Genet. 2003;11:611–8. [PubMed] [Google Scholar]
By yordanos L 47

48. cont.…
 4. Hameetman L, Bovée JV, Taminiau AH, et al.
Multiple osteochondromas: clinicopathological and
genetic spectrum and suggestions for clinical
management.
 Hered Cancer Clin Pract. 2004;2:161–73. [PMC free
article] [PubMed] [Google Scholar
BY Yordanos L) 48

49. Thank
you!!!
49
BY yordanos .L