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Medical Services & Treatments

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Medical Services and Treatments

Specialists within the division treat both adult and pediatric patients with benign and malignant tumors of the musculoskeletal system, either primary (originating in the bone itself) or spread from cancers in other locations (metastatic). Metastatic tumors to the bone are evaluated in collaboration with the other cancer specialists in radiation oncology and medical oncology.

Primary malignant tumors include:

• Chondrosarcoma
• Ewing's sarcoma
• Osteosarcoma
• Soft tissue sarcomas

Benign primary tumors include:

• Aneursymal bone cysts
• Enchondroma
• Fibrous dysplasia
• Giant cell tumor of bone
• Osteochondroma
• Simple or unicameral bone cysts

Benign soft tissue tumors include:

• Fibromas
• Hemangiomas
• Lipomas
• Other tumors

Additionally, many nontumors or tumor-like conditions are treated, including metabolic bone diseases, chronic infections, systemic diseases affecting the musculoskeletal system or congenital skeletal diseases.

Evaluations are performed in consultation with expert musculoskeletal radiologist and pathologists. Treatment planning for a malignant tumor involves physician consultants in pediatric or adult oncology and radiation therapy.

Diagnostic Procedures and Evaluations

All patients undergo a medical history and physical examination and review of previous tests and images, if available. Once this is complete the patient is advised of any additional tests that may be needed, including radiographs (x-rays), laboratory tests, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and nuclear medicine studies.

Treatment options are then discussed with the patient. These include a diagnostic biopsy, surgery or continued observation if the condition is benign with little possibility for progression.

What to Expect

Patients should expect a discussion about their symptoms and medical history, followed by an examination of the affected area, as well as related areas. The surgeon will then determine which tests to order.

Treatment Options

Surgery is the primary treatment of tumors of the musculoskeletal system. For benign tumors, surgery is usually all that is needed. With malignant cancers or sarcomas, surgery is often accompanied by radiation therapy or chemotherapy.

Benign tumors in the bone are often scraped out and the area filled with bone graft or bone graft substitute. For more aggressive tumors of bone and with soft tissue tumors, operations called resections are performed to remove the abnormal growth and a margin of normal tissue to make sure the tumor is completely removed. If the area is so significantly involved that there is lack of support for the boney skeleton, a reconstruction may involve large metal implants similar to total hip or knee replacements so maximum function can be achieved.

Chemotherapy and/or radiation therapy may be required after surgery.

Once the treatment phase is finished, the patient will have follow-up visits along with therapy, if needed. Follow-up visits usually occur at three-month intervals for the first two years and then increases to four- or six-month intervals for the next three years. Follow-up visits include physical exams and x-ray, CT or MRI scans.

What to Expect

Each patient is unique and is treated as an individual. Time is spent with the patient and family to ensure all questions are answered before proceeding with the treatment plan.

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