Oncology-Related Orthopaedic Procedures

Bone Tumour Resection

 

OVERVIEW

Bone tumours are a result of mutations within the bone cells. These mutations cause the cells to multiply unnaturally. Tumours can affect any part of the bone, like the bone’s surface or inside the bone (marrow). They increase in size, resulting in the destruction of healthy surrounding tissue and weaken the bone, increasing the risk of fractures.

Bone tumours can be benign or malignant. Benign tumours are generally slow growing and don’t usually spread to other areas of the body. In contrast, malignant tumours are highly aggressive and can spread easily to other areas of the body like the lungs. Malignant tumours can compromise the health of the limb and become life-threatening.

HOW ARE BONE TUMOURS TREATED?

  1. The first step in managing tumours is to get specialized imaging and a biopsy of the tumour to diagnose the type, nature, and extent of the condition.
  2. Oncology referral: Malignant tumours will need referral to an oncologist to assist with further workup as well as radiation therapy or chemotherapy. This is not always necessary but rather dependent on the nature of the tumour.
  3. Tumour excision: Tumour excision depends on the type of tumour and the nature of the tumour. Benign tumours can be managed with simple excisions, curettage, or even observation. Malignant tumours often require wide radical excisions (removal of the entire tumour with a cuff of normal tissue) followed by replacement of the bone with a metal prosthesis.
  4. Amputation is a major surgery done to remove a part or the whole limb (leg or arm). Amputation is considered when the tumour is not resectable, for example when it encases large blood vessels or nerves.

FREQUENTLY ASKED QUESTIONS

1Is bone tumour removal considered safe?
Typically, when conducted by a highly skilled orthopaedic surgeon with specialized training, the procedure is deemed safe. However, as with any surgical intervention, there is a potential for complications such as tumour recurrence, nerve damage, bleeding, fracture, and infection.
2What is wide resection?
Wide resection is a surgical technique that involves removing the tumour, along with a normal margin of tissue surrounding the bone, to ensure complete resection of the tumour. This technique is generally used for malignant bone tumours.
3Is a benign tumour unsafe?
Benign tumours are tumours that are slow growing and generally don’t metastasise. However, benign tumours can weaken the bone integrity, cause pain, and lead to fracture.