Childhood bone tumours – How is it diagnosed?
Bone tumours are uncommon in children. The two most common subtypes are osteosarcoma and Ewing sarcoma and usually present with pain in a bone or in a joint. There may be an associated swelling or mass. Occasionally the bone may break for no reason or with minimal trauma.Â
These children are typically referred to an orthopaedic surgeon who orders a combination of imaging, including plain X-rays of the bone, CT scans, and MRIs. Once there is a suspicion of a tumour on the imaging, a biopsy is indicated. This is usually performed by an orthopaedic surgeon who has experience in treating tumours. The biopsy requires a general anaesthetic. A small piece of the tumour is sent to a laboratory where a pathologist examines the specimen and makes the diagnosis of the bone tumour.
Additional staging examinations required may include a CT scan of the chest, bone scan, PET scan. If the diagnosis is confirmed as Ewing sarcoma, then a bone marrow aspiration and biopsy is also required. These children are then referred to a paediatric oncologist for further treatment.
The diagnosis of cancer in a child is always daunting for both parents and the child being diagnosed. However, it’s important to remember that for most childhood cancer, treatment is available and although the journey is difficult, cure is achieved in the majority of patients.
Childhood cancer is rare and comprises less than 1% of all malignant disease. It occurs in about 1 in 650 children, or 140 children per million. It’s estimated that almost half the children with cancer in SA will never be diagnosed.
The most common types are as follows:
- Leukaemia 34%
- Brain tumours 22%
- Lymphoma 11%
- Nephroblastoma 6%
- Neuroblastoma 6%
- Soft tissue sarcoma 6%
- Bone tumours 5%
Dr Kate Bennett is a paediatric oncologist; she qualified as a paediatrician in 2009 and then as a paediatric oncologist in 2011. She has a special interest in the treatment of paediatric leukaemia and lymphoma, immune thrombocytopaenia, and sickle cell anaemia.
Header image by Freepik
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