Primary malignant tumours of the bone

Primary bone tumours are rare, with approximately 400 new cases per year in the UK. The diagnosis of bone tumours are hampered by delays in presentation. Radiographic changes are often characteristic for each type of bone tumour and should alert the physician to investigate further. Investigations should include blood tests, local staging and systemic staging. MRI, CT of the chest and isotope bone scans are important in evaluating the tumour. The most common types of bone tumour are osteosarcoma, chondrosarcoma, Ewing sarcoma, spindle cell sarcoma of bone and chordoma. The important pathological features and treatment of each type of tumour are described in this article. Early contact to a supra-regional bone tumour unit is mandatory when a bone tumour is suspected, where a multidisciplinary team approach is employed for an accurate diagnosis and appropriate management. Biopsy and surgical treatment should only be undertaken in such a unit and all patients should be enrolled in international clinical trials, where feasible, to gather data that will ultimately improve outcomes. The survival rates from most bone tumours are of the order of 60–80% with appropriate treatment.