Dr. Vinod Dubey

Bone and soft tissue tumors

Bone Tumors

Benign bone tumors


Benign (noncancerous) tumors are even more common than malignant tumors in the musculoskeletal system.

Common types of benign tumors include:

  • Osteochondromas.
  • Aneurysmal bone cysts.
  • Simple bone cysts.
  • Fibrous dysplasia.
  • Langerhans Cell Histiocytosis.
  • Non-ossifying fibromas.

Benign bone tumors that are more aggressive, such as giant cell tumor or chondromyxoid fibromas, usually require surgery. In these cases, techniques such as synthetic bone graft substitutes are used to rebuild rather than remove bone. Drugs such as denosumab are also used to treat specific tumors.

Malignant bone tumors

Common types of malignant bone tumors include:

  • Osteosarcoma (osteogenic sarcoma).
  • Ewing’s sarcoma.
  • Fibrosarcoma.
  • Chondrosarcoma.
  • Multiple myeloma.

More than one-third of bone sarcomas are diagnosed in patients under the age of 35 years old; many are diagnosed in children.

Metastatic bone tumors

As opposed to primary bone sarcoma (cancer that starts in the bone), metastatic bone cancer starts in another location (such as an organ) and travels to the bone. This cancer comes in many forms, most often thyroid, lung, kidney, breast or prostate.

When a cancer from a distant organ spreads to the skeleton, it can create structural problems in the bone that may lead to greater pain and reduced functioning.

Soft Tissue Tumors

Benign soft tissue tumors

Benign soft tissue tumors are very common (fewer than 5% of all lumps or bumps discovered are cancerous). Many of these tumors can be monitored regularly, but some have to be removed by surgery. Some benign tumors, such as desmoid tumors, may require treatment from the medical oncology, radiation oncology or interventional radiology teams, all of which work closely together.

The most common types of benign soft tissue tumors include:

  • Desmoid tumors.
  • Large arteriovenous malformations.
  • Lipomas (fatty tumors).
  • Pigmented villonodular synovitis.
  • Schwannomas.
  • Synovial chondromatosis.

Malignant soft tissue tumors


Soft tissue sarcomas begin in the muscle or other connective tissues of the body. Unlike bone tumors, most soft tissue sarcomas occur in adults, though certain types, such as rhabdomyosarcoma, are found mostly in children.

Some of the most common types of soft tissue sarcomas include:

  • Desmoplastic small round cell tumors.
  • Gastrointestinal stromal tumor (GIST).
  • Leiomyosarcoma.
  • Liposarcoma.
  • Malignant peripheral nerve sheath tumor.
  • Rhabdomyosarcoma.
  • Synovial sarcoma.
  • Undifferentiated pleomorphic sarcoma.

Symptoms

The symptoms of sarcomas vary. For example, in their early stages, some sarcomas may not cause noticeable symptoms. Sarcomas may appear as a painless lump under the skin. Other sarcomas may form in the abdomen, and may not cause symptoms until they grow very large and press on an organ.

Other sarcomas can present as long-lasting bone pain or swelling in an arm or leg that gets worse at night, or decreased mobility.

Sarcoma symptoms that should be investigated are masses (growths) that grow larger, painless masses that have become painful or masses larger than a golf ball (around five centimeters).

In the case of children, a child who has bone pain that does not get better on its own, and that did not occur with an injury, should have an imaging test to investigate.

Treatment

Sarcomas are treated by specialists, depending on where the sarcoma is located. In larger medical centers, sarcomas are treated by a team of caregivers, including surgeons, radiologists, medical oncologists (cancer specialists), radiation oncologists, pathologists, pediatric specialists (for cancers in children), psychologists and social workers. The most common forms of treatment for sarcoma are:
  • Surgery
  • Radiation
  • Chemotherapy.
  • Limb Salvage
  • Thermal ablation

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FAQ'S

What is the basic knowledge of cardiology?

Cardiology is the medical specialty that deals with the diagnosis and treatment of diseases related to the heart and blood vessels. Basic knowledge of cardiology includes understanding the anatomy and function of the heart, the various cardiovascular diseases, risk factors for heart disease, diagnostic techniques such as electrocardiograms (ECGs) and echocardiograms, treatment options including medications, interventions, and surgeries, and preventive measures to maintain heart health.

What are some good questions to ask a cardiologist?
  • What lifestyle changes can I make to improve my heart health?
  • What are the risk factors for heart disease, and how can I manage them?
  • What symptoms should I be aware of that might indicate a heart problem?
  • What diagnostic tests might be necessary to assess my heart health?
  • What are the treatment options available for my specific condition?
  • Are there any potential side effects or risks associated with the prescribed medications?
  • How often should I have follow-up appointments to monitor my heart health?
  • Are there any specific dietary recommendations I should follow?
  • Can you provide information on cardiac rehabilitation programs?
  • What steps can I take to prevent future heart problems?
What Type of Cardiologist Should You See for Specialized Heart Care?
  1. The type of cardiologist you should see for specialized heart care depends on your specific condition. Here are a few examples:
  • Interventional Cardiologist: Specializes in performing procedures such as angioplasty, stenting, and catheter-based treatments for coronary artery disease and other structural heart problems.
  • Electrophysiologist: Focuses on the diagnosis and treatment of heart rhythm disorders (arrhythmias) using techniques like electrophysiology studies and cardiac ablation.
  • Heart Failure/Cardiomyopathy Specialist: Specializes in managing heart failure and cardiomyopathy, including the use of advanced therapies like implantable devices or heart transplantation.
  • Adult Congenital Heart Disease Specialist: Deals with the diagnosis and treatment of heart conditions that were present since birth but persist into adulthood.
  • Cardiovascular Surgeon: Performs surgical procedures on the heart and blood vessels, such as coronary artery bypass grafting, heart valve repair or replacement, and heart transplantation.
What are the different types of heart disease?
  1. Coronary artery disease (CAD): This is the most common type of heart disease and occurs when the coronary arteries, which supply blood to the heart, become narrow or blocked due to a buildup of plaque.
  2. Heart failure: This refers to a condition where the heart is unable to pump enough blood to meet the body’s needs. It can result from various underlying causes such as CAD, high blood pressure, or heart valve disease.
  3. Arrhythmias: These are abnormal heart rhythms that can occur due to electrical disturbances in the heart. They can cause the heart to beat too fast, too slow, or irregularly.
  4. Heart valve disease: This condition occurs when one or more of the heart valves do not function properly. It can involve valve stenosis (narrowing) or valve regurgitation (leakage).
  5. Cardiomyopathy: This refers to diseases of the heart muscle, where the muscle becomes thick, rigid, or weak, affecting the heart’s ability to pump effectively.
  6. Congenital heart disease: This is a type of heart disease that is present at birth. It involves structural defects in the heart that affect its normal function.
  7. Pericardial disease: This involves inflammation or abnormalities of the pericardium, the sac-like membrane surrounding the heart.
What are the common symptoms of heart disease?
  1. Chest pain or discomfort (angina): This is a common symptom of coronary artery disease. It may feel like pressure, tightness, or a squeezing sensation in the chest.
  2. Shortness of breath: Difficulty breathing or feeling breathless, especially with exertion or when lying flat, can be a sign of heart disease.
  3. Fatigue: Feeling excessively tired or lacking energy, even with minimal physical activity, may be a symptom of heart disease.
  4. Heart palpitations: Sensations of a rapid, fluttering, or pounding heartbeat may occur with certain heart conditions.
  5. Dizziness or fainting: Feeling lightheaded, dizzy, or actually fainting can be a result of inadequate blood flow to the brain due to heart problems.
  6. Swelling: Fluid retention can cause swelling in the legs, ankles, feet, or abdomen.
  7. Rapid weight gain: Sudden and unexplained weight gain may be a sign of fluid buildup related to heart failure.

It is important to note that these symptoms can also be caused by other conditions, and some individuals with heart disease may not experience any symptoms until a more advanced stage. If you are experiencing any concerning symptoms, it is recommended to consult a healthcare professional for a proper evaluation.