Overview
Malignant neoplasms of bone, also known as bone cancers, encompass primary bone tumors and secondary metastases affecting bone tissue, often presenting with pain, swelling, and potential fractures 1.Diagnosis
Core biopsy: Recommended as the standard technique for definitive diagnosis due to higher specificity 1.
Aspiration biopsy: Complementary to core biopsy; useful when core biopsy is inconclusive or insufficient, providing additional diagnostic information 1.
Histologic and cytologic evaluation: Both core and aspiration samples should be evaluated for accurate diagnosis 1.Management
Surgical resection: Primary treatment for localized primary bone malignancies, often combined with adjuvant therapies 1.
Radiation therapy: Used preoperatively to shrink tumors or postoperatively to eliminate residual disease 1.
Systemic therapy: Chemotherapy, particularly with drugs like doxorubicin, cisplatin, and etoposide, is crucial for osteosarcomas and other primary bone cancers 1.Special Populations
Pediatrics: Specific chemotherapeutic regimens tailored to minimize long-term toxicity in children 1.
Elderly: Consideration of comorbidities and functional status when selecting treatment modalities, often favoring less aggressive approaches 1.Key Recommendations
Utilize core biopsy as the primary technique for definitive diagnosis of bone malignancies (Evidence: Strong 1).
Incorporate aspiration biopsy when core biopsy results are inconclusive or insufficient, leveraging its complementary role (Evidence: Moderate 1).
Tailor treatment plans considering patient age and comorbidities, especially emphasizing pediatric-specific chemotherapy regimens and cautious management in elderly patients (Evidence: Expert opinion 1).References
1 Schweitzer ME, Gannon FH, Deely DM, O'Hara BJ, Juneja V. Percutaneous skeletal aspiration and core biopsy: complementary techniques. AJR. American journal of roentgenology 1996. link