The Pediatric Bone and Soft Tissue Tumor Program, led by affiliated physician, Ernest “Chappie” Conrad III, MD, offers an experienced team of specifically trained physicians and nurses to treat all types of bone and soft tissue tumors, both benign (non-cancerous) and malignant (cancerous).
Timely diagnosis is key to the management of bone and soft tissue tumors. Families benefit from the coordinated care provided by a specialized team, including orthopedic surgeons, radiologists, nurses, pathologists, physical therapists and Child Life specialists, who strive to provide quality care to every patient. Children’s Memorial Hermann Hospital offers limb salvage surgery for malignant tumors. This is an advanced surgical approach, aimed to protect the child’s leg or arm and preserve normal growth, while also achieving an adequate resection of the bone or soft tissue tumor.
Tumors are growths that typically form when a group of abnormal cells multiply in one specific area of the body, resulting from injury or disease. Bone and soft tissue tumors can either be benign or malignant. Malignant tumors of the musculoskeletal system are commonly referred to as sarcomas. They have an aggressive growth rate and the ability to spread to more distant locations in the body. Benign tumors generally are limited to a small area and are usually less harmful to the patient.
A bone tumor is a mass of cells that develops inside of the skeletal system, specifically on the bone. Most bone tumors are not cancerous and are not life-threatening. All tumors are classified as benign or malignant.
Benign bone tumors are much more common than malignant bone tumors. They almost never advance to become cancerous. The three most common benign bone tumors found in children are:
Malignant bone tumors (bone cancers) can occur in any bone in the body. They can be aggressive and spread cancer cells to other parts of the body. A malignant bone tumor can threaten limb or life.
Symptoms of a bone tumor vary based on the specific tumor type, where it is located and if it has grown or spread. The most common symptoms associated with bone tumors include:
If your child is experiencing persistent pain and/or swelling in his/her bones and/or joint lasting for more than one to two weeks, he/she should be evaluated by their pediatrician, primary care physician or an orthopedic specialist.
Soft tissue tumors typically form in connective tissues of the musculoskeletal system such as muscles, tendons, fat and skin. All soft tissue tumors are classified as benign or malignant.
The most common benign soft tissue tumors found in children include:
Malignant soft tissue tumors are not common in children but can occur at any age and in any musculoskeletal location. They are typically a challenging diagnosis to make. These cancers begin in soft tissues that connect or support other areas of the body including muscles, tendons, fat, blood vessels, nerves and the soft tissues in and around joints. The most common malignant soft tissue tumor in children is:
Soft tissue tumors are commonly diagnosed when the mass becomes visible under the skin. MRI imaging is required for soft tissue tumors larger than 3 centimeters. Soft tumors usually cause little to no pain and grow slowly over several years.
Benign bone tumors, in general, are best imaged with regular X-ray. Malignant bone tumors require both X-ray and MRI. For benign or malignant soft tissue tumors larger than 3 centimeters, MRI is required, especially if those tumors are showing signs of growth. If imaging tests show there may be a bone or soft tissue tumor, a biopsy should be done prior to tumor resection or removal. Biopsy of the tumor involves withdrawal of a small sample of the abnormal tissue to confirm findings based on imaging results.
The multidisciplinary team of affiliated physicians provides both operative and non-operative treatment options for children with bone and soft tissue tumors. Whether the tumor is benign or malignant, all tumors require proper treatment upon diagnosis. Timely diagnosis is key to the management of bone and soft tissue tumors.
If your child is experiencing persistent pain and/or swelling in their bones and/or joint lasting for more than one to two weeks, they should be evaluated by their pediatrician, primary care physician or a pediatric orthopedic specialist.
Benign bone and soft tissue tumors can be periodically monitored for approximately 6-12 weeks with repeat X-ray to determine the extent of pain, make decisions about treatment, obtain additional imaging ( e.g. MRI), or biopsy.
Large painful benign tumors are usually surgically removed and require a bone graft to fill the tumor bony defect.
Certain types of benign bone tumors can effectively be treated through less invasive surgical treatments. These include radiofrequency ablation, used to reduce pain, or cyst injections, to treat the tumor. Currettage, the removal of tissue, and bone grafting are required for large and/or painful benign bone tumors. This may require two to three months of recovery. Surgery to remove the tumor will eliminate pain, prevent fractures and deformities.
Malignant bone and soft tissue tumors are less common and require timely diagnosis with an MRI and biopsy. Your team of specialists will determine the best treatment options available depending on the type of tumor, its location and if the cancer has spread to other parts of the body. For children with malignant tumors, treatment may include radiation therapy, the use of high energy waves to kill or shirk cancer cells, surgery to remove the tumor or chemotherapy, medicines used to fight cancer cells given orally or through an IV. Surgical treatment for malignant tumors is frequently referred to as limb salvage or limb sparing surgery because it is can preserve a child’s leg with good function and the risk of tumor recurrence is very small (10 percent).
Limb-sparing surgery, also referred to as limb-salvage surgery, is a treatment option for malignant (cancerous) bone or soft tissue tumors. This approach removes the malignant tumor while reconstructing the resulting bony defect in the affected limb. Surgical options for treating malignant tumors include amputation of the extremity to minimize the risk of tumor recurrence if the tumor is very large. Limb salvage focuses on removing the involved bone and affected soft tissues and keeping the limb intact. After removal of the tumor and surrounding soft tissue, a bone graft transplant or total knee or total hip implant is used to reconstruct the defect. Patients are usually given chemotherapy before and after surgical tumor resection.
For young children under 12 years of age who undergo limb sparing surgery, it is especially important to preserve the growth plate. At Children’s Memorial Hermann Hospital, the affiliated surgeons use devices called growing prostheses, implants, so the growth plate is separated from the tumor and saved. This technique can make it possible for young kids to have limb-sparing surgery even if a tumor is removed in or near the growth plate in their extremity.
The Pediatric Bone and Soft Tissue Tumor Program, affiliated with Children’s Memorial Hermann Hospital and the affiliated physicians at McGovern Medical School at UTHealth, offers a multidisciplinary team working together to optimize treatments for each patient’s unique case. Children’s Memorial Hermann Hospital is a comprehensive academic medical center capable of providing services to children of all ages.
The affiliated orthopedic surgeons and multidisciplinary team offer a continuum of care and are ready to care for any orthopedic condition children may face.
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Children's Memorial Hermann Hospital
Houston, TX 77030
Phone: (713) 486-4880
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