Diagnosis of malignant bone tumors in children
DOI:
https://doi.org/10.12775/JEHS.2022.12.11.044Keywords
Children pediatric care, diagnostics, bone tumors, adolescents, malignant tumorsAbstract
Bone cancers occur mainly in adolescents and young adults, and benign lesions are more frequent than malignant ones. The most common malignant tumors include osteosarcoma, Ewing's sarcoma and chondrosarcoma. The course of the disease may not be obvious and symptoms may be ambiguous, so it is important to catch them early and take appropriate action. Laboratory tests such as CRP, ESR, LDH, ALP may prove useful in the diagnosis of bone neoplasms in children. All children with suspected malignant bone cancer should undergo an x-ray examination. MRI, CT scans are performed to expand the diagnosis and determine the extent of the disease. The basis of diagnosis is histopathological examination. The result of this study is very important in the selection of therapeutic procedures, it influences decisions regarding the scope and degree of radicality of the operation. It is crucial that the entire diagnostic process is carried out in highly specialized centers that have extensive experience in the diagnosis and treatment of malignant bone tumors in children. It is most beneficial to conduct diagnosis and treatment at the same center, and preferably by the same team of specialists. This team should include doctors from orthopedics, radiology, oncology, radiation therapy and pathomorphology. Conducting diagnosis and treatment in highly specialized centers has a positive effect on the prognosis and quality of life of patients.
The purpose of this article is to highlight the early and uncharacteristic symptoms of bone cancer in children and to present the complexity of the diagnostic process, as well as the importance of carrying it out in highly specialized centers with extensive experience in treating pediatric bone malignancies.
References
Raciborska A., Pachuta B., Rogowska E.: Bone tumors in children and adolescents in pediatric practise, Klinika Chirurgii Onkologicznej Dzieci i Młodzieży. Instytut Matki i Dziecka, Standardy Medyczne. Pediatria. T. 13, nr 4 (2016), s. 711-717
Woźniak W.: Nowotwory kości, Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych - 2011 r. Tom II, Via Medica, dostęp online: https://www.sarcoma.pl/pliki/Zasady_leczenia/Miesakikoscimlodzi.pdf
Raciborska A., Klepacka T., Michalak E.; Standard diagnostic procedures in bone tumors in children and adolescents; Przegląd pediatryczny 2019 Vol. 48/No. 3/112-115
Anna Raciborska A., Rogowska E.: Guzy kości u dzieci i młodzieży – ważne informacje dla pediatry, Pediatria po Dyplomie 2015/04
Raciborska A, Bilska K, Drabko K, Chaber R, Sobol G, Pogorzała M, Wyrobek E, Połczyńska K, Rogowska E, Rodriguez-Galindo C, Wożniak W. Validation of a multi-modal treatment protocol for Ewing sarcoma--a report from the polish pediatric oncology group. Pediatr Blood Cancer. 2014 Dec;61(12):2170-4.
Casali PG, Bielack S, Abecassis N, Aro HT, Bauer S, Biagini R, Bonvalot S, Boukovinas I, Bovee JVMG, Brennan B, Brodowicz T, Broto JM, Brugières L, Buonadonna A, De Álava E, Dei Tos AP, Del Muro XG, Dileo P, Dhooge C, Eriksson M, Fagioli F, Fedenko A, Ferraresi V, Ferrari A, Ferrari S, Frezza AM, Gaspar N, Gasperoni S, Gelderblom H, Gil T, Grignani G, Gronchi A, Haas RL, Hassan B, Hecker-Nolting S, Hohenberger P, Issels R, Joensuu H, Jones RL, Judson I, Jutte P, Kaal S, Kager L, Kasper B, Kopeckova K, Krákorová DA, Ladenstein R, Le Cesne A, Lugowska I, Merimsky O, Montemurro M, Morland B, Pantaleo MA, Piana R, Picci P, Piperno-Neumann S, Pousa AL, Reichardt P, Robinson MH, Rutkowski P, Safwat AA, Schöffski P, Sleijfer S, Stacchiotti S, Strauss SJ, Sundby Hall K, Unk M, Van Coevorden F, van der Graaf WTA, Whelan J, Wardelmann E, Zaikova O, Blay JY; ESMO Guidelines Committee, PaedCan and ERN EURACAN. Bone sarcomas: ESMO-PaedCan-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018 Oct 1;29(Suppl 4):iv79-iv95. doi: 10.1093/annonc/mdy310. PMID: 30285218.
P. Picci, D. Vanel, A. Briccoli, K. Talle, U. Haakenaasen, C. Malaguti, C. Monti, C. Ferrari, G. Bacci, G. Saeter, T.A. Alvegard,: Computed tomography of pulmonary metastases from osteosarcoma: The less poor technique. A study of 51 patients with histological correlation, Annals of Oncology,Volume 12, Issue 11,2001, Pages 1601-1604, ISSN 0923-7534,https://doi.org/10.1023/A:1013103511633.
Meyer JS, Nadel HR, Marina N, Womer RB, Brown KL, Eary JF, Gorlick R, Grier HE, Randall RL, Lawlor ER, Lessnick SL, Schomberg PJ, Kailo MD.: Imaging guidelines for children with Ewing sarcoma and osteosarcoma: a report from the Children's Oncology Group Bone Tumor Committee. Pediatr Blood Cancer. 2008 Aug;51(2):163-70. doi: 10.1002/pbc.21596. PMID: 18454470.
Ferguson J.L., Turner S.P.: Bone Cancer: Diagnosis and Treatment Principles, Am Fam Physician. 2018;98(4):205-213
Miller RW, Boice JD Jr., Curtis RE. Bone cancer. In: Schottenfeld D, Fraumeni JF Jr., eds. Cancer Epidemiology and Prevention. 3rd ed. New York: Oxford University Press; 2006:946–958.
Pan KL, Chan WH, Chia YY. Initial symptoms and delayed diagnosis of osteosarcoma around the knee joint. J Orthop Surg (Hong Kong). 2010;18(1):55-57.
Widhe B, Widhe T. Initial symptoms and clinical features in osteosarcoma and Ewing sarcoma. J Bone Joint Surg Am. 2000;82(5):667-674.
Mankin HJ, Lange TA, Spanier SS. The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. J Bone Joint Surg Am. 1982 Oct;64(8):1121-7. PMID: 7130225.
van den Berg H, Slaar A, Kroon HM, Taminiau AH, Hogendoorn P. Results of diagnostic review in pediatric bone tumors and tumorlike lesions. J Pediatr Orthop. 2008 Jul-Aug;28(5):561-4. doi: 10.1097/BPO.0b013e31817bb800. PMID: 18580373.
Biazzo A, De Paolis M. Multidisciplinary approach to osteosarcoma. Acta Orthop Belg. 2016 Dec;82(4):690-698. PMID: 29182106.
Lanzkowsky P. Manual of pediatric hematology and oncology. 4th ed. Oxford, Elsevier 2005.
Wittig JC, Bickels J, Priebat D, Jelinek J, Kellar-Graney K, Shmookler B, Malawer MM. Osteosarcoma: a multidisciplinary approach to diagnosis and treatment. Am Fam Physician. 2002 Mar 15;65(6):1123-32. PMID: 11925089.
Özkan EA, Göret CC, Özdemir ZT, Yanık S, Doğan M, Gönültaş A, Akkoca AN. Pattern of primary tumors and tumor-like lesions of bone in children: retrospective survey of biopsy results. Int J Clin Exp Pathol. 2015 Sep 1;8(9):11543-8. PMID: 26617888; PMCID: PMC4637704.
Traoré O, Chban K, Hode AF, Diarra Y, Salam S, Ouzidane L. Intérêt de l’imagerie dans les tumeurs osseuses bénignes chez l’enfant [Interest of imaging in tumors benign bone in children]. Pan Afr Med J. 2016 Jun 30;24:179. French. doi: 10.11604/pamj.2016.24.179.9920. PMID: 27795776; PMCID: PMC5072874.
Lam Y. Bone Tumors: Benign Bone Tumors. FP Essent. 2020 Jun;493:11-21. PMID: 32573182.
Isakoff MS, Bielack SS, Meltzer P, Gorlick R. Osteosarcoma: Current Treatment and a Collaborative Pathway to Success. J Clin Oncol. 2015 Sep 20;33(27):3029-35. doi: 10.1200/JCO.2014.59.4895. Epub 2015 Aug 24. PMID: 26304877; PMCID: PMC4979196.
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Copyright (c) 2022 Anna Małek, Olga Wysokińska, Klara Iwaniszyn-Zapołoch, Karolina Zadrożna, Piotr Sidorczuk, Mateusz Fabiś, Bartłomiej Wójcik, Justyna Żyga, Katarzyna Klajda
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