Types of Bone Cancer and Soft Tissue Sarcoma

Your bones and soft tissue can develop cancer, like any other body organ. Cancer occurs when cells develop mistakes, or mutations, in their DNA, which make cells grow and multiply out of control. Cancer in your soft tissues is called soft tissue sarcoma.

Tumors can be malignant (cancerous) or benign (noncancerous).

The orthopedic cancer specialists at Henry Ford Cancer are experienced in diagnosing and treating all types and stages of cancer affecting bones and soft tissue.

Types of malignant bone tumors

Doctors classify bone cancers based on the type of cell where the cancer began. We see and treat all types of bone cancer. Some of the most common types are:

• Osteosarcoma: Cancer that grows in the cells that make up your bones, usually developing in legs or arms, and sometimes outside of bones (extraskeletal osteosarcomas)
• Chondrosarcoma: Cancer that forms in cells that produce cartilage (a flexible tissue covering the ends of bones) and usually affects the pelvis, legs or arms
• Ewing sarcoma: Tumors that usually develop in the pelvis, legs or arms of children and young adults
• Multiple myeloma: Cancer that forms in a type of white blood cell in the bone marrow called a plasma cell

Metastatic cancer in the bones

Metastatic cancer is also called stage 4 cancer or advanced cancer. It happens when cancer cells spread from the original tumor to other areas in the body, which can include the bones.

Types of benign bone tumors

Benign tumors are noncancerous and don’t spread to other areas of the body unless they become malignant (cancerous). Yet some benign tumors can destroy bone and surrounding tissue over time and may need to be removed with surgery. These tumors include:

• Aneurysmal bone cyst (ABC): Cysts filled with blood that expand bone, causing pain, swelling and fractures
• Chondroblastoma: Rare tumors that grow at the ends of the body's long bones, usually the thighbone, shinbone or upper arm bone
• Chondromyxoid fibroma (CMF): Tumors that grow in cartilage-forming tissue found in bone marrow, usually in the shinbone, thighbone, foot or pelvis
• Enchondroma: Tumors that begin in cartilage, often affecting the hands and feet, and sometimes the thighbone, upper arm bone or lower leg bone
• Fibrous dysplasia: Fibrous tissue that replaces normal bone and marrow, causing bones to hurt and lose function
• Giant cell tumor: Rare, aggressive tumors made of fused cells that look "giant" under a microscope, usually affecting the thighbone or shinbone
• Osteoblastoma: Rare tumors that break down healthy bone and form a new bone material (osteoid), putting the surrounding area at risk of fracture
• Osteoid osteoma: A type of tumor like osteoblastoma, but small and limited in spread
• Osteochondroma: Overgrown cartilage and bone that affects the ends of bones near growth plates, often in the leg, pelvis or shoulder blade. It is the most common benign bone tumor and typically affects children and young adults.
• Unicameral bone cyst (UBC): A common condition in children in which a space in the bone fills with fluid, usually affecting long bones near a joint and growth plate (near the knee, hip or shoulder)

A benign bone tumor may not require treatment unless it affects the bone’s function or movement. We monitor benign tumors with X-rays to make sure they don’t get bigger, spread or become malignant.

Types of soft tissue sarcoma

There are many types of soft tissue sarcomas (cancer). Sarcomas are typically named according to the tissue cells the cancer developed in. The most common types of soft tissue sarcoma and where they grow include:

• Angiosarcoma: Blood vessel linings
• Leiomyosarcoma: Smooth muscle tissue, usually in the abdomen, including the uterus and blood vessels
• Liposarcoma: Fat cells
• Rhabdomyosarcoma: Smooth muscle tissue, usually skeletal muscle tissue but sometimes organs such as the bladder or uterus (most common among children)
• Synovial sarcoma: Soft tissue, such as muscle or ligaments in the arm, leg or foot, near joints such as the wrist or ankle, or in soft tissues in the lung or abdomen
• Undifferentiated (pleomorphic sarcoma): Soft tissue, usually in the arms or legs, and sometimes behind abdominal organs

Joint lesions

Joint lesions grow in or around the cartilage capsules of joints such as the wrist, elbow, shoulder, hip, knee or foot. As these lesions press against joints, they cause pain during movement. This pain subsides when the joint is at rest.

Types of benign joint lesions include:

• Pigmented villonodular synovitis (PVNS): A progressive condition, usually affecting the knee, that causes the joint lining (synovium) to overgrow, causing bone damage and arthritis
• Synovial chondromatosis: A rare condition, usually affecting the knee, in which the synovium grows improperly and produces cartilage nodules that can damage the inside of the joint
• Tenosynovial giant cell tumor: Rare tumors that cause the affected synovium, fluid-filled sacs (bursae) or tendon sheaths to overgrow, damaging surrounding tissue and structures

Signs and symptoms of bone cancer and soft tissue sarcoma

Detecting cancer early helps us treat it successfully. If you experience any of these signs, see a doctor. These symptoms don’t necessarily indicate cancer, but it’s important to get an accurate diagnosis.

• Lumps: A lump may be painless at first but can grow more painful as it becomes bigger and presses against nerves and muscles.
• Pain: Soreness in the affected bone or soft tissue area starts when you use or move the affected area and worsens as cancer progresses. Bone cancer on or near a fracture can cause sudden pain instead of soreness.
• Swelling: Swelling can signal that a tumor is present, but detecting swelling can be difficult depending on the tumor’s location.

Risk factors for bone cancer

Most people with bone cancer don’t have any apparent risk factors. A few known risk factors include:

• Bone marrow transplant: Receiving a transplant can slightly increase your risk of developing osteosarcoma.
• Genetic disorders: Some inherited diseases can put you at higher risk for bone cancer.
• Paget disease: This condition causes bone tissue to form improperly. Bone cancer develops in about 1 percent of patients with Paget disease.
• Radiation: Having high doses of radiation exposure, such as radiation therapy for previous cancer treatment, can increase your risk for bone cancer.

Risk factors for soft tissue sarcoma

Like bone cancer, most people who develop soft tissue sarcoma don’t have any risk factors. A few of the known risk factors include:

• Damaged lymph system: Lymph nodes are small collections of immune system cells. Radiation therapy can remove or damage lymph nodes, causing swelling (lymphedema). Lymphangiosarcoma, a type of soft tissue sarcoma, is a rare complication of chronic lymphedema.
• Radiation: People who had high doses of radiation exposure, such as radiation therapy for previous cancer treatment, are at higher risk for soft tissue sarcoma.
• Chemicals: Some chemicals, such as dioxin and high doses of herbicides that contain phenoxyacetic acid, may also be risk factors.