Benign lesions form in a bone and can grow locally but do not spread to other organs to cause harm. Malignant lesions, more commonly referred to as cancer, are lesions which may form and develop in the bone but have the capacity to spread to other areas of the body and continue to grow.
It's rare that your provider will order blood or urine tests to diagnose a benign blood tumor. A bone tumor specialist will likely order a bone scan, CT scan, MRI scan or biopsy. The appropriate first step is an initial evaluation and X-rays. Your pediatrician or primary care provider can order these first tests.
Symptoms. A lump or swelling can be the first sign of a benign tumor. Another is ongoing or increasing aching or pain in the region of the tumor. Sometimes tumors are found only after a fracture occurs where the bone has been weakened by the growing tumor.
Blood tests, a biopsy, or imaging—like an X-ray—can determine if the tumor is benign or malignant.
The most reliable indicator in determining whether these lesions are benign or malignant is the zone of transition between the lesion and the adjacent normal bone (1).
Benign tumors tend to grow slowly and do not spread. Malignant tumors can grow rapidly, invade and destroy nearby normal tissues, and spread throughout the body.
Imaging is used not only for local staging but also to differentiate between benign and malignant lesions. MRI is the preferred imaging modality for the evaluation of soft-tissue masses in clinical practice.
There is no way to tell from symptoms alone if a tumor is benign or malignant. Often an MRI scan can reveal the tumor type, but in many cases, a biopsy is required.
Imaging tests, such as CT scans or MRIs, are helpful in detecting masses or irregular tissue, but they alone can't tell the difference between cancerous cells and cells that aren't cancerous. For most cancers, the only way to make a diagnosis is to perform a biopsy to collect cells for closer examination.
Lumps that could be cancer might be found by imaging tests or felt as lumps during a physical exam, but they still must be sampled and looked at under a microscope to find out what they really are. Not all lumps are cancer. In fact, most tumors are not cancer.
Bone cancer is rare, making up less than 1 percent of all cancers. In fact, noncancerous bone tumors are much more common than cancerous ones. The term "bone cancer" doesn't include cancers that begin elsewhere in the body and spread (metastasize) to the bone.
Giant cell tumour of bone
GCTs are usually benign (80%). However, recurrence after excision may occur in 20–50%, with 10% becoming malignant on recurrence [10].
Osteosarcoma (also called osteogenic sarcoma) is the most common primary bone cancer. It starts in an early form of bone cells. It most often occurs in young people between the ages of 10 and 30, but about 1 in 10 osteosarcomas develop in people older than 60.
They can feel firm or soft. Benign masses are more likely to be painful to the touch, such as with an abscess. Benign tumors also tend to grow more slowly, and many are smaller than 5 cm (2 inches) at their longest point.
Blood tests are not needed to diagnose bone cancer, but they may be helpful once a diagnosis is made. For example, high levels of chemicals in the blood such as alkaline phosphatase and lactate dehydrogenase (LDH) can suggest that the cancer may be more advanced.
Diagnosing a bone lesion and determining whether it is cancerous involves blood tests, CT and MRI imaging, followed by a biopsy if needed. For lesions that do not appear cancerous or destructive, serial images over time can be obtained and compared for changes, and biopsy is often unnecessary.
Ultrasound can usually help differentiate between benign and malignant tumours based on shape, location, and a number of other sonographic characteristics. If the ultrasound is inconclusive, your doctor may request follow-up ultrasound to monitor the tumor or a radiologist may recommend a biopsy.
Can a Radiologist See Breast Cancer from a Mammogram, Ultrasound, or MRI? While breast imaging techniques can find suspicious areas in your breast that may be cancer, they can't tell for sure if cancer is present. A breast biopsy is needed to confirm a diagnosis of cancer.
Non-cancerous tumors can also cause fatigue. Some grow large enough to damage organs or glands, causing their function to decline. Most pituitary adenomas (tumors) are non-cancerous.
Even benign tumors can be uncomfortable. If you feel or see a lump, visit an oncologist for an examination. If the doctor confirms that you have a malignant tumor, you will likely feel some uncertainty and fear. However, you can have peace of mind that the doctor will develop an effective treatment plan.
When a benign tumor requires treatment, it isn't too different from the treatment of a malignant or cancerous tumor. It may be radiation therapy, radiosurgery for benign tumors located in the skull base, surgery or chemotherapy.
MRI scan. An MRI scan uses a strong magnetic field and radio waves to produce detailed pictures of the bones and soft tissues. An MRI scan is an effective way of assessing the size and spread of any cancerous tumour in or around the bones.
Benign and malignant tumors are generally visible on an MRI. There are a few exceptions to what can be seen, such as growth rates, but the differences between them are typically consistent.
Magnetic resonance imaging is considered the modality of choice for evaluation of other benign musculoskeletal lesions because it is highly sensitive to changes in the signal intensity of bone marrow and adjacent soft tissues.