The word “tumor” makes us think of something scary or harmful. However, not all tumors are harmful. In fact, many tumors are benign, meaning they are non-cancerous and generally do not pose serious health risks. One such category is benign bone tumors. Although they can vary in size and location, they generally do not spread or cause significant harm to surrounding tissues. Among the different types of benign bone tumors, osteochondroma is the most common.
Osteochondroma arises in people less than 30 years old. They affect males more often than females and are often triggered by hormones that stimulate growth. They represent 20–50% of benign tumors and 10–15% of all tumors in general.
What is an Osteochondroma?
An osteochondroma is a type of benign tumor that develops on the surface of a bone. It is made up of both bone and cartilage, hence the name oste (bone) and chondroma (cartilage). Osteochondromas are most commonly seen during childhood and adolescence when the bones are still growing.
Osteochondromas are most commonly diagnosed in children and young adults, particularly those aged 10 to 20 years. They are more prevalent in males than females. While they can occur in anyone, certain genetic conditions, such as hereditary multiple exostoses (HME), can increase the likelihood of developing osteochondromas.
Osteochondromas arise from the growth plate (epiphyseal plate), where new bone is formed. As a person grows, this area can sometimes produce abnormal growth, resulting in an osteochondroma. The exact cause of this abnormal growth is not fully understood, but it is believed to be related to genetic factors.
What Are the Different Types of Osteochondroma?
Osteochondromas can appear in the following two main ways:
Solitary Osteochondroma (Single Growth)
Solitary osteochondroma is the most common type. It usually does not cause any symptoms and is often discovered by chance during imaging for another issue. These do not spread to other parts of the body, are non-cancerous, and may be inherited.
Solitary osteochondromas rarely need treatment unless they press on nearby tissues, nerves, or blood vessels, which could cause pain or other issues. In such cases, surgery to remove the tumor might be necessary. While the risk of an osteochondroma turning cancerous is very low (about 1%), your doctor may still monitor it over time.
Multiple Osteochondromas (Multiple Growth)
Multiple osteochondromas occur in about 15% of cases and usually result from a genetic condition HME. In some cases, multiple osteochondromas can occur randomly. Although they are non-cancerous, they can interfere with bone growth, especially in children.
While they may only change appearance, they can sometimes cause pain or limit movement. These cases need closer monitoring, as having multiple osteochondromas may increase the risk of cancer.
What are the Characteristics of Osteochondromas?
The characteristics of osteochondromas include the following:
- Their shape often resembles a small bump or a mushroom, growing outward from the bone.
- They can vary in size from a few centimeters to several inches, but most are relatively small.
- Osteochondromas most commonly occur near the ends of long bones, particularly around the knee (the femur and tibia) and the shoulder (the humerus). They can also appear in the pelvis, ribs, and other bones.
What are the Symptoms of Osteochondromas?
Most people with osteochondromas are asymptomatic, and many are unaware they have a tumor. If symptoms do present, they may include the following:
- A noticeable lump or bump near a joint or bone, often in the knee or shoulder area.
- Some individuals may experience pain, especially if the tumor presses against nearby nerves, blood vessels, or muscles.
- If the osteochondroma is very close to one of the joints, it can restrict mobility or occasionally cause pain during movement.
- In rare cases, osteochondromas can weaken the bone structure, leading to fractures.
If you ever get these bumps anywhere on your body or find yourself with persistent pain, consult your doctor for proper assessment.
How Are Osteochondromas Diagnosed?
Diagnosing an osteochondroma typically involves several steps:
Medical History
The doctor will take your medical history and record any symptoms you may be experiencing.
Physical Examination
Your doctor will perform a physical exam to identify lumps or swelling.
Imaging Tests
Your doctor may order the following imaging tests to identify the issue more accurately:
- X-rays help visualize the tumor. They can show the size and shape of the osteochondroma and its relationship to the surrounding bone.
- In cases where the X-ray cannot provide a clear result, doctors will opt for MRI or CT scans. These help determine tumor size along with its impact on other structures nearby.
Biopsy
In rare cases, if there is any doubt about the tumor’s nature, a biopsy may be performed to confirm if it is benign.
What Treatment Options Are Available for Osteochondromas?
If the osteochondroma is small and does not cause any pain or any other issue, then doctors would generally advise watchful waiting. They will monitor for changes in the tumor after conducting regular follow-ups and imaging tests.
In most cases, osteochondromas do not require treatment unless they cause symptoms. Some of the common treatment options include the following:
Surgery
If the osteochondroma causes much pain, restricts motion, or produces other complications, you will need surgery. Surgery includes:
- Removal of the tumor without any damage to surrounding bone and tissue
- Recovery from the surgery and return to normal activities within a few weeks
Physical Therapy
After surgery, you might need physical therapy to help restore strength and mobility to the affected area. This can include exercises to improve range of motion and strength.
While osteochondromas are benign, there is a small risk that they can transform into malignant tumors, particularly in individuals with HME. Regular check-ups with your doctor are essential to monitor for any changes in the tumor or the development of new symptoms.
Conclusion
Osteochondromas are the most common benign bone tumors, primarily affecting children and young adults. Usually they are harmless and require no treatment. However, if you notice any unusual lumps or experience persistent pain, immediately consult your doctor. Early detection and monitoring can help ensure that any potential issues are addressed promptly.
By staying informed and proactive about your health, you can make informed decisions about your well-being. Remember, while tumors can sound frightening, many are manageable and not a cause for alarm.
FAQs
Should benign bone tumors be removed?
Not all benign bone tumors require removal. If they are asymptomatic, non-growing, and not causing harm, observation may be sufficient. However, if they cause pain, limit mobility, or have the potential for complications, surgical removal may be recommended.
How do you know if a bone tumor is benign or malignant?
To determine whether a bone tumor is benign or malignant, doctors typically rely on imaging tests like X-rays, CT scans, or MRIs. A biopsy may also be conducted for a definitive diagnosis if the tumor’s characteristics are unclear.
What is a benign tumor of the bone called?
A benign tumor of the bone is called an osteoma, osteochondroma, osteoid osteoma, or other specific names depending on the type of tissue involved. These tumors are non-cancerous and generally do not spread.
Can an MRI tell if a bone lesion is benign?
An MRI can provide detailed images of a bone lesion’s size, shape, and characteristics. It helps differentiate between benign and malignant tumors. However, it may not always be conclusive, and a biopsy might be needed for further confirmation.
How do you treat a benign tumor?
Treatment for a benign tumor depends on its size and symptoms. If it is asymptomatic, it may just be monitored, but if it causes pain or functional issues, surgical removal is often recommended. In some cases, medications like pain relievers may also be used to manage symptoms.