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Orthopaedic Cancer

albert aboulafia orthopaedic oncologist medstar baltimore

Albert Aboulaifa, MD, orthopaedic cancer specialist and medical director of The Harry and Jeanette Weinberg Cancer Institute at MedStar Franklin Square, talks with a patient

Orthopaedic cancers start in or travel to bone, muscle, or soft tissue. MedStar Health orthopaedic oncologists are leaders in the surgical advances and innovations to treat this type of cancer, including limb-sparing surgery, a modern technique that can save an affected arm or leg and avoid amputation. 

At The National Center for Bone and Soft Tissue Tumors at MedStar Franklin Square Medical Center, we offer a comprehensive approach to treating these rare tumors, incorporating every resource we have to ensure our patients receive the best treatment available. Working with patients, their families, and referring physicians, our dedicated specialists provide expert guidance and support throughout the diagnosis and treatment process. Because of our experience, we frequently perform complex and revision surgeries referred from other medical centers in the country.

In addition to our advanced and compassionate clinical care, we have a highly successful, accredited fellowship training program and educate students and residents with an emphasis on our surgical services and research.

Learn more about orthopaedic cancer, including: 

Meet Albert Aboulaifa, MD, orthopaedic cancer specialist and medical director of The Harry and Jeanette Weinberg Cancer Institute at MedStar Franklin Square, in the video below:

Types of Orthopaedic Cancer

Benign Orthopaedic Tumors

Benign orthopaedic tumors put pressure on healthy tissue but do not spread. They pose minimal risks and are considered non-cancerous. Some childhood benign tumors, such as bone cysts, may fully resolve over time as the bone matures with age.

Other benign bone tumors are considered more aggressive and require additional care. These include:

  • Giant cell tumors occur around the knee or the ends of long bones and can quickly damage the bone. These tumors tend to affect young adults.
  • Chondroblastomas occur at the very ends of the long bones in the arms or legs and can damage the growth plate or joint surfaces. These tend to occur in children.
  • Aneurysmal bone cysts cause the bones in the arms, legs, trunk, or skull to expand dramatically. These tumors tend to affect children and younger adults and can damage bone and often grow back.
  • Osteoid osteomas may occur anywhere in any bone and are typically extremely painful, due to chemicals released by the tumor into the the surrounding nerves.

Treatment

Giant cell tumors, chondroblastomas and aneurismal bone cysts are often treated with the same therapy, including a combination of:

  • Curettage, where the tumor or cyst is scraped out during a surgical procedure
  • Cryosurgery, where the tumor or cyst is frozen with liquid nitrogen and destroyed
  • Reconstruction, where the remaining bone is repaired with metal rods, cement and bone graft

Osteoid osteoma is often treated with:

  • Surgery
  • Radiofrequency ablation

Sarcomas

Sarcomas are tumors that occur in bones or soft tissue such as muscles, fat, and nervous tissue, and are distinguished by the type of tissue from which they originate.

Bone Sarcomas

  • Primary tumors originate in the bones (less common than many other cancers that spread, or metastasize, to bone)
  • Secondary tumors begin in a different part of the body and spread to the bones. Primary bone tumors are.

Common bone sarcomas include:

  • Osteosarcoma, which forms osteoid or hard bone tissue, is the most common form of bone sarcoma, found in about 35 percent of cases. While it may occur at any age, it tends to affect children in late adolescence and appears most commonly around the knee.
  • Chondrosarcoma, which forms cartilage tissue, is found in about 30 percent of cases. It tends to affect adults older than 40, and appears in the hip, pelvic, and shoulder areas.
  • Ewing's Sarcoma, which develops in the lungs, bone or the pelvis, arises from cells of unknown origin. It tends to affect children younger than age 19, and appears in the legs and arms. It is more common in boys than girls.

Risk Factors

Certain conditions, as well as exposure to certain chemicals, put people at higher risk for developing bone sarcomas, particularly osteosarcoma. These include:

  • Hereditary conditions, including a rare childhood eye cancer called hereditary retinoblastoma, and hereditary bone diseases, such as enchondromatosis and osteochondromatosis
  • Prior radiation exposure
  • Treatment with anti-cancer medications

Symptoms

As a sarcoma begins to develop, there may be no noticeable symptoms. However, over time, patients may feel:

  • Persistent pain
  • Swelling
  • A bump or mass where the tumor is located

Diagnosis and Treatment

Your doctor can detect the presence of a bone sarcoma in the following ways:

  • History and physical examination: This includes feeling and looking at the area of pain, as well as gathering information about family medical history.
  • Imaging tests help to determine a tumor's size, shape, location and whether a tumor is benign or malignant. Imaging tests include:
    • X-rays, CT and PET scans, and MRI
    • Angiogram: creates a picture of the interior of the blood vessels
    • Bone scan: a doctor injects and then tracks a radioactive substance through the blood. A scanner can detect the substance's route once it settles in the bones.
  • Blood work: tests for levels of alkaline phosphatase. This chemical in the blood may be higher than normal because of tumor growth in the bone tissue.
  • Biopsy: your doctor collects a tissue sample from the affected area to identify the exact type of tumor

After examining the results of one or more of these tests, your doctor will tell you if you have a bone sarcoma and will always answer any questions you have. MedStar Health also has compassionate patient support services for newly diagnosed patients.

Many patients will have success from a combination of treatment types. Each patient undergoes a thorough evaluation to determine the most effective course of treatment, which include

Soft Tissue Sarcomas

Soft tissue sarcomas are rare cancerous tumors that can grow in muscle, fat, nerves, and blood vessels, and they are distinguished by where in the body they originate. About half of all soft tissue sarcomas affect the arms and legs, while the rest appear in the head, neck, or trunk. Regardless of where they begin to grow, soft tissue sarcomas tend to present with similar characteristics and symptoms, and are treated the same way.

Types

  • Fibrosarcoma: Develops from the tissues keeping bones, organs, and muscles secure and appears most often in the legs, arms, and trunk.
  • Hemangiosarcoma: Develops from the blood vessels in the arms, legs, head and trunk.
  • Leiomyosarcoma: Develops from smooth muscles used to control the movement of internal organs and blood vessels. These tumors tend to affect adults.
  • Liposarcoma: Develops from fatty tissues, and appears most often in the legs and trunk.
  • Lymphangiosarcoma: Develops from the lymph vessels, and appears in the arms. It tends to affect tissues that may have been exposed to radiation.
  • Malignant fibrous histiocytoma: Develops within muscle or fat, most often in the thighs and trunk. It tends to affect older adults.
  • Neurofibrosarcoma: Develops from nerves, and appears most often in the legs, arms and trunk.
  • Rhabdomyosarcoma: Develops from skeletal muscles used to move bones. It tends to affect young children, and appears most often in the arms and legs.
  • Synovial sarcoma: Develops from tissues that cushion the joints, such as knees and elbows. It tends to affect children and adolescents.

Risk Factors

Certain conditions, as well as exposure to certain chemicals, put people at higher risk for developing soft tissue sarcomas. These include:

  • Hereditary conditions, including a rare childhood eye cancer called inherited retinoblastoma, Li-Fraumeni syndrome, Gardner's syndrome, and a nerve tissue disorder called neurofibromatosis.
  • Radiation exposure, specifically when used to treat other cancer types.
  • High dose chemical exposure to
    • Vinyl chloride, an ingredient in plastic
    • Phenoxyacetic acid, an ingredient in certain herbicides
    • Chlorophenols, an ingredient in wood preservatives
    • Arsenic

Symptoms

As the soft tissue sarcoma develops, patients may feel a lump. These sarcomas often do not cause pain or swelling, so it is important to have a doctor examine any lump that lasts a long time.

Diagnosis and Treatment

Your doctor can detect the presence of a soft tissue sarcoma in the following ways:

  • History and physical examination: This includes palpating (feeling) the tumor mass. as well as gathering information about family medical history.
  • Imaging tests help to determine a tumor's size, shape, location and whether a tumor is benign or malignant. Imaging tests include X-rays, CT and PET scans, and MRI

After examining the results of one or more of these tests, your doctor will tell you if you have a bone sarcoma and will always answer any questions you have. MedStar Health also has compassionate patient support services for newly diagnosed patients.

Many patients will have success from a combination of treatment types. Each patient undergoes a thorough evaluation to determine the most effective course of treatment, which include

Learn more about orthopaedic cancer treatment.

Location Information

For a physician referral, please call 1-877-715-HOPE.

Our Locations

Orthopaedic Cancer at MedStar Franklin Square Medical Center
The Harry and Jeanette Weinberg Cancer Institute
The National Center for Bone and Soft Tissue Tumors
9103 Franklin Square Drive
Suite 2200
Baltimore, MD 21237

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