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Bone Sarcomas

Sarcomas are tumors that occur in bones or soft tissue, such as muscles, fat, and nerve tissue. Our doctors classify sarcomas according to the type of tissue in which they start. Primary bone sarcomas begin in the bones, while secondary tumors begin in a different part of the body and spread to the bones.

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Osteosarcoma is the most common type of bone cancer. Most osteosarcomas occur in children and young adults, though they can develop at any age.

There are three grades of osteosarcomas:

  • High-grade
  • Intermediate-grade
  • Low-grade

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High-Grade Osteosarcomas

There are three main types of high-grade osteosarcomas:

  • Intracortical osteosarcoma is the rarest type of osteosarcoma. We commonly find it in the arms or legs of patients who are 30 or younger.
  • High-grade surface osteosarcoma (juxtacortical high-grade) is the least common of surface osteosarcomas found in the legs or arms. We usually treat these tumors through surgery, as well as chemotherapy before and after surgery.
  • Telangiectatic osteosarcoma is a rare form of osteosarcoma most commonly found in patients who are 15 to 20.

Intermediate Osteosarcomas

The main type of intermediate osteosarcoma we treat is periosteal osteosarcoma (juxtacortical intermediate-grade). We most commonly find this type of sarcoma in the upper and lower parts of the leg.

Most patients with periosteal osteosarcoma are between the ages of 10 and 20. We usually treat these tumors with the same therapies as low-grade osteosarcomas.

Low Grade Osteosarcomas

There are three main types of low-grade osteosarcomas:

  • Conventional intramedullary osteosarcoma starts in the bones of the arms, legs, or pelvis. This type of sarcoma appears more often in males than females and in patients under 30.
  • Low grade intraosseous osteosarcoma is typically found around the knee. It only occurs in 1 percent to 2 percent of all osteosarcoma patients, usually in adults older than 20.
  • Parosteal osteosarcoma is typically found behind the knee. It is most commonly diagnosed in women who are between 20 and 40.


Chondrosarcoma is the second most common type of bone cancer. It begins in the cartilage and tends to become more common as patients age past 20.

There are many types of chondrosarcoma, including:

  • Clear-cell chondrosarcoma is most commonly found in the upper arms and legs. The prognosis for this type of cancer is typically better than for other chondrosarcomas.
  • Conventional chondrosarcoma is the most common type of chondrosarcoma and typically does not spread.
  • Dedifferentiated chondrosarcoma is a very aggressive form of bone cancer. Treatment can include surgery and chemotherapy.
  • Juxtacortical (periosteal) chondrosarcoma is found in the upper leg, upper arm, pelvis, or ribs. These types of tumors are most common in patients younger than 20.
  • Mesenchymal chondrosarcoma is found in the jaw, pelvis, spine, and shoulder blade. It is most common in adults 30 and older.
  • Secondary chondrosarcoma is a rare type of bone cancer. This type of cancer can be difficult to diagnose, although it has a high survival rate.

Ewing Sarcoma and Other Types of Bone Sarcomas

Our doctors have a vast amount of expertise in the treatment of many other forms of bone sarcoma in addition to osteosarcomas. These types of tumors include:

  • Adamantinoma is a rare form of bone cancer that we most often find in the shinbone. This type of sarcoma can affect anyone, although it occurs most frequently in younger men between the ages of 20 and 35.
  • Chordoma is a rare type of cancer occurring in the bones at the base of the skull and spine, usually in the sacrum or area where the two hipbones of the pelvis meet.
  • Ewing tumor is the third most common type of bone cancer. Also known as Ewing’s sarcoma, this sarcoma can either begin in the bones or in the soft tissue. Ewing tumors occur most often in children and teens.
  • Fibrosarcoma of bone is a rare cancer that is most common in the legs or trunk of the body. It can affect patients of all ages.
  • Lymphoma of bone is very rare, occurring in only 3 percent of cancerous bone tumors. It is most common in patients over age 30, affecting more men than women.
  • Malignant fibrous histiocytoma (MFH) of bone is a rare type of tumor that typically affects adults in their 50s. Treatment can include surgery and radiation therapy.
  • Myeloma is a cancer of the plasma cells in the bone marrow. This tumor type most commonly affects patients older than 65.
  • Paget’s sarcoma is a rare type of bone cancer that occurs in older patients with extensive Paget’s disease, a chronic disease that involves the deterioration of bone tissue in the spine, skull, or pelvis.
  • Primitive neuroectodermal tumor (PNET) is a rare, malignant tumor that forms from early nerve cells. PNET is most common in children and young adults. We typically find PNET in the brain’s cerebrum, and it is among the most aggressive kind of tumors found in children.

Our Locations

Orthopedic 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 Dr., Ste. 2200
Baltimore, MD 21237

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