Primary malignant tumours of the bone

Primary bone tumours are rare, with a prevalence of approximately 550 cases per year in the UK. Late presentation and identification of tumours delays diagnosis and negatively impacts on the survival of these patients. Characteristic clinical and radiological features of bone tumours should alert the physician to investigate further. Investigations should include blood tests and local and systemic imaging. MRI, CT and isotope bone scans are important in evaluating the tumour. The most common types of bone tumour are osteosarcoma, chondrosarcoma, Ewing sarcoma, spindle cell sarcoma of bone and chordoma. The important pathological features and treatment of each type of tumour are described in this article. Early contact with a supra-regional bone tumour unit is mandatory when a bone tumour is suspected, where a multidisciplinary approach to management is employed. Biopsy and surgical treatment should be carried out in these units wherever possible. Patients should be enrolled in international clinical trials, where feasible, to gather data that will ultimately improve outcomes. The survival rates from most bone tumours are 60–80% with appropriate treatment.