A bone lesion is an anomaly in the growth or structure of a bone. Bone lesions can occur in any part of the body, although they are more common in long bones, primarily those in the arms and legs. Bone lesions can also occur at any age, although they are far more common in the rapidly growing bones of children and young adults. Bone lesions may be cancerous or non-cancerous, and methods of treatment vary based on the aggressiveness and type of lesion.
According to Bonetumor.org, "Lesion is a generic term for an abnormality in bone." Bone lesions can be caused by a variety of factors including growth variations, infections, bone injuries, overuse of bones, cysts or tumors. Doctors often use the term "lesion" at the beginning of the diagnostic process, as it is a non-committal, general word that can refer to many bone phenomena. Bone lesions can be small or large and can be found on the surface of the bone or embedded inside.
Many bone lesions are actually bone tumors. When people hear the word "tumor," they automatically think of cancer. But many bone lesions or tumors are not cancerous. Tumors in the bone are often benign, or non-cancerous. While they can still damage the bones, these tumors are not life threatening. A diagnosis of a bone lesion does not necessarily mean a diagnosis of cancer.
The British Institute of Radiology classifies bone lesions in three basic categories: malignant (cancerous), benign (non-cancerous) and non-neoplastic (general bone cysts). The malignant and benign classifications are further divided into tumor types. Among the most common types of malignant bone lesions are osteosarcoma, Ewing's sarcoma, chondrosarcoma, fibrosarcoma, malignant fibrous histiocytoma (MFH) and chordoma. The most common types of benign bone lesions are osteoid osteoma, osteoblastoma, osteochondroma, enchrondroma, chrondromyxoid fibroma and giant cell tumor (which may become malignant).
Bone lesions are usually first diagnosed with X-ray. X-rays can show the pattern of bone destruction, the size and shape of the bone lesion and the exact location. A series of X-rays also demonstrates the growth rate, indicating whether the bone lesion is slow-growing or aggressive (fast growing). In addition to X-rays, which are often just the first step in the diagnostic process, doctors also use CT scans, isotope bone scans, MRIs and PET scans to evaluate bone lesions.
Treatment of bone lesions depends on the exact diagnosis. Malignant bone lesions are often treated with radiation, chemotherapy or a combination of both. Some benign and non-neoplastic bone lesions require no treatment at all. For larger lesions of all types, or for aggressive lesions that are destroying bones, open or laparoscopic surgery is a common treatment option.