Cancers of the musculoskeletal system

Abstract

Primary malignant tumours of bone are rare and comprise a large number of histological subtypes. The most common are osteosarcoma, Ewing’s family of tumours, and chondrosarcoma. Each of these has further subgroups which will be discussed in detail under their subheadings. The remaining subgroups are exceptionally rare and include the presentation of spindle cell sarcoma of bone, e.g. malignant fibrous histiocytoma (MFH), within the bone as a primary lesion. MFH of bone is treated as other primary bone tumours. Soft tissue sarcomas represent a rare collection of heterogeneous tumours characterized by malignant growth of mesenchymal tissue. Different subgroups can be divided by genetics, pathology, anatomical location, and clinical behaviour. Less than 1% of malignant tumours with an incidence of 30 per million per annum. Median age at presentation depends on histological subtype. For example, rhabdomyosarcomas are most common in children and adolescents, whereas leiomyosarcomas predominate over the age of 40. This chapter covers cancers of musculoskeletal system. Topics include bone tumours overview; osteosarcoma (metastatic, non-metastatic, and recurrent); Ewing’s sarcoma; rare bone tumours; soft tissue sarcomas (management of localized disease, and of locally advanced and metastatic disease); retroperitoneal sarcoma; gastrointestinal stromal tumours; and future directions.