Bone Tumors In Children

Is your child experiencing pain in localized areas of the lower extremity? Have you noticed any abnormal growths or physical changes within their legs or feet? If so, than your child may be exhibiting the characteristics of having a Bone Tumor. However, before you begin to worry about cancer and other problems associated with tumors, it is important to understand that NOT all tumors are cancerous. Tumors are classified as an uncontrollable growth of cells within a tissue that usually develop into an abnormal protruding lump. More specifically, when this uncontrollable mass of dividing cells arises within parts of the skeleton, such as the bones of the leg and foot, it is known as a Bone Tumor.

There are two general classifications of tumor types, which are:

  • Benign Tumors – These are non-cancerous masses, which do not spread from their original sites to any other parts of the body.
  • Malignant Tumors – These are the more dangerous masses, which are considered cancerous. The dangerous component of malignant tumors is the spread of uncontrollable dividing cells to other parts of the body, this is known as Metastasis.

The most common group of tumors that arise within the skeleton of children between the ages of 6-12 are Benign Bone Tumors.

There are three main types of Benign Bone Tumors that often appear in children, which are:

  • Osteochondromas – This is the most common benign tumor of the foot and is usually located under the toenail. The tumor may cause deformities to the toenail, such as an ingrown toenail or irritation to the surrounding tissue, but are not typically painful. This type of tumor growth also appears in the metaphysis of long bones such as the Femur and Tibia in children.
  • Unicameral Bone Cysts – This is a different type of tumor that forms from the presence of excess tissue and fluid, which fills a hole in the bone.  This type of tumor is usually found after fracturing a long bone, such as the tibia and upper portion of the femur.
  • Nonossifying Fibromas – This type of tumor growth appears in actively growing sections of long bones, such as an actively growing section of the femur or tibia.

Benign Bone tumors are usually asymptomatic and rarely need surgery because they go away on their own. However, these tumors could put your child at a greater risk of injury or growth problems from the resulting weak spot in the bone. Also, benign tumors should be monitored just in case the growth becomes too large and causes pain or pinches any surrounding nerves.          

There are two main types of Malignant Bone Tumors that often appear in children, which are:

  • Osteosarcomas – This is the most common malignant bone tumor in children and young teens. These malignant tumors arise from mesenchymal cells, which are responsible for the formation of bone. Therefore, these tumors primarily affect immature bone, such as the rapidly growing metaphyseal regions of bones in children.
  • Ewing Sarcomas – This is the second most common malignant bone tumor in children and young teens. These tumors tend to be very aggressive and arise from neuroectodermal cells that affect the metaphyseal regions of bones in the lower extremity of children.

Malignant Bone Tumors are cancerous tumors called Sarcomas, which are less common in children. However, these tumors are dangerous because over time, the cancerous cells of these tumors find their way into the blood and can spread to vital organs, such as the lungs. These cancerous cells can destroy the limb of the tumors location and can be life threatening when they spread to other parts of the body.

The key symptom for both Osteosarcomas and Ewing Sarcomas is the presence of pain at the affected site. Swelling and weight loss are other key findings in Ewing Sarcomas. Regardless of the severity of symptoms associated with malignant tumors, it is your responsibility to take action because these cancerous cells can spread to your child’s vital organs and cause serious damage or even worse, death.

Therefore, if your child is complaining about pain in a localized region of their bone or you notice an abnormal lump on their limb then it is crucial that you contact your podiatrist as soon as possible. Bone tumors can be extremely challenging to find and diagnose correctly, so your podiatrist may use multiple imaging tests in combination with assessing the tumors location and your child’s age to determine the best course of action. An accurate, early diagnosis and treatment plan significantly enhances the success rate for treating malignant bone tumors.




Dr. Shine John, DPM, FACFAS
Podiatric Physician, Surgeon, Specialist at Austin Foot and Ankle Specialists