Benign Tumors

What is a Benign Tumor?

Benign tumors are tumors which do not spread to other parts of the body. These tumors are NOT cancer. Benign tumors of bone and soft tissue can occur at any age and in any location, although most tumors have a preference for a particular age group or a particular location. These types of lesions may be painful, or may have no symptoms associated with them at all.

In many cases, they are known as “incidental findings,” meaning they are discovered because of another source of pain. Orthopedic Oncologists are trained to recognize lesions based on imaging and to determine which lesions need treatment and which ones do not.

How do I treat my Benign Tumor?

Some benign tumor do not require treatment. For tumors that do not require treatment, observation over time is usually performed by the doctor with imaging to make sure the lesion is not changing over time, which could change the treatment plan. In many cases, your orthopedic oncologist will try to determine what the real source of pain is, which may be due to more routine conditions like trochanteric bursitis of the hip, or rotator cuff tendinitis of the shoulder, and will treat those conditions to ensure that the lesion is not responsible for the pain.

Other benign tumors will require treatment. For tumors that do require treatment, your orthopedic oncologist will determine if the best treatment is surgical or non-surgical. Some bone lesions can be treated with non-surgical means such as Radiofrquency ablation (RF Ablation) or other minimally invasive techniques. These procedures are usually performed by another type of specialist that your orthopedic oncologist will refer you to. For surgical treatments, your orthopedic oncologist will discuss the operation required, what the expected outcome is, and what the rehabilitation plan is. It is also important to understand that some tumors, even if treated appropriately the first time, may have a tendency to come back. For this reason you may be presented with a long term follow up plan including doctor visits and imaging to make sure there is no sign of recurrence over time.

Are Benign Tumors Common?

Most benign soft tissue tumors are rare, with the exception of the lipoma, or benign fatty mass. These are extremely common. Many benign soft tissue tumors do not require any treatment. Some may be followed with imaging. In general, Magnetic Resonance Imaging, or MRI, is the best way to image a soft tissue tumor. Your doctor will talk with you about the details of your tumor and what exactly is required.

Some tumors, either bone or soft tissue, are referred to as “benign but locally aggressive”. This is an “in-between category” which falls between non-cancerous and cancerous tumors. Examples of these types of tumors are desmoid tumor, or atypical lipomatous tumor in the soft tissue, or Giant Cell Tumor of Bone in the bones. Although the majority of these tumors generally do not spread to other parts of the body, they do have high recurrence rates, and can cause damage if not removed. These tumors can be serious and even life or limb threatening in the worst cases. Even after removal, you will be carefully monitored for any sign of recurrence usually with a doctor’s visit and imaging at routine intervals. It is somewhat misleading to call these tumors “benign,” since they are not cancer, which is why the separate category of “benign but locally aggressive” was created to better describe their behavior.

I Have a Benign Tumor. Now What?

Understanding the correct management of benign bone and soft tissue tumors of the extremities involves reading the imaging, including (Xray, CT scan, and MRI) and recognizing the characteristic features of each lesion. In many cases, given the rarity of many extremity lesions, the orthopaedic oncologist may even be more familiar with the imaging than the radiologist. For this reason, it is important to rely on the full evaluation of the orthopedic oncologist for any extremity lesion.

In some cases, a mass is caused by something other than a growth of abnormal cells. Examples can be reactive changes in a limb from trauma, or deposition of material into the tissues by a medical condition. These are called “tumor mimics” or “tumor-like conditions” and usually don’t require surgery, but may require treatment of the underlying condition.

A biopsy is not always required. In many cases, a biopsy is not the best choice and in some cases it is actually incorrect to perform a biopsy. If not done properly, a biopsy may do more harm than good. In some cases, a biopsy will be needed, and that decision is best made by the orthopedic oncologist. Proper treatment requires familiarity with the appearance of each tumor on a slide, and your doctor will work with a specialty pathologist to come to the appropriate diagnosis.

Dr. John A. Abraham understands Benign Tumors

Dr. Abraham is specially trained from the top bone and soft tissue tumor centers in the country to identify, diagnose, treat, and follow these tumors. He has consistently been rated as a Top Doctor in the area for orthopedic oncology and joint replacement, and has been ranked the #1 orthopedic oncologist in the Philadelphia area by Main Line Today Magazine. We look forward to helping you manage your orthopedic oncology diagnosis.

Call (267)715-0700 to make an appointment.

Benign Bone Tumors

Aneurysmal Bone Cyst (ABC)
Bone Island (also called enostosis)
Chondroblastoma
Chondromyxoid fibroma
Enchondroma
Enchondromatosis (Ollier Disease, Mafucci Syndrome)
Eosinophilic granuloma
Fibrous dysplasia
Melorheostosis
Non-Ossifying Fibroma
Osteoblastoma
Osteochondroma
Osteoid Osteoma

Benign Soft Tissue Tumors

Elastofibroma
Fibroma
Fibrous histiocytoma
Glomus tumor
Granular cell tumor
Hemangioma
Benign Hemangioendothelioma
Hemangiopericytoma
Hibernoma
Leiomyoma
Lipoma
Lymphangioma
Myxoma
Neurofibroma
Rhabdomyoma
Schwannoma (Neurilemmoma)
Xanthoma

Gouty tophi
Heterotopic ossification
Myositis Ossificans
Nodular fasciitis
Rheumatoid nodules

Benign but Locally Advanced Tumors, or Rarely Metastasizing Tumors

Atypical Lipomatous Tumor (ALT)
Desmoid tumor (desmoid fibromatosis, aggressive fibromatosis)
Desmoplastic fibroma of bone
Giant Cell Tumor of bone
Tenosynovial Giant Cell Tumor, TGCT) [formerly known as Pigmented Villonodular synovitis, PVNS, also known as giant cell tumor of tendon sheath)
Epithelioid Hemangioendothelioma (EHE)