In medicine there are oncological diseases, otherwise they are called malignant formations; skull cancer also refers to such ailments. Oncology of the cranial bone is a malignant formation in parts of the skull, as well as in the facial and brain regions.

What is it?

This disease can affect people of any age. Brain department represents the vault and base of the skull.

Skull bone cancer - pathological process. This type of disease is malignant and develops very rapidly. Happening accelerated process tissue growth, it begins to undergo mutation. Cancer of the skull bones occurs with the outcome of a benign pathological process.

The primary formation of cranial bones and soft tissues of the head with a benign pathological process has the ability to grow, which will begin to destroy them. They are located near the corner of the eye in the form of dermoid cysts.

On the head there are soft fabrics, on which defects that form on the bone plate outside. begin to grow into the bones, this occurs along the length of the osteon channels. Tissue compaction and destruction occurs, in some cases this is associated with the proliferation of osteoblasts.

Types of malignant processes of the cranial bone

Cancer of the cranial bone is represented by:

• Malignant fibrous histiocytoma;
• Ewing's sarcoma in the tissues of the skull;
• Chordoma at the cranial base;
• Osteogenic sarcoma in the temporal part;
• Chondrosarcoma with parts of cartilaginous tissue mutation.

Chondrosarcoma is a malignant pathological process of the skull bone, which grows from cartilage tissue. It harms the larynx, skull and trachea. This disease is rare in children; most often it affects people whose age ranges from twenty to seventy-five years. It appears as bony prominence which is covered with cartilage. Also, chondrosarcoma can be the result of malignancy of a pathological benign process.

Of the benign tumors of the skull, the most common are atheromas, somewhat less frequently angiomas and dercoids, and very rarely fibromas, lipomas and neurofibromas.

Atheromas of the head more common in adulthood.

Clinically, atheroma (retention cyst of the sebaceous gland) is a slowly growing, painless tumor with a smooth surface, soft or tightly elastic to the touch. Large atheromas fluctuate. The size ranges from a pea to a potato. The tumor is covered with unchanged or somewhat thinned skin, with which it, as a skin derivative, is closely connected and with which it easily moves in relation to the underlying tissues.

Atheromas are often single, less often multiple. They are located mainly in the scalp, especially often in the parietal region. The course of the disease is sometimes complicated by suppuration or malignant degeneration. The tumor must be removed carefully; not a single piece of the membrane should be left, otherwise a relapse is inevitable.

Dermoids represent cysts formed from particles of the ectodermal layer included in the underlying tissue in the embryonic period of life. The wall of the cyst is lined with skin containing sebaceous and sweat glands and hair follicles. The contents of the cyst consist of a pasty mass formed from the discharge skin glands and exfoliated epithelium, often mixed with hair.

Clinically, a dermoid is a slowly growing, painless, round, smooth, tight-elastic tumor ranging in size from a pea to a tangerine or larger. Dermoids, usually buried deep, are loosely connected to the skin. Unlike atheromas, the skin easily moves over the tumor. In the bone under the tumor, due to prolonged pressure, a depression is sometimes formed, the edges of which can be felt around the circumference of the tumor in the form of a hard ridge.

The depression in the bone sometimes turns into a hole, and the tumor comes into contact with the dura mater. Typical locations of dermoids: median canthus, temporal and occipital region, region mastoid process and the lateral end of the eyebrow. Clinically, dermoids are detected in childhood and adolescence.

Dermoids located at the inner canthus can be mistaken for a cerebral hernia. Distinctive features the latter is due to greater softness, compressibility (not always) and a defect in the cranial bone, established x-ray. Lipomas are distinguished by their lobulation and great softness.

Dermoids are removed surgically. To avoid relapse, the cyst shell should be bluntly isolated or completely cut out. During the operation, one must keep in mind the possibility of skull distortion and, consequently, damage to the hard meninges.

Hemangioma of the skull found in all its characteristic forms.

Superficial capillary hemangioma looks like a more or less extensive spot with a smooth or slightly bumpy surface and is usually located on one side of the head. Capillary hemangioma involves only the skin and does not spread to subcutaneous tissue. If arterial capillaries predominate, the spot is bright red; if venous capillaries are developed, it is blue-red. Superficial hemangioma is a congenital formation, therefore it is also called vascular birthmark(naevus vasculosus).

WITH therapeutic purpose electrocoagulation, cauterization with a hot needle, x-ray therapy, radiotherapy, surgical removal of hemangioma followed by closure are used significant defect large epithelial flaps obtained using a dermatome, or a lattice flap.

Cavernous cavernous hemangioma (haeman-gioma cavernosum) is a cluster of blood-filled cavities communicating with each other and with small blood vessels. The most common are cavernous hemangiomas, located in the subcutaneous tissue.

Clinically cavernous hemangioma appears as a red spot or soft node that appears through thinned skin or protrudes onto its surface. With pressure, the angiomatous node collapses.

The tumor may be congenital or may appear early childhood, developing from an imperceptible initially innate rudiment. Small cavernous hemangiomas sometimes disappear spontaneously, but more often they slowly enlarge. Often the growth of hemangioma is greatly accelerated, and the tumor in short time invades a significant area of ​​neighboring tissues, growing over a large area and even usurizing the bone.

Once ulcerated, hemangioma can become a source heavy bleeding. Rarely, cranial hemangiomas, especially those located in the midline, communicate with intracranial blood vessels, for example, with venous sinuses.

Due to the usually rapid growth and sometimes observed malignant degeneration, cavernous hemangiomas are subject to surgical removal. Bleeding during surgery is perfectly prevented, as the experience of our clinic has shown, by preliminary application around the tumor of a looped hemostatic suture used during craniotomy. Small superficial cavernous hemangiomas can also be successfully treated with electrocoagulation or radium rays.

Branched hemangioma (haemangioma racemosum), also called serpentine aneurysm (aneurysma cirsoides), is rare and is a flat, irregular shape a pulsating tumor consisting of elongated, tortuous and highly dilated vessels.

The essence of the disease is a broad communication arterial system with a vein. The veins are arterialized. The number and caliber of capillaries are extremely increased. On the tumor, a constant noise is heard that increases with systole, caused by numerous anastomoses between arteries and veins.

Anastomosis is sometimes single. Its presence and location are determined by arteriography. Most often, a serpentine aneurysm is observed in the area of ​​branches of the temporal artery, less often in the area of ​​other branches of the external carotid artery. Sometimes it spreads to the entire half of the head. The disease develops in connection with a head injury or from a cavernous hemangioma and tends to progress.

A radical cure can only be achieved complete removal tumors. To limit bleeding, which is sometimes dangerous, a preliminary ligation of the adductor artery is performed and the tumor is cut around the circumference with a hemostatic suture, and an elastic tourniquet is applied around the skull. In the case of a single anastomosis, the communication between the artery and vein is first closed.

Neurofibromas are very rare. These are multiple small, dense, painless tumors in the thickness of the skull, congenital or detected in early childhood. The starting point for the formation of tumors is the nerve sheath. Neurofibromas of the head can also be a manifestation of general neurofibromatosis. Surgery indicated for large single nodes or when there is a threat of malignant degeneration.

Malignant tumors of the skull

Of the malignant tumors of the skull, cancer is often encountered and sarcoma is much less common.

Cancer of the skin covering the skull originates from skin epithelium or from the epithelium of sebaceous or sweat glands and hair follicles and is seen almost exclusively in the more benign superficial basocellular form. A more malignant spinocellular form, which has a tendency to spread early and metastasize into lymph nodes, is rare. Treatment of skin cancer of the skull area is carried out according to the same rules as the treatment of facial skin cancer.

Sarcoma of the skull in the initial stage is a dense skin nodule, which quickly enlarges and soon ulcerates. Growing deeper, the tumor often grows into the underlying cranial bone. Surgical treatment gives best results in combination with x-ray or radiotherapy.

Skull tumors can cause compression of the brain and the appearance of neurological symptoms, primarily local headache and symptoms of brain irritation.

Osteomas. These are benign, slow-growing tumors. Indications for their removal arise when tumors reach significant sizes and begin to compress the brain or when they are located in paranasal sinuses nose

Osteomas of this localization can cause inflammatory complications– osteomyelitis, abscesses.

Hemangioma. This benign tumor, localized more often in the parietal and frontal bones. On craniograms, rounded formations with a characteristic honeycomb structure or trabecular structure are determined. Surgery is indicated when neurological symptoms appear.

Epidermoids and dermoids. They look like intraosseous cystic formations with compacted walls. Surgical removal is indicated.

Tumors that destroy the base of the skull (chordomas, glomus tumors) have already been described.

Malignant tumors of the skull base include chondro- and osteosarcomas and some others. Their treatment is ineffective and usually consists of partial removal in combination with radiation and chemotherapy

Pseudotumors of the brain (benign intracranial hypertension). The disease is characterized by a persistent increase intracranial pressure, accompanied by nausea, dizziness, sometimes double vision and congestion in the fundus Most dangerous manifestation– progressive decrease in vision, in some cases – to complete blindness.

The etiology of this syndrome is not completely known. It is assumed that it may be based on endocrine metabolic disorders, since there is a dependence of benign intracranial hypertension, which is more often observed in women, from obesity, disorders menstrual cycle, postpartum complications.

In case of long-standing intracranial hypertension, it is necessary to thorough examination patients to identify others possible reasons high blood pressure: chronic inflammatory processes in membranes (including fungal ones), blood diseases; violation of venous outflow due to sinus thrombosis; toxic effect some medicines etc.

CT, MRI studies and craniography give negative results, with the exception of indirect signs intracranial hypertension: collapsed ventricles, hypertensive changes in the bones of the skull.

Treatment. Aimed at normalizing intracranial pressure: recommended limited consumption liquids and salts, diuretics (furosemide, diamox), steroid therapy is indicated.

With a steady decline in vision, resort to surgical treatment: lumboperitoneal shunting, decompression of the optic nerves.

More on the topic of Skull bone tumors:

1. DISEASES OF THE MUSTOCULAR SYSTEM. TUMORS OF BONES AND SOFT TISSUE
2. TUMOR GROWTH. PROGRESSION OF TUMORS. MORPHOGENESIS OF TUMORS. INVASION AND METASTASIS OF MALIGNANT TUMORS. BIOMOLECULAR MARKERS OF TUMORS. ANTI-TUMOR IMMUNITY. PARANEOPLASTIC SYNDROMES. BASIC PRINCIPLES OF CLASSIFICATION OF TUMORS. MORPHOLOGICAL FEATURES OF TUMORS FROM EPITHELIUM AND TUMORS FROM TISSUE - DERIVATIVES OF MESENCHYME

Cancer is one of the most terrifying and unpredictable diseases known to medicine. There are many types of cancer pathologies, each of which poses a serious danger to human life. Bone cancer is one of the types of this pathological process that can affect the human body.

According to statistics, cancer bone structures is the rarest. At the same time, the disease is more often diagnosed in children and adolescents; people over 30 years of age suffer from this form of pathology extremely rarely, in only 2% of cases. Now we will understand what kind of disease this is, what are its causes and symptoms, types, and methods of control.

First of all, it is worth saying that the word cancer itself in medicine means a pathological process in which rapid and uncontrolled division of cells that form a tumor occurs. The neoplasm, wherever it appears, constantly increases in size, affecting nearby tissues. Doctors distinguish only two types of tumors:

1. Malignant – development malignant tumor represents greatest threat human life, since this type of neoplasm can spread throughout the body and give metastases. On late stages metastasis of cancer cells malignant formation affect the entire body, the process ends in death.
2. Benign – the appearance of benign tumor neoplasms is considered a conditionally safe process. Such tumors grow extremely slowly and do not metastasize; they are removed surgically without further treatment. The neoplasm itself is called benign if it is surrounded by healthy tissue.

Cancer of the joints and skeletal system as a whole “submits” to the same gradation. In addition to this, there are two individual species bone cancer:

1. Primary – the neoplasm originates directly in the bone tissue. If we're talking about about the back, this is the spine, if about the lower extremities, a certain area of ​​the leg, etc.
2. Secondary - cancer begins not in the bones, but in any affected organ in any part human body. Over time, at the metastasis stage, metastases appear in the bones, spreading throughout the body from the mentioned organ. The secondary type of bone cancer is more common than the primary one.

It is important to understand that cancer cells can develop in any bone structure. It doesn’t have to be bones; oncology begins in joints, cartilage, and periosteum.

As mentioned earlier, the disease most often affects people under 30 years of age. At this age, as well as in children, oncology is more often localized in the bones of the lower extremities; in older people, the bones of the skull are more likely to be affected.

Reasons

Despite quite high level modern medicine and active study of bone cancer by scientists real reasons the development of tumor formations, as well as bone cancer, has not yet been established. Despite this, doctors identify a number of reasons that, in their opinion, predispose or at least precede the development of the disease.

Causes of bone cancer:

• Bone marrow transplant.
• Exposure of the body to ion radiation, prolonged or repeated exposure to ionizing rays.
• Related genetic diseases, among which the most dangerous are retinoblastoma, Li-Fraumeni or Rothmund-Thompson syndrome.
• Paget's disease, in which disturbances in the regenerative abilities of bone tissue occur, followed by the occurrence of disorders in bone structures.
• Development of primary clinical cancer Injuries, mainly bone fractures, contribute to this. In this case, the injury may even be ten years old.

All of the above points relate directly to bone tumors, that is, the primary type of oncology. As for the secondary type of pathology, it is preceded by neoplasms of a different localization. In most cases, we are talking about the most common types of cancer, that is, lung, breast, and prostate cancer metastasizes.

Spine cancer

Despite the fact that spinal cancer has no differences with everything said earlier, it is worth talking about it separately. This is explained severe course tumor formation in spinal column, because the spinal cord is located here, and the spine itself plays a colossal role in the human body.

In addition, for example, cancer thoracic spine will be symptomatically different from the same neoplasm in another region.

But first of all, it is worth saying that doctors distinguish three separate types of spinal cancer, depending on the location of the tumor:

• Extradural - the tumor is localized outside the dura mater of the spinal cord. Such a tumor often gives metastases, but they do not affect the functions of the central nervous system.
• Intradural – tumor growth occurs directly into the structure of the dura mater. The main danger is compression of the spinal cord, which only aggravates the pathological process.
• Intramedullary - the neoplasm is localized in the very spinal cord, its increase is accompanied by the loss of certain functions. In this case, it all depends on in which part the tumor grows, for example, oncology lumbar region spine, among other things, threatens paralysis of the lower extremities.

Symptoms of the disease

The development of bone cancer is accompanied by certain symptoms, which become more varied as bone cancer develops and the tumor increases in size.

If we talk about the general clinical picture, the symptoms and manifestations are as follows:

• Pain is the main one cancer symptom. Painful sensations have a clear localization at the site of growth of the malignant tumor. Pain syndrome permanent, does not disappear depending on body position. Pain increases with any physical activity, movements, and also at night, when the muscles relax.
• Edema - also forms at the site of tumor growth, for example, in one of the lower extremities. The swelling is encircling, it surrounds the tumor, but is clearly visible only when the tumor reaches a significant size. When it comes to defeat internal bones in the pelvic area or other hard-to-reach area, swelling may not be visible.
• Deformation of the affected area, which should not be confused with edema, and this is difficult to do. Given clinical sign characterized by protrusion, swelling, swelling skin on the affected area of ​​the body. The deformation has the shape of a tubercle, sometimes uneven, its size depends on the size of the growing tumor.
• Impaired motor functions are not always observed, mainly in cases where the tumor is localized near movable joints or structures on which they depend. motor functions, innervation of the limbs, etc. A striking example there will be hip cancer closer to knee joint. As the tumor grows, it will become more difficult to move your knee, and your leg may become numb or tingly.
• TO general symptoms Oncology also includes signs of causeless weight loss, the appearance of fever (often low-grade), systematic lethargy, loss of appetite, and excessive sweating.

In addition to the general clinical picture, we can highlight characteristic symptoms inherent in certain types of bone cancer:

In most cases clinical picture bone cancer is obvious, but only in late stages. As for the onset of the disease, you should be concerned about any deterioration general condition lasting more than one week.

Types of tumors

As mentioned earlier, doctors distinguish benign and malignant neoplasms for bone cancer. Besides, oncological process characterized depending on the location of the tumor, the characteristics of the course, which affect the principles of treatment. For these reasons, it is worth talking about each type of tumor separately.

Ewing's sarcoma

This type of neoplasm belongs to the malignant ones, it mainly affects tubular bones. It is more common in the lower extremities, spine, pelvis, ribs, collarbone, and shoulder blades.

Ewing's sarcoma is diagnosed primarily in people between 10 and 15 years of age. In most cases, the tumor directly affects bone structures, since doctors associate its development with injuries. Extraosseous cases of tissue damage are extremely rare.

Even at the beginning of its development, Ewing's sarcoma can already metastasize, affecting soft tissues, organs, bone marrow, central nervous system. For this reason, this type of tumor is considered one of the most aggressive and dangerous.

Osteosarcoma

Osteogenic sarcoma is one of the most common types of bone cancer. The formation of a neoplasm begins with changes in bone structures, develops quickly and gives metastases in the early stages.

In most cases, bone tissue damage occurs in the legs, but there are also known cases of localization in the area shoulder girdle and pelvic bones. If we talk about the limbs in general, most often this type of oncology affects the knee or elbow joints in a child's body.

According to statistics, this type of oncology is more often diagnosed in males. The disease primarily affects people between 10 and 30 years of age, but it is likely to occur at any age. The peak incidence and rate of tumor development occurs during the period of bone growth ( adolescence), is more often diagnosed in tall, tall people.

Chondrosarcoma

Grows mainly in cartilage tissues or flat bone structures, was rarely diagnosed in other bones. The “favorite” location is the area of ​​the larynx and trachea, since small bones are located here.

There are two scenarios for tumor development:

• Favorable – slow growth with a late stage of metastasis.
• Unfavorable – rapid growth with metastases in the early stages.

It is more often diagnosed in people over 40 years of age, but exceptions are possible.

Fibrosarcoma

It is formed mainly in connective tissues, muscles and tendons located deep. Only after this the tumor spreads and affects bone tissue. The main place of damage is the legs.

Hondarma

A rare type of cancer, according to some data, developing from embryonic tissues and their residual mass. Localized in the sacrum or bone structures of the base of the skull.

By its structure, this tumor is considered benign. But due to the specifics of its localization, as well as high probability compression of vital nerve branches and organs due to tumor growth, it is regarded as malignant.

Histiocytoma

Malignant neoplasm affecting the upper and lower limbs, trunk, especially the bones in the peritoneal area. Growth occurs in the tubular bones of small and large sizes. The neoplasm quickly passes into the stage of metastasis; in most cases, metastases affect the lung tissue.

Parosteal sarcoma

A subtype of osteosarcoma, much rarer and less different aggressive course. The site of development is the surface of the bone, the growth of the tumor is slow, it is less malignant, so to speak.

In most cases it affects the femoral or tibia, in less than 30% of cases it is localized on the bones of the skull, spine, pelvis, hands or feet.

Eosinophilic granuloma

The nature of the development of this type of neoplasm is unknown. According to statistics, this type tumors most often affect children preschool age. The pathology is characterized by numerous foci that “attack” hollow and tubular bones.

The tumors themselves are granulomas, that is, infiltrates, in the structure of which there is high concentration eosinophilic leukocytes. This type of neoplasm is considered benign.

Chondroblastoma

Perhaps the most controversial type of neoplasm, as it can be benign or malignant. It is formed from cartilage tissue and is formed in different parts skeleton in tubular long bones.

Diagnosed in patients over 20 years of age, it is localized in the pelvis, hips, and feet. However, it can develop in the ribs, spine, collarbones, shoulder blades, etc. There is a possibility that after surgical intervention, during which the tumor was not completely removed, it can degenerate into malignant.

Osteoma

It is diagnosed mainly in children and young people under 20 years of age. This type of tumor is benign, it is not prone to rapid growth, does not metastasize, and does not grow into nearby organs and tissues.

Osteomas can form from bone and connective tissues on the humerus, tibia and thigh bones, as well as thin bones of the skull. Moreover, when osteomas appear, there are no symptoms. The only exceptions are those cases when the tumor reaches a large size and puts pressure on any organ.

Angioma

In most cases, angioma is a vascular formation that is formed from blood or lymphatic vessels. Angioma can also affect bone tissue, but these cases are rare.

Chondromyxoid fibroma

A benign neoplasm that affects mainly long bones, but in in rare cases exceptions are possible, with germination in other bone structures. Tumor growth is accompanied painful sensations, there is a possibility of its degeneration into malignant.

Chondromyxoid fibroma is a very rare oncological manifestation; in the worst cases, it causes muscle atrophy in the area of ​​localization or limitation of joint mobility, if there is one nearby.

Giant cell tumor

A benign tumor that does not metastasize and is localized in the terminal areas of the bones. In this case, the tumor often grows into nearby tissues, and its main disadvantage is that even after surgical removal of the tumor, it can grow again.

Osteoid osteoma

Single benign education, not growing more than 1 centimeter in diameter. The tumor can develop in any bone structure of the human skeleton. Moreover, osteoid osteoma is rarely diagnosed, since it is small, and when it appears there are no symptoms.

Stages of bone cancer

Recognizing the stage of development of the pathological process plays decisive role in setting up treatment, and sometimes in predicting life. In total, there are 4 stages of bone cancer development:

1. Education does not leave the bone. Tumors at the first stage are divided by size, above and below 8 centimeters.
2. The tumor is still limited to the bone, but tests confirm signs of cellular malignancy.
3. The tumor spreads to several bone structures, and cancer cells penetrate into the area of ​​regional lymph nodes.
4. The fourth stage is characterized by the growth of the tumor beyond the bone, onto nearby tissues. With stage 4 bone cancer, the process of metastasis begins.

Diagnostics

Bone cancer always requires diagnosis. To do this, you need to see a doctor, who will prescribe the necessary diagnostic measures. Diagnosis is necessary to identify cancer cells in principle, clarifying the stage of development of oncology, prescribing treatment.

Diagnostic methods are as follows:

• The first thing to do is to take an x-ray of the bones at the suspected location of the tumor.
• The patient in mandatory You need to donate blood for a test that detects tumor markers for cancer.
• Isotope scanning - a special substance is injected into the bloodstream, which is absorbed by bone tissue. Then a special scanner is used to “highlight” the substance in the bones and detect even the smallest formations.
• Computed and magnetic resonance tomography.
• A biopsy of tumor tissue to determine the type of tumor (malignant or benign).

How to treat bone cancer

Treatment of any cancer– a complex and painstaking process, especially for bone cancer. Cancer should be treated only by contacting an oncologist, who will make a diagnosis and prescribe a treatment regimen based on the diagnostic data obtained.

It is important to understand that for each patient and specific case of the disease, treatment is prescribed individually. For some, this means radiation and chemotherapy, but in most cases they still resort to surgical removal tumors or parts of bone. In the second case, the bone is subsequently replaced by a special prosthesis. In particular difficult situations Together with the patient, a decision is made to amputate the affected limb.

How long do you live with bone cancer?

The life expectancy of people with bone cancer is, again, controversial and has a huge number of variables. It is necessary to take into account the location of the tumor, the stage of its development, the type of tumor, the presence or absence of metastases, the age of the patient, etc.

Of course, the most favorable prognosis will be if the cancer was detected at the first stage and the tumor was completely removed. After this, irradiation is carried out and the survival rate exceeds 80%. The higher the stage of cancer, the more unfavorable factors, the lower this figure.

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The first symptoms that allow one to suspect a pathological process in the body are weakness, spontaneous rises in body temperature, loss of weight and appetite. Most common symptom bone tumors, which occurs in 70% of patients, is pain. At first, the pain may be mild and disappear spontaneously. In the future, persistent, constant pain that intensifies over time and at night is characteristic, which is poorly relieved or cannot be relieved with painkillers. As a rule, from the moment the first pain It takes 6 to 12 months before diagnosis is made. Physiotherapy, often carried out before diagnosis, can increase pain or reduce it only for a short time. The pain can vary in intensity, but what faster growth tumors, the pain syndrome is stronger there. In addition, tumor formation can be detected various sizes and limited mobility in the joint near which the tumor appeared. At the site of the tumor, the limb is enlarged in circumference, painful, the skin over it may be swollen and thinned, and hot to the touch.