I have a lump on my right leg just under my knee. I saw my doctor yesterday and went for an exray. He said it wasn't a fat deposit as he said it was attached to the bone. I noticed it about a month ago and now has grown allot larger. I am going in to find out the results of the xray but wanted to know what it could be. If it is cancerous what is the treatment etc.. Thank you so much. Lin
It depends upon how old you are and where the lump is located.
In adolescents and young adults, lumps "just under the knee" are usually either Osgood-Schlatter's disease (OGS) or an osteochondroma. Both of these conditions are benign.
OGS is an overgrowth of bone at the attachment of the patellar tendon, just below the knee in the front. This is usually seen in athletic patients, who participate in running, jumping, and kicking sports. It used to be limited to young men, but now that young ladies are playing more sports, they are developing the condition also. It is the body’s way of making sure the attachment of the patella does not come off under stress. There is a growth plate there, a weak spot, so the body puts down extra bone at the attachment of the patellar tendon. This can result in a significant lump at that location.
An osteochondroma is a benign tumor that arises from the growth plate of a bone. Though these are developed during adolescence, they may not be picked up until later. The most common location for these to occur is around the knee (on the distal femur and proximal tibia), but they can occur anywhere in the body there is a growth plate. In this “tumor”, a nest of cartilage cells responsible for a bone’s growth, somehow get left behind as the bone grows in length. This nest of cells continues to do what it is programmed to do, make bone. But, since it is not in the usual place, a spike of bone is produced off to the side of the bone. Some of these extra bones are pedunculated (like a mushroom), while others are sessile (like a mound of earth). These usually do not cause any problems, unless they interfere with the motion of tendons, which snap over them.
However, if you are older, and the mass has just now arisen, then there is more concern for malignancy. BUT, primary bone cancer is very rare. AND, there are also some other things that can cause lumps and bumps besides cancer. An enthesopathy is a condition where there is inflammation at the insertion of a tendon onto bone. This can cause a lump to form. Calcified bursitis can sometimes cause a lump. And some other things.
Primary bone cancer does also occur in the youngsters. It has a bimodal distribution, in other words, it is seen in the very young and the very old. But, again, it is very rare.
Bone cancer is actually usually brought to the patient’s attention because it is painful. Bone pain is the usual presenting symptom, rather than a lump.
Most bone cancers have very unique appearances on x-ray. If there is any doubt, then usually a bone scan and/or MRI is obtained.
As to the treatment of bone cancer, this is jumping the gun a little. You should get a diagnosis before thinking about treatment. Mainly because, each type of bone cancer (there are a lot of them) is treated in its own way. Some can be treated with radiation or chemotherapy, while others are not sensitive to these treatments. Some are aggressive and have to have a wide resection (amputation), while others can be treated with simple excision.
So, you have to know for sure what you are dealing with before a treatment plan can be determined. Usually, if there is concern for a tumor, a biopsy will be performed. A biopsy is a big deal, and it should only be done by the surgeon who would end up doing a resection (if one becomes necessary). A biopsy should not just be done by any old surgeon. If the biopsy comes back as cancer and the person who did the biopsy contaminated several compartment when doing the biopsy, or placed the biopsy incision in the wrong place, this can lead to unnecessary amputation. So, biopsies should only be done by the surgeon who will do the final operation (if one is necessary).
But, again, this is jumping the gun a little. You first have to have a diagnosis.