Even though children’s malignant bone tumours are rare, it is crucial to understand how to identify and stage them accurately to develop an appropriate treatment plan. Ewing’s sarcoma and osteosarcoma are the two main paediatric bone malignancies and require multidisciplinary treatment involving radiologists, orthopaedists, oncologists, pathologists, and paediatricians. These neoplasms may be associated with genetic syndromes but typically occur in patients with no known germline abnormalities. With a frequency of 4.4 per million, osteosarcoma is the most common malignant bone tumour in children. Ewing’s sarcoma has an incidence of 2.5 to 3 per million, making it the second most prevalent. Clinically, these neoplasms present with pain and inflammation in the bones and joints, nocturnal pain unresponsive to drug therapy, systemic symptoms such as fever or weight loss, and persistent symptoms—all of which should prompt clinicians to initiate further diagnostic investigations. The gold standard for diagnosis includes X-ray examination and MRI, which provide an accurate assessment of tumour extension into the medullary canal and surrounding soft tissues. Fluorine-18-labelled FDG-PET scans or fluoro-deoxyglucose positron emission tomography are valuable for evaluating tumour aggressiveness and excluding metastases. A biopsy is mandatory once all other diagnostic tests have been completed. Accurate diagnosis and timely referral to an experienced clinic are essential for ensuring prompt access to treatment and improving patient outcomes.
尽管儿童恶性骨肿瘤较为罕见，但准确识别和分期对于制定合适的治疗方案至关重要。尤文氏肉瘤和骨肉瘤是两种主要的儿童恶性骨肿瘤，其治疗需要放射科、骨科、肿瘤科、病理科和儿科医生的多学科协作。这些肿瘤可能与遗传综合征相关，但通常发生在无已知胚系异常的患者中。骨肉瘤的发病率为每百万人口4.4例，是儿童中最常见的恶性骨肿瘤。尤文氏肉瘤的发病率为每百万人口2.5至3例，位居第二。临床上，这些肿瘤表现为骨骼和关节的疼痛与炎症、药物治疗无效的夜间疼痛、发热或体重减轻等全身症状，以及持续存在的症状——所有这些都应促使临床医生启动进一步的诊断检查。诊断的金标准包括X射线检查和磁共振成像，可准确评估肿瘤向髓腔及周围软组织的侵犯范围。氟-18标记的FDG-PET扫描（氟代脱氧葡萄糖正电子发射断层扫描）对于评估肿瘤侵袭性和排除转移灶具有重要价值。完成所有其他诊断检查后必须进行活检。准确诊断并及时转诊至经验丰富的诊疗中心，对于确保患者及时获得治疗并改善预后至关重要。
肿瘤(癌症)患者之家