Rare bone tumours of the extremities

Of the various types of mesenchymal tumours of the extremities, bone neoplasms are significantly less frequent than soft tissue neoplasms. Because of their relative frequency, osteosarcomas, Ewing's sarcomas, and chondrosarcomas, including the dedifferentiated variant, are the most significant forms of primary malignant bone neoplasms. In the first two groups, interdisciplinary multimodal treatment concepts involving combinations of neoadjuvant chemotherapy, extremity-preserving operations (when possible) and, in some circumstances, radiation therapy (Ewing's sarcoma) have long been applied in international treatment trials (EURAMOS, Euro-BOSS, Euro-EWING) that have been initiated in the paediatric oncological sector. This has significantly improved the prognoses of these highly malignant tumours. Surgery is the principal form of treatment for chondrosarcomas. Although the relative importance of chemotherapy has not yet been established for these tumours, which are predominantly associated with adulthood, treatment options are being sought, so it is necessary to check whether these patients could be considered for treatment under the Euro-BOSS protocol. Giant cell tumours, which can cause considerable local destruction but only rarely metastasize, are generally given intralesional surgery using adjuvants or cement fillings. Modern therapeutic options using osteoclast-inhibiting substances might well produce positive results.