Bone cancer types

Primary bone cancers are a specific subtype of a group of cancers known as sarcomas. Sarcomas are cancers that start in bone, muscle, connective tissue, blood vessels or fat, and may be found anywhere in the body. Primary bone cancers, which are rare, originate in the bone and can spread.

Metastatic bone cancer forms in the bone but spreads to other parts of the body, most often to the lungs. Bone cancer that spreads to other organs or tissues is still called bone cancer.

Learn more about metastatic bone cancer

Types of primary bone cancer

Osteosarcoma

Also known as osteogenic sarcoma, osteosarcoma is the most common type of bone cancer and typically starts in bone cells in the arms, legs or pelvis. It occurs most frequently in people between the ages of 10 and 30, and is more common in males than females.

Osteosarcoma has three subtypes, based on how the bone cells look at the microscopic level.

• Low-grade osteosarcoma: This type of osteosarcoma grows slowly, and almost all of the bone cells look normal. Only a few can be seen dividing.
• Intermediate-grade osteosarcoma: With this type of osteosarcoma, cells grow a bit faster than with the low-grade type. It’s not very common, and it’s often treated like the low-grade osteosarcoma subtype.
• High-grade osteosarcoma: These osteosarcomas grow very fast, and they can easily be seen dividing under a microscope. Osteosarcomas that occur in children and teenagers are most often high-grade ones. There are many kinds of these fast-moving osteosarcomas. The three most common are osteoblastic, chondroblastic and fibroblastic.

The overall five-year relative survival rate for all osteosarcoma types is 60 percent, according to the American Cancer Society. When the cancer is localized, that number is 74 percent.

Chondrosarcoma

Chondrosarcoma forms in cartilage cells and is the second most common form of the disease. This type of bone cancer rarely occurs in people under the age of 20, and the chances of developing it increase with age.

Chondrosarcoma most often develops in the pelvis, legs and arms, and less frequently in the ribs, skull, chest, shoulder blades, larynx and trachea. However, any part of the body where there’s cartilage is susceptible. With chondrosarcoma, the overall five-year survival rate is 75.2 percent, according to a 2019 study in the Journal of Cancer.

Ewing tumor

Also known as Ewing’s sarcoma, Ewing tumors typically start in the bones, but they may also form in other tissues and muscles. This is the third most common form of primary bone cancer. Ewing tumors occur most frequently in children and teenagers and are rarely seen in adults over the age of 30.

Fibrosarcoma and malignant fibrous histiocytoma

This bone cancer typically develops in the soft tissue around the bones, such as tendons, ligaments, fat or muscle. These types of bone cancer also tend to occur in older adults, and usually affect the arms, legs or jaw.

According to a 2017 study in the journal Oncotarget, fibrosarcoma has an overall five-year survival rate of about 40 percent to 60 percent, depending on the cancer’s grade. Malignant fibrous histiocytoma has a five-year survival rate of 10 percent to 30 percent when the cancer is local and hasn’t spread, but survival is far lower when it’s advanced, as reported by a 2016 case study in the journal OncoTargets and Therapy. However, new treatment developments may help lead to improved survival rates.

Giant cell tumors of the bone

Giant cell tumor of bone have benign and malignant forms, although the malignant form is less common. It usually occurs in the arm or leg bones of young and middle-aged adults, and rarely spreads to distant parts of the body. However, these cancers may return after surgical removal, and the chance of spreading to distant sites increases with each local recurrence.

Chordoma

Chordoma affects bones in the spine and the base of the skull. Though they can occur anywhere in the spinal region, chordomas most commonly are found in the sacral area (lower back) and the base of the skull.

This type of bone cancer occurs most frequently in adults 30 or older, particularly men. It tends to be a slow-growing tumor with a low risk of spreading to distant sites, but it may return at the original site if not removed completely during surgery. Chordomas may also eventually spread to the lungs, liver or lymph nodes.

Patients with chordoma have a five-year survival rate of 82 percent, according to the American Society of Clinical Oncology.