Benign Spinal Tumors

Aneurysmal bone cysts (ABCs) are benign, hollow, blood-filled bone lesions that can change shape and cause significant symptoms and structural damage, despite being non-cancerous. In other words, these benign tumors can be locally aggressive and usually require treatment. They are commonly found in children and adolescents and can occur in any bone, though they frequently affect the posterior part of the spine. The cause is not clearly understood, but likely involves a spontaneous genetic anomaly. When an ABC behaves aggressively or causes symptoms, a variety of treatment options may be recommended, including surgery, embolization (removing the tumor’s blood supply) or sclerotherapy (injection of a weak alcohol which may cause the tumor to involute) may be recommended.

An osteoblastoma is a rare, benign bone tumor that primarily affects the posterior spine and bones in the legs, hands, and feet. It typically affects young people ages 10-30. They are twice as common in males as in females. Osteoblastomas are generally slow-growing but may behave aggressively and cause bone destruction and pain. Surgery is typically necessary to remove the tumor, and this tumor may grow back even after successful surgical removal.

Osteoid osteoma is a small, benign bone tumor that commonly affects young individuals, typically between the ages of 10 and 35. It often occurs in the long bones of the legs, particularly the femur and tibia, but can also affect the posterior spine and other bones. An osteoid osteoma does not typically grow but can produce pain and abnormal bone reactivity around it. Males are about three times more likely to develop this tumor than females. Most osteoid osteomas resolve on their own over the course of a few years using aspirin or non-steroidal anti-inflammatory treatment, but this tumor typically is treated with surgery or radiofrequency ablation (RFA, a method of burning the tumor using a needle) if the symptoms are not tolerable.

This is a rare, self-limiting benign bone tumor that can occur as part of a systemic syndrome, but isolated lesions do occur. This lesion affects the spinal bones or the leg or arm bones of patients younger than age 20. It is twice as common in males than in females. Treatment includes observation, steroid injections, or surgery for difficult cases. This tumor is famous for resolution with biopsy or steroid injection alone, and in many cases surgery can be avoided.

Giant Cell Tumor of Bone is one of the most common benign bone tumors that mostly occurs in young adults ages 20 to 40. It is benign (non-cancerous) but can be fast-growing, aggressive in destroying bone, and has the potential to be a benign metastasizer, with some patients experiencing lung lesions. The treatment for a Giant Cell Tumor of Bone depends on its size, location, and aggressiveness. Treatment options usually include surgery to remove the tumor, but denosumab is a medication which is highly effective at reconstituting bone and getting the tumor to heal. The recurrence rate even after successful surgery can be 20% or more.