Assuming a bone tumor is benign?

[Ann.without.an.e]

Ya'll have always been better at walking me through these things than any doctor.  

9yo DS fell and hurt his knee.  He couldn't put weight on it.  The next day I notice a lump above the growth plate in his knee.  I thought he had just really messed something up in there.  I took him to the orthopedic doctor yesterday and he saw a PA.  The PA said that the knee is probably just bruised and sprained.  It is inflamed and just needs time.  The lump is a bone tumor that we had simply never noticed before.  It is fairly large. The PA was not the least bit worried about it though.  He said that it looks completely benign.  He is going to have a doctor look at the x ray this week to confirm his thoughts but he said not to worry at all unless I heard back from him.  

Someone with more experience than me please tell me if this is right?  If it was malignant then it would look different?  He said that a malignant tumor would be tender.  DS says it doesn't hurt at all.  Is this still true if it is early?  The malignant type is most commonly diagnosed in boys 10-20 and he will be ten in a few weeks.  It is also in the most common location for the malignant sort.  I am not worried about it, I just want to make sure something isn't overlooked.  

[Catwoman]

I wouldn’t take any chances, and would insist that they do more tests to be 100% positive it’s benign. 

They are probably right about it, but if it was my child, I wouldn’t be able to rest until I had a definitive answer, and I would take my child to a specialist as soon as possible. I would not trust the opinion of a PA and a general pediatrician.

Edited April 23, 2019 by Catwoman

[Suzanne in ABQ]

My niece had a bone tumor (malignant) in her shoulder that wasn't diagnosed for a good while.  It was painful, basically ached all the time, but the medical folks she was seeing didn't find anything wrong.  When it was finally diagnosed (at age 18), she required surgery to remove it, but no other treatment was needed (no radiation or chemo).  It's been several years now, and she's fine.  

Wait a few days, as suggested, but don't accept the "Don't call us; we'll call you" line that the PA gave you.  I would be calling the doctor at the end of the week, asking what he saw in the X-ray, and asking whether a biopsy is in order, or what other kind of tests they can do.  Also, even if it is benign, ask what to watch for in the future.  Is it likely to continue growing?  What kinds of problems might it cause, especially as your son enters puberty and starts growing rapidly?  Should it be monitored by a doctor? At what point should you think about having it removed?

[klmama]

((Hugs))  I hope the PA is right, but don't just assume all is well if you don't hear back. If no message within a few days, please call to verify.  

[Ann.without.an.e]

22 minutes ago, Suzanne in ABQ said:

My niece had a bone tumor (malignant) in her shoulder that wasn't diagnosed for a good while.  It was painful, basically ached all the time, but the medical folks she was seeing didn't find anything wrong.  When it was finally diagnosed (at age 18), she required surgery to remove it, but no other treatment was needed (no radiation or chemo).  It's been several years now, and she's fine.  

Wait a few days, as suggested, but don't accept the "Don't call us; we'll call you" line that the PA gave you.  I would be calling the doctor at the end of the week, asking what he saw in the X-ray, and asking whether a biopsy is in order, or what other kind of tests they can do.  Also, even if it is benign, ask what to watch for in the future.  Is it likely to continue growing?  What kinds of problems might it cause, especially as your son enters puberty and starts growing rapidly?  Should it be monitored by a doctor? At what point should you think about having it removed?

 

I was already thinking that I will call anyway if I don't hear from him.  I just want to make sure that an orthopedic doctor actually looks at it and it doesn't get forgotten.  He said that it will grow until he is done growing.  They will not remove it unless it becomes a problem or gets painful.  I think they view it as a situation to monitor.  

[hornblower]

I'd want the specific diagnosis - I'm guessing they think it's an osteochondroma. I'd want to see the written reports from the radiologist analyzing the xray saying that, and then I'd want to hear from the doctor what their plan for monitoring it is. 

[Ann.without.an.e]

The office called today.  The Doctor and PA sat down and reviewed the film together.  They both agree that it has all of the characteristics of being benign.  I think osteochondroma is the right name @hornblower. 

[TravelingChris]

My daughter had one of those that was found when she had a knee injury too.  That was when she was 10 and now she is 22 and about to graduate college.  It didn't cause any problems though she has plenty of other medical issues.