Although rare, bone sarcomas may occur in the head and neck, at the base of the skull, in the pelvis, or in the chest wall. These tumors are often managed with surgery but, as with other sarcomas, may also require radiation therapy or chemotherapy.
Head and Neck Sarcoma
Sarcoma can sometimes develop in the bones of the head and neck. Osteosarcoma, for instance, can develop in the jawbone. These tumors are often managed with surgery that may require reconstruction of the jawbone after tumor removal. NYU Langone physicians can reconstruct the jawbone using bones from the leg and are pioneers in planning surgery using computer-generated, three-dimensional models.
Other bones in the face can also be reconstructed. For example, the cheekbones, eye sockets, or the palate, which is the roof of the mouth, can be replaced with bones from other parts of the body. These bones may come from the leg, the forearm, or scapula, which is the shoulder blade.
Sarcoma of the Skull
Sarcomas, mostly chordomas, can occur in the bones at the base of the skull. To remove skull base tumors, our surgeons may use an endoscope, which is a long, thin, lighted tube with a tiny camera on it that allows them to see inside the body.
Surgeons place the endoscope through the nose and sinuses—which are the air-filled cavities on either side of the nose—and into the skull base. Surgeons then place small instruments through the endoscope and into the skull base to remove the tumor.
Sometimes, open surgery, called a craniotomy, may be used to remove tumors in the skull. In craniotomy, surgeons make an incision in the scalp and remove a small part of the skull to create an opening through which to access the tumor. They then remove as much of the growth as possible.
Spine and Sacrum Sarcoma
Tumors that occur in the spine—for example, chordomas—may require the removal of one or two vertebrae, the bones that make up the spine, to ensure the complete removal of the cancer.
Those that occur in the sacrum, a larger triangular bone at the end of the spine, may necessitate removal of part of the sacrum or the entire bone, followed by reconstruction of the involved bones and surrounding soft tissue.
Some bone sarcomas—for example, chondrosarcomas and osteosarcomas—develop in the pelvic bones. These tumors tend to be large by the time they are detected, making reconstructive surgery an important part of treatment.
After NYU Langone’s orthopaedic surgeons remove the tumor and a margin of healthy tissue, reconstructive surgeons may take bone from the leg to reconstruct the pelvis. Other options include using bones from a donor or a special molded composite to replace the bones in the pelvis.
Chest Wall Sarcomas
The chest wall consists of muscle, tissue, and bones, including the ribs and sternum, that protect the organs in the chest cavity.
When a sarcoma develops in the bones of the chest wall, our thoracic surgeons work to remove the tumor and a margin of surrounding healthy tissue while protecting the area’s vital organs, including the lungs and heart.