Types of bone cancer

There are several different types of primary bone cancer that can start in the cells of the bones. The cancer cells are bone cells that have become cancerous.

Secondary bone cancer

Most people who have cancer cells in their bones don't have primary bone cancer. They have cancer cells that have spread into the bone from a cancer elsewhere in the body. This is called secondary or metastatic bone cancer. For example, in breast cancer that has spread to the bones, the cancer cells in the bones will be breast cancer cells. 

If you have secondary bone cancer, this is not the right section for you. You need to look at the section for your type of primary cancer. It's named after the part of your body where your cancer started.

Osteosarcoma

You can get osteosarcoma at any age. But it's the most common type of primary bone cancer in adolescents (10 to 19 years). Osteosarcomas can grow anywhere in the skeleton. The most common sites for osteosarcoma include the:

  • thigh bone (femur)

  • upper shin bone (tibia)

  • upper arm bone (humerus)

Chondrosarcoma

Chondrosarcoma is most common in adults aged 30 to 60 years old. It is a cancer of cartilage cells within the bone.

Cartilage is the shiny, smooth substance that normally covers the ends of bones in the joints. But it can also be found within the bone.

Chondrosarcoma can grow inside a bone or on the bone surface. The most common sites for chondrosarcoma are the:

  • hips (pelvis)

  • shoulder bones (girdle)

  • upper thigh bone (femur)

  • ribs

Ewing sarcoma

Ewing sarcoma is most common in children (0 to 14 years) as well as adolescents. It usually starts in the:

  • pelvis (hips)

  • thigh bone (femur)

  • shoulder bones (girdle)

  • ribs

You can also get a Ewing sarcoma in the soft tissues of the body. Soft connective tissue tumours are called soft tissue sarcomas. These are treated the same way as Ewing bone tumours.

Spindle cell sarcoma

Spindle cell sarcomas are mostly found in adults aged 30 to 60 years old. The most common sites are the bones of the legs.

Spindle cell sarcoma of the bones is rare. They are very similar to osteosarcomas but don't produce the bony substance called osteoid, which osteosarcomas do. They behave like osteosarcomas, and doctors treat them in a similar way.

There are several types of spindle cell sarcoma:

  • fibrosarcomas

  • leiomyosarcomas

  • angiosarcomas

  • undifferentiated pleomorphic sarcomas

Chordoma

Chordoma is a very rare, slow growing type of bone cancer. 

Chordomas grow from the notochord. The notochord forms the early spinal tissue in a baby developing in the womb. During development, the notochord gets replaced by bone. But sometimes small areas of notochord may remain in adults.

About 50 out of 100 chordomas (about 50%) grow in the bone at the bottom of the spine (sacrum). The rest develop in the bones of the skull and spine.

  • Bone sarcomas: ESMO-EURACAN-GENTURIS-ERN PaedCan Clinical Practice Guidelines for diagnosis, treatment and follow-up
    S Strauss and others
    Annals of Oncology December 2021. Volume 32, Issue 12, Pages 1520 to 1536

  • UK guidelines for the management of bone sarcomas 
    C Gerrand and others
    Clinical Sarcoma Research, May 2016. Volume 6, Number 7

  • Chondrosarcoma
    R Weinschenk and others
    Journal of the American Academy of Orthopaedic Surgeons, July 2021. Volume 29, Issue 13, Pages 553 to 562

  • Cancer: Principles and Practice of Oncology (12th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Wolters Kluwer, 2023

  • Ross and Wilson​ Anatomy and Physiology in Health and Illness (13th edition)
    A Waugh and A Grant
    Elsevier, 2018

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
20 Jun 2024
Next review due: 
20 Jun 2027

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