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Types of bone cancer

Men and women discussing bone cancer

This page tells you about the different types of cancer that start in the bones. There is information about


A quick guide to what's on this page

Primary and secondary bone cancer

A primary bone cancer is one that starts in the bones. A secondary cancer in the bones has spread from somewhere else in the body. All the information in this section is about primary bone cancer. If you have secondary bone cancer, you need the section for your original cancer type.


The most common type of primary bone cancer in teenagers and young adults is osteosarcoma. You can get it at any age. Osteosarcomas can grow anywhere in the skeleton, but the commonest places are around the knee or upper arm.

Ewing’s sarcoma

This bone cancer is most often diagnosed in teenagers. It most often starts in the pelvis or leg bones. Ewing's tumours can also develop in the soft tissues. The treatment for these soft tissue tumours is the same as for Ewing's bone tumours.


This is most often diagnosed in middle age and usually grows slowly. Chondrosarcoma can start in the pelvis, the thigh, the upper arm, shoulder blades or ribs.

Rare types of sarcoma

Very rare types of bone sarcoma are chordoma and spindle cell sarcomas. Spindle cell sarcomas include the following types: undifferentiated sarcoma of bone, malignant fibrous histiocytoma, fibrosarcoma, and leiomyosarcoma.


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The difference between primary and secondary bone cancer

A primary bone cancer is one that starts in the bones. The cancer cells are bone cells that have become cancerous. All the information in this section is about primary bone cancer.

A secondary cancer in the bones has spread from somewhere else in the body. This is also called metastatic cancer. The cancer cells are like the cells of the original tumour. So if you have had breast cancer and it spreads to the bones, the cancer cells in the bones will actually be breast cancer cells.

We keep stressing this because it is very important when you are looking for information on cancer. If you have a secondary cancer, you need to look in the section for your original cancer type. The behaviour of the cancer, including the treatment that it will respond to, depends on where the cancer started in the body.



Osteosarcoma is the most common type of primary bone cancer found in teenagers and young adults. But you can get it at any age. Osteosarcomas can grow anywhere in the skeleton. The most common sites are the

  • Lower thigh (femur)
  • Shin bone (tibia)
  • Upper arm (humerus)

Ewing’s sarcoma

This type of bone cancer is named after the surgeon who first described it. It is most common in teenagers.

Ewing's sarcoma usually starts in the pelvis (hips), thigh (femur) or shin (tibia) bones. But you can also get a Ewing's tumour in the soft tissues of the body. Soft connective tissue tumours are called soft tissue sarcomas

If you have a soft tissue Ewing's tumour, you will have the type of treatment described in this section. This is because these tumours respond to the same treatment as Ewing's bone tumours.

Children's impact statement - Ewing's sarcoma



This type of primary bone cancer is most often found in adults over 40 years old. It is relatively rare.

Chrondrosarcoma is a cancer of cartilage cells. Cartilage is the shiny, smooth substance that normally covers the ends of bones in the joints. It provides support for the joint and allows bones to move smoothly over one another.

Chondrosarcoma can grow inside a bone or on the bone surface. The cancer makes cartilage. So you may have islands of cartilage inside the bone or on the bone surface, in an area where it wouldn't normally grow.

This bone tumour is usually slow growing. The most common sites for chondrosarcoma are the

  • Hips (pelvis)
  • Thigh bone (femur)
  • Upper arm (humerus)
  • Shoulder blade (scapula)
  • Ribs

Spindle cell sarcoma

Spindle cell sarcomas are very similar to osteosarcomas but don't produce the bony substance called osteoid, which osteosarcomas do. They behave in a similar way to osteosarcoma and doctors treat them in a similar way. They are usually found in adults over 40. There are several types of spindle cell sarcoma including

Undifferentiated sarcoma of bone means that the cells are not specialised. They are quite undeveloped (immature) and it isn't possible to tell which type of normal bone cells they started from. If you have a spindle cell sarcoma with more well developed (specialised) cells, your doctor will call it a fibrosarcoma or leiomyosarcoma, depending on the appearance of the cells under a microscope.

Malignant fibrous histiocytoma (MFH) isn't a commonly used diagnosis any more. Most of the tumours that used to be called MFH are now more accurately diagnosed as other types of sarcoma. The small number that would still be called MFH are now known as undifferentiated high grade pleomorphic sarcoma. When this tumour starts in the bone, your doctors may refer to it as spindle cell sarcoma of the bone.

Fibrosarcoma is also very rare and most often found in middle aged adults. The most common site for fibrosarcoma is the thigh bone (femur).

Leiomyosarcoma of bone is extremely rare and very little is known about it.



Chordomas are a very rare, slow growing type of bone cancer. They are most common in people between 40 and 60 years of age. They are found more often in women than men.

Chordomas develop from the notochord (pronounced no-tow-cord). The notochord forms the early spinal tissue in a baby developing in the womb. After about 6 months, this tissue is replaced by bone. But sometimes small areas of notochord may remain.

About 2 out of 5 chordomas (35 to 40%) grow in the skull or the bones in the middle of the face. The rest develop in the bones of the spine (the vertebrae). About half of these are in the lower part of the spine.

Chordomas do not usually spread. But if they do, the most common places are the lungs, nearby lymph nodes, the liver, the bones and the skin.

We have detailed information about chordomas and their treatment in our question and answer section.

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Updated: 23 May 2013