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Types of bone cancer

Find out about the different types of cancer that start in the bone.

Primary and secondary bone cancer

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

Most people who have cancer cells in their bones don't actually 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. So for example, if you have breast cancer that spreads to the bones, the cancer cells in the bones will actually 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 is named after the part of your body where your cancer started.


You can get osteosarcoma at any age. But it's the most common type of primary bone cancer found in teenagers and young adults. Osteosarcomas can grow anywhere in the skeleton. The most common sites for osteosarcoma include:

  • around the knee
  • the lower thigh bone (femur)
  • the upper shin bone (tibia)
  • around the shoulder
  • the upper arm bone (humerus)

Ewing's sarcoma

Ewing's sarcoma is most common in teenagers. It usually starts in the:

  • pelvis (hips)
  • thigh (femur)
  • shin (tibia)

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


Chondrosarcoma is most often found in adults aged between 30 and 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)
  • 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 like osteosarcomas and doctors treat them in a similar way. They are usually found in adults over 40. There are several types of spindle cell sarcoma:

Undifferentiated sarcoma of bone

This means 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.

Malignant fibrous histiocytoma (MFH)

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.


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

Leiomyosarcoma of bone

This is extremely rare and little is known about this type of spindle cell sarcoma. Your specialist will talk you through what they know about having leiomyosarcoma of the bone.


Chordomas are a very rare, slow growing type of bone cancer. 

Chordomas develop from the notochord, which 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.

Last reviewed: 
20 Nov 2017
  • UK guidelines for the management of bone sarcomas
    C Gerrand and others
    Clinical Sarcoma Research, 2016. Volume 6

  • Bone sarcoma: incidence and survival rates in England
    The National Cancer Intelligence Network (NCIN), 2012

  • Cancer and its Management (7th edition)
    J Tobias and D Hochhauser
    Blackwell, 2015

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