Bone Tumors: Symptoms, Concerns, and Next Steps

Osteoma issues?

Hello Doctor: Thank you for taking the time to patiently answer my questions.
Thirty years ago, I suffered an open fracture of the tibia in my right leg, which required four surgeries over four years, including the insertion and removal of a metal plate.
During rehabilitation, I accidentally fractured the same area again.
After switching orthopedic surgeons, I underwent a bone graft using my own pelvic bone along with the insertion of screws.
Eventually, the metal plate was removed, and following the doctor's instructions, I gradually healed.
Although I still carry some psychological scars, fortunately, after recovery, aside from a large scar on my leg and some swelling after prolonged standing, I can engage in regular activities without issues, and changes in weather do not affect me.
In late September of last year, after participating in a water polo activity, I noticed a round, soft swelling on the inner side of the tibia where I had surgery, resembling a bruise, approximately 1 cm in size.
It only hurt when I pressed on it with my fingers.
Not wanting to take any chances, I applied ice and consulted an orthopedic doctor.
After an X-ray, the doctor informed me that there was a tumor on the bone, measuring exactly 1 cm.
I was shocked, thinking it was just a bruise from an accidental bump, not a tumor.
The doctor repeatedly asked if it hurt, and I honestly replied that it only hurt when pressed; otherwise, I felt nothing.
The doctor advised me to monitor it and return if I experienced persistent pain, and also mentioned that I had varicose veins (with slightly prominent veins on the soles of my feet).
A week later, the swelling disappeared completely, and I could no longer feel any lump, so I didn't pay much attention to it.
However, in the past couple of days, I've started to feel a slight tingling sensation in the same area of the tibia after standing for a while, but it goes away with rest, and I have no pain at other times.
I'm starting to feel anxious and nervous, not wanting to go through this again.
I am currently on a business trip abroad, where medical resources are limited, and I feel quite uneasy, especially since I have travel plans next month that involve flying.
I would like to ask the doctor: 1.
Do I need to return to the hospital for an examination immediately? (It has only been 5 months since the last check-up in late September.) 2.
Is the disappearance of the swelling related to the tumor seen on the X-ray? 3.
What other symptoms should I be aware of? 4.
Aside from the tingling sensation, I currently have no other symptoms.
Should I be concerned about a sudden fracture or stopping physical activity? Thank you very much for your patience, and I look forward to your response!

Ms. Chen, 40~49 year old female. Ask Date: 2017/02/06

Dr. Shi Guozheng reply Orthopedics

1.
Go to the hospital for a check-up when you have time.

2.
It may be unrelated.

3.
If the tumor is growing, there is usually a phenomenon of pain.

4.
Temporarily avoid vigorous exercise.

Reply Date: 2017/02/06

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your bone health and the recent developments with the lump on your tibia. I understand that you have a complex medical history, and it's completely normal to feel anxious about any new symptoms, especially after previous surgeries and injuries. Let’s address your questions one by one.

1. Do you need to return to the hospital for an examination?
Given that it has only been five months since your last X-ray, and the lump you previously experienced has resolved, it may not be urgent to seek immediate medical attention. However, if you notice any new symptoms, such as increased pain, swelling, or changes in mobility, it would be prudent to consult your orthopedic specialist. Regular follow-ups are important, especially considering your history of surgeries and the previous diagnosis of a bone tumor.

2. Is the disappearance of the lump related to the tumor seen on the X-ray?
The lump that you felt was likely a soft tissue reaction, possibly due to inflammation or a benign process, especially since it resolved on its own. The fact that it disappeared could indicate that it was not a malignant tumor. However, the X-ray findings should be interpreted in conjunction with clinical symptoms. If the lump was indeed a benign bone tumor, it could have caused localized swelling, which may have subsided as the inflammation decreased. It is essential to keep in mind that not all bone tumors cause persistent symptoms.

3. What other symptoms should you be aware of?
You should monitor for any changes in your leg, such as increased pain, swelling, or changes in skin color. Additionally, if you experience any new symptoms like fever, night sweats, or unexplained weight loss, these could be signs of a more serious condition and warrant immediate medical evaluation. Given your history of venous insufficiency (varicose veins), be cautious of any signs of deep vein thrombosis (DVT), such as swelling, redness, or warmth in the leg.

4. Should you be concerned about sudden fractures or stopping exercise?
While it is natural to worry about the risk of fractures, especially after a history of bone issues, the absence of significant pain or other alarming symptoms is reassuring. However, it is crucial to listen to your body. If you feel discomfort or unusual sensations, such as the "tingling" you mentioned, it may be wise to modify your activities and avoid high-impact exercises until you can consult with a healthcare professional. Strengthening exercises and maintaining mobility are essential, but they should be done cautiously.

In conclusion, while your current symptoms do not immediately suggest a serious issue, it is always best to err on the side of caution. If your symptoms persist or worsen, or if you have any new concerns, please seek medical advice as soon as possible. Regular monitoring and communication with your healthcare provider are key to managing your health effectively.

Safe travels and take care of yourself!
Best regards.

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