Tibial Tumors: Symptoms, Diagnosis, and Treatment Options

Q: Tibial Tumors: Symptoms, Diagnosis, and Treatment Options

Dr. <br>Yeh Min-Nan from Orthopedics responds： (1) Regarding the issue of tibial tumors： your concern requires an outpatient examination. <br>In the Taichung area, you can visit Taichung Municipal Hospital, Chung Shan Medical University, or China Medical University. <br>(2) For s

Tibial tumor

Hello Doctor, five years ago, I started experiencing unexplained pain in my left calf while running, and I noticed slight swelling in the front of my left calf.
Initially, I consulted a traditional Chinese medicine practitioner who diagnosed it as inflammation.
After a year of this, I was admitted to Taichung Veterans General Hospital on January 3rd, 1996, for further examination.
The doctor said it was a benign tumor of the tibia.
When my mother inquired about possible medical treatments, the doctor shockingly stated that amputation was the only option! Over the past four to five years, I often experience cramping pain even when at rest, and I cannot run at all; every step is painful! I jokingly say that the affected area is becoming more like rheumatism, especially severe during cold weather.
The affected area has grown larger over the years, but unless closely examined, others cannot tell there is a problem! I would like to ask the doctor what exactly is wrong with my leg? (Is it a mutation? ...as no one in my family has this condition.) Recently, with the colder weather, the frequency of cramping has increased, and I feel pain almost all the time.
Additionally, besides the Veterans General Hospital, what other hospitals in the central region can I visit for orthopedic care?
Furthermore, five years ago, I began experiencing stiffness and sharp pain in my shoulders, possibly due to sitting too long in front of the computer.
The situation has worsened, and in the past two years, if I ride a motorcycle for more than 45 minutes, my shoulders often hurt to the point where I cannot move, and even my buttocks have started to hurt, especially near the coccyx.
This prevents me from sitting and reading for too long; otherwise, my whole body feels paralyzed and uncomfortable, requiring more than a day of rest for the pain to lessen.
A friend mentioned that there is a hard protrusion at the end of my spine, which she does not have! I would like to ask the doctor what is wrong with my "strange" bones throughout my body? Now, even when sleeping, if the mattress is too thin, I often feel that my bones are not positioned well, and if I hit the hard bed board, I cannot find a comfortable sleeping position for my arms and legs! For instance, when sleeping on my stomach, I must place something under my elbows; otherwise, my bones will hurt! Thank you.

Neo, 20~29 year old female. Ask Date: 2000/12/13

Dr. Shi Qiming reply Orthopedics

Dr.
Yeh Min-Nan from Orthopedics responds: (1) Regarding the issue of tibial tumors: your concern requires an outpatient examination.
In the Taichung area, you can visit Taichung Municipal Hospital, Chung Shan Medical University, or China Medical University.
(2) For shoulder issues: try to keep the keyboard and mouse low while at the computer to allow your shoulders to relax naturally while typing.
(3) Riding a motorcycle for 45 minutes is a bit long; you should take a break.
(4) There is a hard lump on your coccyx; please have it checked at an outpatient clinic.
(5) It is normal to have a mattress pad on the bed board.

Reply Date: 2000/12/13

More Info

Understanding tibial tumors, particularly benign ones, can be quite complex, especially when symptoms persist over several years. Based on your description, it seems you have been experiencing pain and swelling in your left tibia for five years, which has been diagnosed as a benign tibial tumor. The pain you describe, particularly during activities like running, and the swelling in the area, are common symptoms associated with bone tumors, even benign ones.

Symptoms of Tibial Tumors
Tibial tumors can present with a variety of symptoms, including:
- Localized pain, which may worsen with activity.

- Swelling or a noticeable mass in the area.

- Possible tenderness to touch.

- Limited range of motion in the affected limb.

- In some cases, systemic symptoms like fatigue or weight loss may occur, although these are less common with benign tumors.

Diagnosis
Diagnosis typically involves imaging studies such as X-rays, MRI, or CT scans to assess the size, location, and characteristics of the tumor. A biopsy may also be necessary to confirm the diagnosis and rule out malignancy. Given that you have already undergone examinations, it would be essential to follow up with your healthcare provider regarding the results and any further diagnostic steps.

Treatment Options
Treatment for benign tibial tumors can vary based on the type and size of the tumor, as well as the symptoms experienced. Options may include:
- Observation: If the tumor is asymptomatic and not growing, a "watchful waiting" approach may be taken.

- Surgical Intervention: If the tumor is causing significant pain or functional impairment, surgical options may include curettage (removal of the tumor) or, in some cases, more extensive procedures. Amputation is typically a last resort and is not common for benign tumors unless there are complications.

- Physical Therapy: This can help improve function and reduce pain, especially if there is associated muscle weakness or stiffness.

Pain Management
Given your ongoing pain, it is crucial to address this with your healthcare provider. Pain management strategies may include:
- Medications: Over-the-counter pain relievers like NSAIDs (e.g., ibuprofen) can help manage pain and inflammation.

- Physical Therapy: A physical therapist can provide exercises to strengthen the surrounding muscles and improve flexibility.

- Lifestyle Modifications: Avoiding activities that exacerbate the pain, using supportive footwear, and applying ice to the affected area may also be beneficial.

Additional Concerns
You mentioned experiencing shoulder pain and discomfort in your lower back and tailbone area, which could be related to posture or prolonged sitting. It’s essential to address these symptoms as well, as they may indicate underlying musculoskeletal issues. Consulting with an orthopedic specialist or a physical therapist could provide insights into your overall musculoskeletal health.

Seeking Further Care
If you are looking for alternative orthopedic care in your region, consider reaching out to local hospitals or clinics that specialize in orthopedic surgery. Many institutions have dedicated orthopedic departments that can provide comprehensive evaluations and treatment options.

Conclusion
In summary, while benign tibial tumors can cause significant discomfort and functional limitations, there are various treatment options available. It is crucial to maintain open communication with your healthcare provider about your symptoms and treatment preferences. Additionally, addressing your shoulder and back pain with appropriate medical professionals can help improve your overall quality of life. If you have further questions or concerns, do not hesitate to seek a second opinion or consult with a specialist in orthopedic oncology.

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