Musculoskeletal tumors presenting to an oncology multidisciplinary team in Northeast India

Musculoskeletal tumors (MSTs) are a challenge to diagnose and treat. Though they are generally rare, referral bias exists in tertiary institutions. This study was performed to audit the various MST presenting to an oncology Multidisciplinary Team (MDT) in Northeast India.

An oncology MDT was set up in June 2016 at a tertiary hospital in Northeast India, which caters to a wide region comprising different ethnicities. In addition to patients diagnosed with MST, patients with suspected MST were also referred to the MDT. Data was collected prospectively and was analyzed up to March 2020. Our findings were also compared to those of other national and international studies.

During the study period, a total of 4704 cases (comprising 3426 patients) were discussed at the MDT meetings of which 174 (5%) were musculoskeletal [bone tumors {n = 110 (63.2%)}, soft tissue {n = 42 (24.2%)}] and skin lesions {n = 22 (12.6%)}]. The malignant among the bone tumors, soft tissue, and skin lesions were 59%, 88%, and 95%, respectively. After excluding secondary bone tumors and multiple myeloma, the total number of patients with primary bone tumor was found to be 88 (80%), out of which both malignant and benign were 50% each. The commonest site and diagnoses among malignant primary bone tumors were femur (15.9%) and osteosarcoma (25%), respectively. The commonest site and diagnosis among benign primary bone tumors were tibia (15.55%) and giant cell tumors (8%), respectively. The majority (56.9%) were male, with a median age of 39 years (range 3-90). The intent of treatment was curative in 71.9% of the malignant lesions.

Osteosarcoma was found to be the most common malignancy among MSTs with male predominance. The accurate diagnosis of MST is aided by the MDT. Benign bone lesions may present to oncologists, and these differentials need to be considered.