ABSTRACT
Benign bone tumors generally occur in patients of young and middle age. A wide spectrum of histologies is recognized that reflect the elements present within bone including bone marrow and osseous, cartilaginous and fibrous constituents. A detailed description of the demographic and site distribution, physical signs and symptoms, radiographic features and histopathology can be found in any of several bone pathology texts (3-5). Osteochondroma are the most common benign bone tumor. Rare benign tumors that occasionally become aggressive and undergo malignant transformation include giant cell tumors, chondroblastomas, osteoblastomas, and histiocytosis. Giant cell tumors are vascular, and resection may result in severe bleeding. Unlike other bone tumors, giant cell tumors are slightly more common in females. During pregnancy, they may grow inordinately rapidly. Resection is usually done after a fetus is believed to be viable. Both giant cell tumors and chondroblastomas are slow growing, but the treatment of choice is a complete resection of the lesion. Pulmonary metastasis rarely occurs (1-3%) with either giant cell tumors or chondroblastoma. When it does occur, it is usually found 3-20 years after resection. When histiocytosis includes systemic involvement, it is referred to as HandSchuller-Christian disease or Letterer-Siwe disease. Hand-Schuller-Christian disease is a clinical triad of skull lesions, exophthalmos, and diabetes insipidus. Letterer-Siwe disease affects patients less than 3 years old with fever, lymphadenopathy, hepatosplenomegaly, and multiple bone lesions. The presentation is similar to that of acute leukemia. Lung involvement is possible and can manifest as respiratory distress, tachypnea, retraction, and persistent cough. Patients may have chronic respiratory failure resulting from the development of multiple cysts or bullae, and pneumothorax may occur if the bullae rupture. These medical issues should be considered when indicated for the perioperative care of these patients (6-8).
