In this section
Musculoskeletal tumour surgery has been performed by the
Orthopaedic surgeons at the Royal Children's Hospital for over 30
years. The musculoskeletal tumour clinic looks after children with
benign and malignant tumours of bone and soft tissue, affecting the
limbs, pelvis and spine.
The clinic caters to children 16 years and under. Our
clinic works closely with other specialty units at the Royal
Children's Hospital particularly oncology, radiology, and
physiotherapy. The clinic is run by Mr Leo Donnan and Mr Mark O'Sullivan, consultant Orthopaedic Surgeons who has have over 20 years experience
at the Royal Children's Hospital managing these tumours.
Musculoskeletal tumours are lumps or masses that develop in the
arms, legs, pelvis or the spine. 90% of the tumours that we see are
benign, but malignant tumours do occur in children and it is very
important that we pick these tumours up early so that we can get
the best possible outcome for your child. Malignant tumours of the
musculoskeletal system are called sarcomas. They are differentiated
from benign tumours by their ability to spread to distant sites and
produce another tumour.
Benign and malignant tumours can present with a lump or pain.
Any unexplained severe pain or ache needs to be investigated to
exclude a tumour.
Please fax to (03) 9345 5034
Most patients are initially seen in the private rooms, clinic or emergency department. Preliminary discussion and investigations are performed before referral to the musculoskeletal tumour clinic.
Specialist Clinics A1 Ground Floor.
Children with malignant tumours of the Musculoskeletal System
are given first preference and are seen on an urgent basis.
Imaging of bone and soft tissue tumours is always required
before a decision is made regarding the need for biopsy and
After all the investigations have been performed, a further
appointment is made to discuss the radiological findings and
further investigations and treatment. In particular a decision is
made whether biopsy is needed, or whether surgery is indicated for
your child's tumour.
Biopsy is always indicated when there is a suspicion that the
tumour is malignant. Some benign tumours have a malignant
appearance and it is impossible to tell clinically or
radiologically, so that the biopsy is vital as a guide to further
This is performed under General Anaesthetic and usually by a
Specialist Radiologist with CT or Ultrasound guidance. Some tumours
will need open biopsy with a small operation.
The biopsy results take between 2 and 10 days to come back to
us. Tumours of bone usually take 7-10 days for a biopsy result,
while soft tissue tumours are faster and we usually have a result
in 2-3 days
Benign tumours of bone and soft tissue are treated in many
different ways, depending of their site, size and pathology. The
treatment will be discussed with you after initial consultation,
imaging and biopsy, if necessary.
Malignant tumours of Bone and Soft Tissue are treated with a
Multidisciplenary approach, by a team including an Orthopaedic
Surgeon and Oncologist. Treatment is discussed over several
meetings between the patient and their family and the RCH team.
In general, the initial treatment for malignant tumours is with
chemotherapy. This treatment is used for several months in an
attempt to shrink the tumour and kill any cells that are
circulating in the rest of the body.
The tumour is then restaged with Plain radiology, bone scanning
and MRI. These investigations are used to determine whether the
tumour has shrunk and whether the tumour can be removed safely. We
also need to know whether there has been any spread of tumour
throughout the body.
Once the tumour has been restaged, a decision is made about how
to remove the tumour. Before 1970, almost all tumours were treated
by amputation. Most tumours in children now are treated by Limb