Rationale: There is few data on epidemiology or clinico-pathology of malignant bone tumors in children and adolescents in Romania. These tumors are very rare compared to other malignancies, yet they account for a major source of mortality and morbidity among patients with cancer. Bone tumors often have a similar presentation and clinical approach, but they present individual characteristics that are important for treatment and prognosis.

Objective: To describe the characteristics of primary malignant bone tumors in children and adolescents in Romania.

Methods and Results: A retrospective analysis of all malignant bone tumors registered at a large referral center, “Maria Sklodowska Curie” Emergency Hospital for Children, between 2005 and 2013 was presented. A total of 146 biopsies and surgical resection specimens were reviewed during this period, and were classified as malignant bone tumors.

There were 91 boys and 55 girls in the series, with a male-female ratio of 1.65:1. The average patient age was 13.32 years (2 to 19). The most common anatomical distribution of the tumors was femur – 32.19%, tibia – 25.34% and humerus – 11.64%. Histologically, we found osteosarcoma in 54.1% of all bone tumors, followed by Ewing’s sarcoma – 30.82% and chondrosarcoma – 8.9%.

Discussion: Geographic location did not appear to represent a risk factor for any particular type of bone tumor. Our results were parallel to the findings previously reported in the general literature; the distribution and the epidemiology were similar to those in the other developed and underdeveloped countries. Malignant bone tumors in our country have a high mortality rate, because of the late diagnosis.