Epidemiological Landscape of Musculoskeletal Tumours at a Tertiary Centre in Yemen: A Retrospective Analysis

Abstract

Introduction: Musculoskeletal tumours are diverse neoplasms that present significant diagnostic and therapeutic challenges, particularly in low-resource settings. Epidemiological data from Yemen remain limited, hindering the development of targeted oncological strategies. This study aims to characterise the distribution and clinicodemographic profile of musculoskeletal tumours at a major tertiary centre in Sana’a.

Materials and Methods: A single-centre, retrospective descriptive analysis was conducted at Althawra Modern General Hospital, Yemen. We evaluated 172 consecutive patients with histopathologically confirmed musculoskeletal tumours admitted between January 2019 and March 2023. Demographic data, tumour classification, anatomical location, and histopathological subtypes were extracted from medical registries and analysed using descriptive statistics. This was a case series analysis; no comparative statistical testing was performed.

Results: Benign neoplasms constituted the majority of the cohort (61.0%, n = 105), followed by primary malignant tumours (32.0%, n = 55) and secondary metastatic lesions (7.0%, n = 12). Among benign tumours, osteochondroma was the most prevalent (33.3%), followed by unicameral bone cysts (26.7%) and aneurysmal bone cysts (11.4%), with a marked male predominance (male:female ratio 2:1 for osteochondroma). In the primary malignant group, osteosarcoma was the predominant subtype (61.8%), followed by Ewing’s sarcoma (10.9%) and chondrosarcoma (10.9%). Primary malignancies showed a bimodal age distribution, with a peak in the second decade of life. Notably, all secondary metastatic cases (100%) presented with pathological fractures of the long bones, indicating advanced disease at the time of orthopaedic consultation and highlighting significant systemic diagnostic delays.

Conclusion: Musculoskeletal tumours in Yemen frequently affect children and young adults, with a high burden of primary malignancies such as osteosarcoma. Clinicians should recognize the higher rates of aggressive primary sarcomas and the near-universal presentation of metastatic disease with fractures, which reflects systemic healthcare challenges rather than a unique biological predisposition. These findings underscore the urgent need for improved oncological screening, established national referral pathways, and specialised orthopaedic oncology services to enhance early detection and limb-salvage opportunities in the region.