The National Orthopedic Oncology department at Tel Aviv Sourasky Medical Center treats patients with tumors and tumor-like conditions (oncological and non-oncological) of the skeletal system (bones and joints) and soft tissues in limbs, the pelvis, shoulders, spine, thoracic and abdominal walls, and, in some cases, head and neck.
Orthopedic oncology combines expertise in orthopedics and oncology, focusing on the diagnosis and treatment of bone cancer, benign and malignant tumors of the bones and soft tissues, suspicious lesions of the skeletal system, and bone metastases.
The Department of Orthopedic Oncology at Tel Aviv Sourasky Medical Center (Ichilov) provides specialized care for adults, adolescents, and children. The department is officially recognized by the Israeli Ministry of Health as a specialized orthopedic oncology service.
This recognition means that patients from across Israel are entitled to seek treatment at the department, regardless of their place of residence or health maintenance organization (HMO) affiliation.
Orthopedic oncology services are provided through:
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Adult Orthopedic Oncology: At the Department of Orthopedic Oncology, Tel Aviv Sourasky Medical Center.
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Pediatric Orthopedic Oncology: At the Pediatric Orthopedic Oncology Unit, Dana-Dwek Children's Hospital.
Medical staff
Dr. Yair Gortzak
Dr. Omri Merose
Dr. Solomon Dadia
Dr. Ortal Segal
Dr. Amir Sternheim
The department's specialists focus on limb-sparing surgery, aiming to preserve affected limbs and avoid amputation whenever possible. Surgical procedures involve the use of various types of implants, bone grafts, or a combination of both.
Treating young children presents additional challenges, particularly when preserving bone growth potential is essential to prevent future differences in limb length.
The department's ability to manage these complex cases is based on more than 30 years of experience and a highly skilled team of specialists trained at leading medical centers worldwide, with collective experience encompassing thousands of surgical procedures.
Diseases and Conditions Treated
The department specializes in the diagnosis and treatment of a wide range of benign and malignant bone and soft tissue tumors, including sarcomas, osteosarcoma, Ewing sarcoma, and metastatic bone disease.
Conditions treated include:
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Primary benign and malignant bone tumors
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Primary benign and malignant soft tissue tumors
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Secondary malignant tumors (bone metastases)
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Tumor-like and metabolic bone disorders
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Conditions requiring extensive surgical intervention, including severe, life-threatening infections
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Peripheral nerve tumors, including schwannomas and malignant peripheral nerve sheath tumors
Osteosarcoma and Ewing Sarcoma – Bone Cancer in Children
Bone sarcomas, including osteosarcoma and Ewing sarcoma, are more common in children and adolescents, particularly those under the age of 20.
The department operates a dedicated pediatric orthopedic oncology unit specializing in complex surgical treatment of bone tumors in children, with the highest volume of such procedures in Israel.
Soft Tissue Sarcoma – Limb-Sparing Surgery
Soft tissue sarcomas are malignant tumors arising from connective tissues, including fat, muscle, nerve sheaths, and blood vessel walls.
Surgical treatment of soft tissue sarcomas in the extremities requires specialized expertise and extensive experience.
The department performs more than 750 soft tissue sarcoma procedures per decade, with reported outcomes in recovery and limb preservation comparable to those of leading international centers.
Bone Metastases
Cancers such as lung, breast, and kidney cancer, as well as multiple myeloma, may affect the bones and weaken their structure, potentially leading to pathological fractures.
The department's specialists treat fractures caused by bone metastases and use advanced technologies to assess fracture risk, identify bones at risk of future fractures, and enable preventive treatment when appropriate.
Peripheral Nerve Tumors
The department diagnoses and treats peripheral nerve tumors, including benign schwannomas and malignant peripheral nerve sheath tumors (MPNST).
Academic Activities and Innovative Treatments
The department is actively involved in clinical research and the development of innovative treatment approaches.
Each year, the medical team conducts, presents, and publishes new scientific studies at leading international conferences and in professional medical publications.
Research activities focus on developing advanced treatment techniques, improving clinical outcomes, evaluating established treatment methods, and continuously advancing professional expertise.
Main Research Areas
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Prediction of Pathological Fractures: Using CT-based analysis to assess fracture risk in patients with bone metastases and determine the optimal timing for preventive surgery.
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Advanced 3D Technologies and Imaging: Using three-dimensional tools and advanced imaging techniques to improve the planning and precision of bone cancer surgery.
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Soft Tissue Sarcoma Research: Evaluating clinical outcomes over the past decade and developing technologies to improve surgical techniques and treatment results.
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Percutaneous Cryoablation of Desmoid Tumors: Minimally invasive, image-guided freezing of desmoid tumors under anesthesia, without the need for open surgery.
Medical Units
The Pediatric Orthopedic Oncology Unit at Dana-Dwek Children's Hospital operates as part of the National Department of Orthopedic Oncology at Tel Aviv Sourasky Medical Center (Ichilov). Ichilov is the only hospital in Israel with a nationally designated orthopedic oncology department providing care for both adults and children from across the country.
As a national department, we provide highly specialized, advanced medical care, supported by extensive clinical experience, expertise, and a high volume of treated cases.
This designation allows children and adolescents from anywhere in Israel to receive treatment at our unit, regardless of their place of residence or health maintenance organization (HMO) affiliation.
The unit treats children and adolescents from birth to age 18. Some patients are referred from other hospitals specifically for surgical treatment due to the unit's specialized expertise and capabilities.
In pediatric orthopedic oncology, the experience and expertise of the treating team are particularly important. Access to highly specialized care may therefore be a key consideration, even when the medical center is not the closest to the patient's home.
Conditions Treated
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Bone Cancer and Malignant Tumors: Including osteosarcoma, Ewing sarcoma, chondrosarcoma, and soft tissue sarcomas involving muscles, tendons, fat, blood vessels, joints, and connective tissues.
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Benign Tumors: Including benign bone tumors, bone cysts, osteochondromas, enchondromas, and other noncancerous lesions.
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Suspicious or Indeterminate Lesions: Bone or soft tissue abnormalities detected on imaging that have not yet been identified as benign or malignant and require specialist evaluation, MRI, biopsy, or ongoing monitoring.
The Treatment Process
Every child and adolescent treated at the unit receives individualized care from a multidisciplinary team of specialists, assembled according to their specific medical needs.
Each treatment plan is tailored to the patient's diagnosis and clinical condition. Alongside orthopedic oncologists, the team may include oncologists, orthopedic surgeons, plastic surgeons, specialized radiologists, and pathologists with expertise in bone and soft tissue tumors.
All care is provided at Dana-Dwek Children's Hospital, in a dedicated pediatric environment equipped with advanced medical facilities and services designed specifically for children and adolescents.
Minimally invasive techniques are used to treat bone and soft tissue tumors with the assistance of advanced imaging and surgical navigation systems. These technologies significantly reduce radiation exposure and improve surgical precision.
The approach enables real-time, three-dimensional visualization of tumors during procedures, allowing surgical instruments to be guided accurately to the targeted area.
Treatment can often be performed through small incisions or, in certain cases, without a surgical incision.
Types of Treatments and Procedures
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Treatment of Painful Benign Bone Tumors: Radiofrequency ablation (RFA), using advanced navigation technology to achieve precise treatment, including in anatomically complex locations.
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Treatment of Soft Tissue Tumors: Percutaneous cryoablation of tumors such as desmoid tumors, without a surgical incision, aiming to reduce tumor size and relieve pain.
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Treatment of Large Bone Cysts: Minimally invasive treatment involving the injection of a sclerosing agent into the lesion, reducing the need for extensive surgery and allowing faster recovery.
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Treatment of Bone Metastases: Ablation or cryoablation, combined when appropriate with bone cement injection to strengthen the affected bone, reduce pain, and improve quality of life.
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Complex Bone Biopsies: Image-guided biopsies in anatomically challenging locations using advanced navigation systems.
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Navigation During Open Surgery: Precise intraoperative localization and marking of tumors to support accurate removal of tumor tissue.
The Bone Metastatic Disease Service provides specialized care for patients with bone metastases arising from any type of cancer who require surgical or minimally invasive intervention.
The service treats patients from across Israel in coordination with the referring medical team, including oncology institutes, orthopedic departments, and community healthcare providers.
Following recovery from the procedure, patients return to their referring medical teams for continued oncological treatment and follow-up.
Indications for Surgical Treatment
The most common reasons for surgical intervention in patients with metastatic bone disease include pathological fractures, extensive bone destruction, and persistent pain caused by bone metastases that has not responded to nonsurgical treatment.
Treatment is based on a comprehensive, multidisciplinary approach involving experienced specialists who assess the patient's overall medical condition, extent of metastatic disease, functional status, and pain severity.
Surgical treatment focuses on limb-preserving techniques that enable removal of tumor tissue from the affected bone while aiming to maintain optimal mobility and function.
Orthopedic Oncology Clinics
Patients referred to the National Department of Orthopedic Oncology for the first time are seen by a senior orthopedic oncology specialist. Each consultation lasts approximately 30 minutes.
Patients should bring all relevant imaging studies, including MRI or CT scans of the affected area (with the imaging files on a disc), as well as a referral letter from their treating physician, a medical summary, and a current medication list.
During the consultation, the specialist reviews the patient's medical history and symptoms, performs a physical examination, and evaluates the imaging studies. The physician then discusses any additional diagnostic tests required, along with appropriate treatment and follow-up plans.
The New Patient Clinic operates daily. The average waiting time from submitting an appointment request to the first consultation is less than two weeks.
The Follow-Up Clinic provides ongoing care for patients who have recently undergone surgery and for those attending scheduled follow-up appointments.
Patients are seen by a senior orthopedic oncology specialist, who assesses their current condition through a physical examination and a review of updated imaging studies.
At the end of the consultation, patients receive a written summary and an explanation of the recommendations for further treatment and follow-up.
The clinic is located on the ground floor of Wing C.
The Multidisciplinary Sarcoma Clinic provides long-term follow-up care for patients with soft tissue and bone sarcomas.
The clinic combines the expertise of a medical oncologist specializing in sarcoma and an orthopedic oncologist.
Patients may continue follow-up for ten years or more after completing cancer treatment. Follow-up includes monitoring the original tumor and surgical sites, assessing for local recurrence and metastatic disease, and evaluating functional recovery and rehabilitation needs.
These clinics provide follow-up care for patients under the age of 18 who have recently undergone surgery, as well as children and adolescents receiving ongoing care through the unit.
The clinics are located in the outpatient clinic building at Dana-Dwek Children's Hospital.
The Multidisciplinary Specialty Clinic provides comprehensive evaluation and diagnosis through collaboration between specialists from different medical fields, including sports medicine (knee), shoulder surgery, hip disorders, growth abnormalities, and joint diseases.
During the consultation, patients are evaluated by a senior orthopedic oncology specialist together with an additional specialist in the relevant medical field.