Differential Diagnosis of Benign and Malignant Bone Tumors
| Disease | Peak Age (years) | Typical Location | Findings | Prognosis |
|---|---|---|---|---|
| Chondroblastoma | 10–20 | Long bone epiphyses | Regional muscle atrophy and localized tenderness; radiographic appearance of a cyst containing calcium deposits | Good |
| Chondroma | >20 | Central diaphyses | Usually asymptomatic;radiographs show stippled calcification | Good |
| Chondromyxoid fibroma | <30 | Distal long bones | Sharply circumscribed, lytic lesion on radiographs | Good |
| Chondrosarcoma | 30–50 | Flat bones, long bone diaphyses | Lobular radiographic appearance with punctate calcification | Fair with surgical resection but resistant to chemotherapy |
| Ewing’s Sarcoma | 10–18 | Long bone diaphyses and flat bones | Localized pain or swelling; `onion peel` periosteal reaction on radiographs | Good if nonmetastatic, poor if metastatic |
| Giant cell tumor | <2, >24 | Epiphyses | Lytic appearance on radiographs | Good; tendency to recur |
| Osteochondroma | 5–15 | Distal femur, proximal tibia | Painless, hard palpable mass; most common benign bone tumor | Good; 10% with multiple lesions develop a malignancy |
| Osteoid osteoma | 5–20 | Femur, tibia | Nocturnal pain relieved by aspirin | Good |
| Osteosarcoma | 10–18 | Long bone metaphyses | Localized pain or swelling; sclerotic or lytic destruction on radiographs | Good if nonmetastatic; poor if metastatic |