Trusted medical expertise in seconds.

Access 1,000+ clinical and preclinical articles. Find answers fast with the high-powered search feature and clinical tools.

Try free for 5 days
Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer.

Benign bone tumors

Last updated: May 17, 2021

Summarytoggle arrow icon

Benign bone lesions are a heterogeneous group of slow-growing neoplasms that arise from cartilage or bone. They appear on x-ray as localized lesions with sharp margins and without soft tissue involvement. Surgical removal or curettage may be required to manage pain and/or prevent pathological fractures.

Benign bone tumors are usually asymptomatic and do not require treatment until they become symptomatic (pain, swelling, etc). Surgery is indicated for symptomatic lesions and may involve curettage, bone grafting, or resection.

Predominantly osseous tumors

Overview of predominantly osseous tumors
Type Description Epidemiology Location Characteristics
Osteoid osteoma
  • Small, predominantly cortical tumor (< 2 cm)
Osteoblastoma
  • Severe chronic pain (not nocturnal) that is unresponsive to NSAIDs
  • X-ray: central lucent nidus with mild or absent perifocal sclerosis
Giant-cell tumor (osteoclastoma)
Osteoma
  • Well-defined solitary tumor, usually with a diameter < 1 cm that arises from osteoblasts
  • Usually asymptomatic
  • A nasal sinus osteoma may result in obstruction of the ostium, with subsequent congestion and pressure headaches.
  • Associated with Gardner syndrome
Torus palatinus
  • Usually asymptomatic and requires no treatment
  • If it interferes with speech or eating, surgery is an option.

Tumors with cartilaginous components

Overview of tumors with cartilaginous components
Description Epidemiology Location Characteristics
(Distal) enchondroma
Chondroblastoma
Synovial chondromatosis
  • Pain, effusion, knee locking
  • Radiographically visible loose bodies
  • Malignant degeneration to synovial chondrosarcoma in extremely rare cases
Osteochondroma (cartilaginous exostosis)

Fibromas

Overview of fibromas
Description Epidemiology Location Characteristics
Nonossifying fibroma
  • Fibrous growth in areas that normally ossify
  • Usually an incidental finding
  • X-ray
    • Marginal sclerosis
    • Lobulated structures with translucent components
Ossifying fibroma

Cysts and hemangiomas

Overview cysts and hemangiomas
Type Description Epidemiology Location Characteristics
Unicameral bone cyst
  • Solitary, generally single-chambered bone cysts
Aneurysmal bone cyst
  • Mostly septated, blood-filled cysts
  • May affect any bone
  • Most common localizations: spine and metaphysis of the long bones
  • Predominantly affects the lower extremities
Intraosseous hemangioma
Langerhans cell histiocytosis
  • Most commonly in the skull

  • Description: benign tumor arising from hyaline cartilage
  • Epidemiology
    • Most common type of hand tumor
    • Peak incidence: 20–50 years (but may occur at any age)
  • Clinical features
    • Usually found in medulla of the long bones of the hands and feet (most often the metacarpals of the hand and phalanges of the fingers)
    • Often painless
    • Widening of the bone
    • Pathological (spontaneous) fractures
  • Subtypes and variants: enchondromatosis [3]
    • Definition: A predominantly hereditary condition that manifests with multiple enchondromas.
    • Epidemiology: peak incidence between 10 and 20 years
    • Clinical features: often leads to skeletal deformities and stunted growth
    • Prognosis: increased risk of malignant degeneration to chondrosarcoma
  • Treatment
    • Asymptomatic tumors do not require treatment and close monitoring suffices.
    • Symptomatic tumors may require surgical curettage and subsequent bone grafting to prevent pathological fractures.

  • Description: cartilage formation as a result of metaplasia of the synovial tissue
  • Epidemiology: peak incidence between 20 and 40 years
  • Clinical features
  • Diagnostics: x-ray shows radiographically visible (calcified) loose bodies
  • Treatment: removal of loose bodies and synovial tissue
  • Prognosis: extremely low risk of malignant degeneration to synovial chondrosarcoma

Osteoid osteoma [4]

Osteoblastoma [6]

Osteomas of the skull and mandible in conjunction with hypertrophy of the retinal pigment epithelium, adrenal adenomas, desmoid tumors, and dental abnormalities are characteristic of Gardner syndrome.

  • Description: growth of fibrous connective tissue into areas that normally ossify; a tumor-like lesion that is considered to be a nonneoplastic disorder of bone growth, rather than a true neoplasm
  • Epidemiology: peak incidence between 10 and 20 years
  • Clinical features
    • Usually metaphyseal (predominantly in the distal femur and distal tibia)
    • asymptomatic; usually an incidental finding [7][8]
  • Diagnostics: x-ray
    • Marginal sclerosis
    • Lobulated structure with translucent components
  • Treatment
    • Usually self-limiting
    • Bone grafting may be required for painful lesions or to prevent pathological fractures.

  • Description: fibrous benign bone tumor
  • Epidemiology: peak incidence between 1 and 5 years
  • Clinical features
    • Most commonly found in tibia and fibula
    • Localized swelling
    • Tibial bowing
  • Diagnostics: X-ray shows intracortical, osteolytic lesions with interspersed sclerosis.
  • Treatment
    • If asymptomatic, monitoring is sufficient.
    • If symptomatic, surgical removal is preferred.

  1. Osteoclastoma. https://radiopaedia.org/cases/osteoclastoma-1. Updated: February 16, 2017. Accessed: February 16, 2017.
  2. Verdegaal SHM, Bovée JVMG, Pansuriya TC, et al. Incidence, Predictive Factors, and Prognosis of Chondrosarcoma in Patients with Ollier Disease and Maffucci Syndrome: An International Multicenter Study of 161 Patients. Oncologist. 2011; 16 (12): p.1771-1779. doi: 10.1634/theoncologist.2011-0200 . | Open in Read by QxMD
  3. Primary Intraosseous Haemangioma. https://radiopaedia.org/articles/primary-intraosseous-haemangioma. Updated: September 1, 2017. Accessed: June 12, 2018.
  4. Howlett D., Farrugia M., Ferner R., Rankin S. Multiple lower limb non-ossifying fibromas in siblings with neurofibromatosis. Eur J Radiol. 1998; 26 (3): p.280-283. doi: 10.1016/s0720-048x(97)01175-3 . | Open in Read by QxMD
  5. Mankin HJ, Trahan CA, Fondren G, Mankin CJ. Non-ossifying fibroma, fibrous cortical defect and Jaffe–Campanacci syndrome: a biologic and clinical review. MUSCULOSKELETAL SURGERY. 2009; 93 (1): p.1-7. doi: 10.1007/s12306-009-0016-4 . | Open in Read by QxMD
  6. Osteoid Osteoma. https://radiopaedia.org/articles/osteoid-osteoma. Updated: June 4, 2018. Accessed: June 12, 2018.
  7. Osteoid Osteoma. https://orthoinfo.aaos.org/en/diseases--conditions/osteoid-osteoma. Updated: August 1, 2019. Accessed: April 29, 2020.
  8. Lucas DR. Osteoblastoma. Arch Pathol Lab Med. 2010; 134 (10): p.1460-6. doi: 10.1043/2010-0201-CR.1 . | Open in Read by QxMD
  9. Osteochondroma. https://orthoinfo.aaos.org/en/diseases--conditions/osteochondroma/. Updated: December 1, 2018. Accessed: April 29, 2020.
  10. Langerhans Cell Histiocytosis in Children. https://www.dynamed.com/topics/dmp~AN~T919995/Langerhans-cell-histiocytosis-in-children. Updated: September 7, 2017. Accessed: June 12, 2018.
  11. Langerhans Cell Histiocytosis. http://www.pathologyoutlines.com/topic/boneLCH.html. Updated: October 19, 2016. Accessed: June 12, 2018.
  12. Langerhans Cells. http://www.pathologyoutlines.com/topic/skinnontumorlangerhans.html. Updated: May 19, 2016. Accessed: June 12, 2018.