Benign Tumors

Abstract

Benign musculoskeletal tumors have a broad spectrum of clinical presentation and radiographic findings that often correlate with the underlying biologic behavior. They may present as clinically asymptomatic incidental findings or with rapidly progressive symptoms with corresponding aggressive bony destruction. Accurate and timely diagnosis of benign bone lesions is important for a multitude of reasons. First, in aggregate, they are very common, often found incidentally by practitioners without expertise in interpreting the imaging findings, and until a definitive diagnosis is rendered, this can cause significant distress to patients and families. Readily available information such as the age of the patient and the location of the primary complaint can form the basis of an initial differential diagnosis, which is narrowed further with thorough history, physical evaluation, and imaging.

The presence, absence, character, and timing of pain as well as other associated symptoms can be helpful in narrowing the differential diagnosis. Most benign latent tumors that do not cause significant mechanical cortical compromise will not be associated with pain, and therefore pain that leads to imaging should be carefully examined to elucidate whether there is a separate trauma, overuse, or degenerative related cause with the lesion being incidental.

Accurate characterization, diagnosis monitoring, and treatment of benign bone lesions rely on the full spectrum of imaging modalities including radiographs, CT, MRI, skeletal scintigraphy, and occasionally PET-CT.

Benign bone tumors are commonly divided into histopathologic and imaging subcategories. These include osteoblastic, cartilaginous, cystic, fibrous, and histiocytic tumors and giant cell tumor of bone.