Bone Tumor Classification

Prepared by Dr Hakan ESKARA

Overview of bone tumour classification systems and key characteristics that distinguish benign from malignant lesions.

Accurate classification of bone tumors is a critical step in determining an effective treatment plan. The WHO introduced the classification of soft tissue and bone tumors (fifth edition) in 2020.

The new WHO classification of soft tissue and bone tumors, introduced in 2020 (fifth edition), has made significant improvements in classification and introduced many new diagnoses.

The basis for the classification of bone tumors is histopathological.

Bone Tumor Classification

GroupBenignIntermediate (Local Agressive)Malignant
ChondrogenicSubungual exostosis, Periosteal chondroma, Enchondroma, Osteochondroma, Chondroblastoma vb.Chondromatosis NOS, Atypical cartilaginous tumorChondrosarcoma (G1-3), Periosteal, Clear cell, Mesenchymal, Dedifferentiated
OsteogenicOsteoma NOS, Osteoid osteoma NOSOsteoblastoma NOSLow-grade central osteosarcoma, Osteosarcoma NOS, Parosteal, Periosteal, High-grade surface, Secondary
FibrogenicDesmoplastic fibromaFibrosarcoma NOS
Vascular (Bone)Hemangioma NOSEpithelioid hemangiomaEpithelioid hemangioendothelioma NOS, Angiosarcoma
Osteoclastic Giant Cell-RichAneurysmal bone cyst, Non-ossifying fibromaGiant cell tumor of bone NOSMalignant giant cell tumor of bone
NotochordalBenign notochordal cell tumorChordoma NOS (chondroid dahil), Dedifferentiated, Poorly differentiated
Other Mesenchymal (Bone)Chondromesenchymal hamartoma, Simple bone cyst, Fibrous dysplasia, Osteofibrous dysplasia, Lipoma, HibernomaOsteofibrous dysplasia-like adamantinoma, Mesenchymoma NOSAdamantinoma (dediff.), Leiomyosarcoma NOS, Pleomorphic sarcoma undiff., Bone metastases
HematopoieticPlasmacytoma, Hodgkin, Non-Hodgkin lenfomalar, Langerhans histiocytosis, Erdheim-Chester, Rosai-Dorfman
Undifferentiated Small Round CellEwing sarcoma, CIC-rearranged, BCOR altered sarcoma

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