Practical Approach to the Diagnosis of Bone Tumors

Abstract

As with lesions of any other organ system, many bone tumors are easy to diagnose, but a few will be difficult. Careful attention to clinical features and roentgenograms should make most bone tumors straightforward. The plain film is the most important image which is helpful in diagnosis. Bone tumors are classified depending on the kind of matrix produced or the cytology of the tumor cells in cases without matrix production. The cases are then divided into benign and malignant counterparts. The staging system uses two criteria: the histological grade and extent of the tumor, i.e., where it involved only one compartment or more than one. The grading system is similar to the one proposed by Broders.

General surgical pathologists have been led to believe that bone tumors and tumorlike lesions are complicated and require a specialist pathologist to render a diagnosis. Nothing could be further from the truth. Bone tumors are not any more difficult than breast cancer. As with lesions of any other organ system, many bone tumors are easy to diagnose but a few will be difficult. On the one hand, roentgenograms are so important in the diagnosis of bone tumors that familiarity with them provides a distinct advantage. On the other hand, bone tumors are extremely uncommon so that most pathologists do not get to see enough of them to feel comfortable. But careful attention to clinical features and roentgenograms should make most bone tumors to be straightforward.