Bone Tumor Classification

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

MD Hakan ESKARA · University of Health Sciences, Istanbul, Sancaktepe City Prof. Dr. Ilhan Varank Health Application and Research Center
Mar 30, 2026

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

Group

Benign

Intermediate (Local Agressive)

Malignant

Chondrogenic

Subungual exostosis, Periosteal chondroma, Enchondroma, Osteochondroma, Chondroblastoma vb.

Chondromatosis NOS, Atypical cartilaginous tumor

Chondrosarcoma (G1-3), Periosteal, Clear cell, Mesenchymal, Dedifferentiated

Osteogenic

Osteoma NOS, Osteoid osteoma NOS

Osteoblastoma NOS

Low-grade central osteosarcoma, Osteosarcoma NOS, Parosteal, Periosteal, High-grade surface, Secondary

Fibrogenic

Desmoplastic fibroma

Fibrosarcoma NOS

Vascular (Bone)

Hemangioma NOS

Epithelioid hemangioma

Epithelioid hemangioendothelioma NOS, Angiosarcoma

Osteoclastic Giant Cell-Rich

Aneurysmal bone cyst, Non-ossifying fibroma

Giant cell tumor of bone NOS

Malignant giant cell tumor of bone

Notochordal

Benign notochordal cell tumor

Chordoma NOS (chondroid dahil), Dedifferentiated, Poorly differentiated

Other Mesenchymal (Bone)

Chondromesenchymal hamartoma, Simple bone cyst, Fibrous dysplasia, Osteofibrous dysplasia, Lipoma, Hibernoma

Osteofibrous dysplasia-like adamantinoma, Mesenchymoma NOS

Adamantinoma (dediff.), Leiomyosarcoma NOS, Pleomorphic sarcoma undiff., Bone metastases

Hematopoietic

Plasmacytoma, Hodgkin, Non-Hodgkin lenfomalar, Langerhans histiocytosis, Erdheim-Chester, Rosai-Dorfman

Undifferentiated Small Round Cell

Ewing sarcoma, CIC-rearranged, BCOR altered sarcoma