Bone or cartilage mass classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Bone and cartilage tumors may be classified according to the WHO histological classification system into benign and malignant tumors, and categorized into 5 sub-types: cartilage tumors, osteogenic tumors, fibrohistiocytic tumors, notochordal tumors, hematopoietic tumors, and miscellaneous tumors. In addition, bone and cartilage tumors may be sub-classified according to tumor location into 4 subtypes: diaphysis, metaphysis, epiphysis, and ungrouped/others.

Classification

Bone and cartilage tumors may be classified by location, origin, and histopahological origin.

• Tumor location

• Diaphysis
• Epiphysis
• Metaphysis
• Other/Unclassifed

• Tumor nature

• Benign
• Malignant

• Origin

• Primary
• Secondary ( see "Secondary tumors classification" below)

• Histopathological origin

• Cartilage tumors
• Osteogenic tumors
• Fibrohistiocytic tumors
• Notochordal tumors
• Hematopoietic tumors
• Miscellaneous tumors.

• The table below summarizes the classification of bone and cartilage tumors according to histopathological origin, tumor location, and tumor nature.

Bone or cartilage mass classification Adapted from ICD-10/WHO (9180–9269)
Osteogenic tumors: bone-forming tumors	Cartilage tumors: cartilage-forming tumors	Fibrogenic or fibrohistiocytic tumors	Cystic tumors	Others ( hematopoietic, notochordal, and neuroectodermal)
Histological Type
Osteoid osteoma Osteoblastoma Osteoma Osteosarcoma	Osteochondroma Chondroblastoma Enchondroma Chondromyxoid fibroma	Desmoplastic fibroma Fibrous dysplasia Ossyifing fibroma Non-ossifying fibroma	Unicameral bone cyst Aneurysmal bone cyst	Giant cell tumor Adamantimoma Eosinophilic granuloma Ewing sarcoma Metastases
Epiphysis		Diaphysis	Metaphysis
Tumor Location
Chondroblastoma Giant cell tumor Intraosseous ganglion Chondrosarcoma Metastases Ewing sarcoma				Eosinophilic granuloma Ewing sarcomaada Myeloma Metastases Adamantinoma Ossyfing fibroma Enchondroma		Osteosarcoma Chondromyxoid fibroma Unicameral bone cyst Osteoid osteoma Metastases
Benign			Malignant
Tumor Nature
Osteoid osteoma Enchondroma Chondromyxoid fibroma Ossifying fibroma Osteoblastoma Unicameral bone cyst Aneursymalbone cyst Giant cell tumor Osteochondroma			Osteosarcoma Ewing sarcoma Chondrosarcoma Fibrosarcoma Malignant fibrous histiocytoma Plasma cell myeloma Metastases

• The table below summarizes the classification of secondary bone tumors (also known as "metastases") according to location, and bone formation pattern.

Secondary bone tumors: classification Adapted from Greenspan A et al. 2006
Bone formation pattern		Tumor location
Osteolytic	Renal cell cancer Melanoma Multiple myeloma Non-small cell lung cancer Thyroid cancer Non-Hodgkin lymphoma Langerhans cell histiocytosis	Skull	Breast cancer Lung cancer Melanoma Prostate cancer Thyroid cancer (usually follicular) Renal cell cancer Lymphoma Leukaemia Multiple myeloma
Osteoblastic	Prostate cancer Carcinoid syndrome Small cell lung cancer Hodgkin lymphoma Medulloblastoma	Vertebral	Breast cancer Lung cancer Prostate cancer Lymphoma Renal cell carcinoma Gastrointestinal tract malignancies Melanoma
Mixed	Breast cancer Gastrointestinal cancers Squamous cancers (at most primary sites)	Distal appendicular	Lung cancer Breast cancer Renal cell cancer Prostate cancer
Other types ( "Blow out" and "Cookie type")	Renal cell carcinoma Thyroid cancer Hepatocellular carcinoma Bronchogenic carcinoma

References

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