Do you have a lesion that has suddenly appeared on your body/ bone or it has been there for some time? Have you heard of benign bone tumours or been diagnosed with one and find little information about it?
In this article, you’ll find answers to the questions you’re probably asking yourself: what is it, how to be sure it’s benign and not malignant, treatment options and when to see a doctor.
I will rely on my knowledge as a diagnostic radiographer and of course as usual on research studies about the subject matter.
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: January , 2026. Written by Juliet Semakula, a diagnostic radiographer.
Though relatively rare, benign bone tumours significantly can impact your health, and may cause pain that gets worse and not better. Some benign bone tumours may need treatment to stop them from destroying bone.
▶️What is a benign bone tumour?
A benign Bone tumour is a rare and diverse group of lesions that can affect any bone in the body.
Bone tumours develop when cells within a bone divide uncontrollably, forming a lump or mass of abnormal tissue.
These osteoblastic lesions, commonly known as “bone islands,” are usually asymptomatic and considered incidental findings.
There is no gender or age preference. They are usually less than 2 cm in diameter, although larger variants have been described as giant bone islands
Source: Motamedi 2011
▶️Does lesion always mean tumour?
No, a lesion does not always mean a tumour, though all tumours are considered lesions.
A lesion is a general term for any area of damaged or abnormal tissue, caused by injury, infection, or disease. Tumours are a specific type of lesion that can be benign (non-cancerous)
The most common bone tumours I see in x-ray are mostly in long bones such as femur, tibia, humerus, pelvis, knee, shoulder, spine and ribs.
Here is an example of a distal femur no ossifying fibroma
A 17-year-old boy with a distal femur no ossifying fibroma (arrow). (A) Frontal radiograph shows an eccentric lesion with sclerotic lobulated margins. (B) Axial CT scan confirming the eccentricity of the lesion and lack of a mineralized matrix (Image from Motamedi,2011)
The main cause of most bone tumours is unknown, as they form when cells in the bone grow out of control due to a problem with their DNA.
Bone tumours develop when cells within a bone divide uncontrollably, forming a lump or mass of abnormal tissue.
Source: Motamedi,2011
Most bone tumours I have seen on x-ray are benign, the word ‘benign’ means ‘not cancerous’
However, some bone tumours are malignant, the word malignant means ‘cancerous’ The findings indicate that osteosarcoma remains the most common primary malignant bone tumour, particularly affecting adolescents and young adults (Hosseini, 2025)
Understanding the occurrence and distribution of bone tumours is crucial for healthcare providers to develop effective screening, diagnostic, and treatment strategies.
Source: Hosseini,2025
▶️Types of benign bone tumours and conditions that are commonly grouped with tumours are:
⚫Non ossifying fibroma tumours are commonly in children which are normally found accidently in children, they often go away on their own.
⚫Unicameral (simple) bone cyst
⚫ Osteochondroma is a type of tumour that grows outside the bone. They are made up of cartilage and bone and can get bigger while the skeleton is growing.
⚫Giant cell tumours grow aggressively.
⚫Enchondroma tumours are found inside the bone in the marrow space, this kind of tumour starts in the cartilage.
⚫ Fibrous dysplasia is a common bone tumour that shows up as a single bone tumour or multiple bone tumours.
⚫Chondroblastoma are common tumours in children which cause pain and its growth affects nearby joints.
⚫Aneurysmal bone cyst
⚫Osteoid osteoma
Motamedi,2011
Rarely, do certain benign tumours spread or become cancerous
▶️What are the symptoms of a benign bone tumour?
Benign bone tumours are often symptomless. Most people with benign tumours do not know they have one often they are found accidental.
For those who get symptoms do complain of the following:
⚫Swelling or a lump which is normally obvious.
⚫Pain that may hurt even when you are resting for example osteoid osteoma being bone tumour causes pain, especially at night, but it can also cause joint pain with synovitis and joint effusion (kitsoulis,2006)
⚫Some people have fractures at the sight of a bone tumour due to bones being weak by a growing tumour.
However, I have seen accidental bone tumours after taking an x-ray for an injury but the patient has no symptoms. So not all bone tumours have symptoms.
▶️How can you tell if you have a bone tumour?
The diagnosis of bone tumours involves a combination of clinical examination, imaging studies, and histopathological analysis.
When you go to the doctors with symptoms, different tests will be done to detect and characterize bone tumours.
Imaging:
♦️X-rays normally show a bone-forming tumour appears as a nidus surrounded by sclerotic tissue. It may be hard to identify when it is intra-articular.
♦️So, a CT scan is normally done because it is accurate in displaying a small, defined nidus surrounded by a sclerotic reaction which may contain calcifications.
X-rays and CT scan of a tibial fracture that occurred in the development site of an Osteoid osteoma (De Salvo 2022)
♦️MRI is always the modality chosen given its excellent soft tissue contrast and lack of radiation exposure.
♦️PET scans
Source: Ghanem 2005
I have also seen:
♦️ Bone Biopsy being done to diagnosis bone tumours and it has been seen as a gold standard for diagnosing bone tumours, as it allows for histopathological examination of the tumour tissue (Iwai,2019)
♦️Molecular and genetic testing can also provide valuable information for diagnosis and treatment planning
▶️Can a bone benign tumour be cured without doing anything?
Most diagnosed benign bone tumours are stage 1 lesions and only in exceptional cases require any treatment.
However, they often cause uncertainty for both the patient and the treating physician, leading to overdiagnosis and potentially further anxiety (Gösling 2024)
♦️If your bone tumour is identified as benign and it is not causing your pain, normally your doctor may recommend just monitoring it closely to see if it changes in size or disappears.
♦️I have seen patients having periodic follow up x-rays to assess tumour growth and appearance.
Research studies state that the natural history of the tumour is of spontaneous resolution within 6 to 15 years, and, if not symptomatic, watchful waiting is the suggested approach (De Salvo, 2022)
So yes, some benign bone tumours may resolve on their own, only requiring monitoring.
▶️What are management and treatment options:
There are several different treatment options available.
The treatment goal is to decrease pain, to avoid the spread of the lesion in the joint and close soft tissues, and to decrease recurrence.
Treatment will depend on the kind of bone tumour you have, your age, and medical history.
Benign and pseudo-neoplastic bone lesions are usually treated by curettage and filling of the cavity by bone cement or graft.
Treatment options:
♦️Some benign tumours with a bone lesion can be treated effectively with medication.
Studies have reported that treatment with NSAIDs or aspirin could reduce the time of healing by 2 or 3 years (De Salvo, 2022)
Case study: a 7-year-old boy who had persistent symptoms such as pain at the top of the humerus, had an x-ray and continued growth of the bone cyst was discovered.
A 7-year-old male with a painful range of motion in his left shoulder diagnosed with a unicameral bone cyst.
♦️The patient was taken to the operating room for aspiration and steroid injection (image a)
♦️Venous drainage during the injection was noted (arrow).
Follow-up x-ray 6 weeks and 10 months after the procedure show the development of peripheral sclerosis and possible cortical and trabecular thickening with no change in size, consistent with healing changes after the steroid injection (b and c).
Source: Dobson 2015
Some benign tumours are removed by surgery to help reduce the risk of fracture.
Surgical approach:
If your symptoms are causing you scoliosis, length discrepancy, and other morpho-functional disorders then your doctor may suggest surgery to remove the tumour.
The most common surgical technique is:
♦️Treating benign bone tumours with curettage and packing, cement or bone graft may be used.
Benefits of cement include:
🔴Immediate structural support.
🔴Favourable imaging appearance for detecting recurrence
🔴Potential cytotoxic effects
However, cement lacks a component of long-term structural integrity, and some surgeons prefer using bone graft whenever possible for its eventual incorporation into bone (Puri 2007)
Here are two case studies: one used cement and the other bone grafting.
Case study 1️⃣: using cement.
🔴22-year-old female with recurrent sharp, burning pain in the proximal right tibia diagnosed with recurrent giant cell tumour of the proximal tibia.
🔴X-ray of the right knee (a) shows post-treatment changes of curettage and packing with cement.
🔴A lytic lesion is present at the inferior aspect of the cement (arrow)
The main x-ray features suspicious for recurrence after packing with cement is a focal lytic lesion along the edge of the cement, especially when growing over time (Dobson2015)
Case study 2️⃣: using bone graft
🔴 21-year-old male with anterolateral right knee pain diagnosed with giant cell tumour of the distal femur.
🔴X-ray of the right knee (a) demonstrates an expansile lytic lesion with a narrow zone of transition abutting the articular surface of the trochlea.
🔴Postoperative x-ray at 6 weeks (b) and 1 year (c) after curettage and packing with bone graft demonstrate progressive incorporation of the graft with a mottled appearance.
🔴There is no evidence of recurrence.
Dobson2015
The normal appearance of bone graft after curettage and packing is more heterogeneous and variable than cement, making detection of recurrence more difficult
Sometimes these tumours can reappear. According to research studies recurrence has a rate of 8.3–21%, and it increases if the surgery is inadequate or if the lesion is localized in the hip or pelvis (Özer,2018)
Pain and swelling are the most common symptoms when recurrence is suspected.
▶️What happens if a benign tumour is left untreated?
Many benign tumours don’t need treatment. But some can continue to grow. For example, benign brain tumours can press against healthy tissue, affecting vision or speech.
That’s why in such cases surgery may be recommended.so if your tumour is growing and pressing on any vital body organ such as a brain. You must seek medical assessment by a professional.
While benign tumours don’t spread, some types, certain colon polyps or skin moles, can become cancerous over time, which is why they are often monitored or surgically removed.
Delaying removal can make surgery more difficult and potentially affect the outcome.
🟠Tumours on endocrine glands can cause hormonal imbalances and lead to symptoms like high blood pressure, rapid heartbeat, and tremors, as seen with certain adrenal tumours
🟠Spinal tumours: Can lead to back pain, numbness, or weakness in the limbs.
Note! It’s very rare for benign tumours to disappear without treatment, most remain stable or grow slowly over time.
Source: Motamedi 2011
▶️Why would your doctor recommend monitoring and removing
♦️Gather information: Monitoring helps doctors understand how the condition is behaving and decide the best time for intervention, ensuring that treatment is only used if necessary.
♦️️Prevent over treatment: Some slow-growing benign tumours might never cause problems within your natural lifespan, meaning immediate treatment would be unnecessary.
♦️To delay or avoid the significant side effects associated with immediate treatments like surgery or radiotherapy, which can impact quality of life
Surgery will be recommended because:
♦️Surgery is often the primary option for removing a localized tumour with the aim of curing the tumour before it can spread to other parts of the body.
♦️Symptom relief: Removal may be necessary to alleviate significant symptoms that affect your quality of life.
♦️Help in diagnosis and testing: Sometimes a doctor will remove a piece of growth or an abnormal area (biopsy) to determine if it is cancerous and what type it is, which then informs the treatment plan.
Ultimately, the decision to monitor or remove will depend on the specific diagnosis, the potential for the condition to spread, your overall health and age, and a shared discussion between you and your doctor about the quality-of-life priorities.
▶️What are the chances of a benign bone tumour being cancerous?
To give you some reassurance, most benign bone tumours do not become malignant.
The chances of a benign bone tumour becoming cancerous are extremely low, with the likelihood being far less than 1% (Reif,2021)
In most cases, benign bone tumours are non-cancerous and will not spread to other parts of the body. They are also rarely fatal.
A small number of specific benign tumours, such as certain giant cell tumours, have a very slight chance of becoming malignant over time.
Certain conditions such as ollier’s disease and Paget’s disease of the bone can increase the risk of a benign bone tumour becoming cancerous.
It is important to consult a healthcare professional for an accurate diagnosis and to discuss any concerns about bone tumours, as they can monitor the situation and recommend appropriate treatment.
▶️Do benign tumours always have to be removed?
No, benign tumours do not always have to be removed; removal depends on factors such as:
🔵Their size.
🔵Location.
🔵The symptoms they cause you.
Some benign tumours, especially those that are small and don’t cause issues, can be monitored with regular check-ups.
Conclusion: Despite advancements in treatment and care, bone benign tumours remain under-researched compared to other malignancies.
This is partly due to their relative rarity and the diverse nature of the tumours, which makes it challenging to conduct large-scale studies.
We have come to the end of this article, hope I have given you some reassurance ,all references used are below, wishing you a quick recovery!🙋
Any experience or questions lets meet in the comments section.
📚Sources:
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Motamedi K, Seeger LL. Benign bone tumors. Radiol Clin North Am. 2011 Nov;49(6):1115-34, v. doi: 10.1016/j.rcl.2011.07.002. PMID: 22024291.
Ghanem N, Uhl M, Brink I, Schäfer O, Kelly T, Moser E, Langer M. Diagnostic value of MRI in comparison to scintigraphy, PET, MS-CT and PET/CT for the detection of metastases of bone. Eur J Radiol. 2005 Jul;55(1):41-55. doi: 10.1016/j.ejrad.2005.01.016. PMID: 15950100.
Iwai T, Hoshi M, Oebisu N, Orita K, Shimatani A, Takada N, Nakamura H. Exploration of the Optimal Shape for Bone Tumour Biopsy. Anticancer Res. 2019 Aug;39(8):4191-4197. doi: 10.21873/anticanres.13579. PMID: 31366505.
Steffner R. Benign bone tumors. Cancer Treat Res. 2014;162:31-63. doi: 10.1007/978-3-319-07323-1_3. PMID: 25070230.
Gösling T, Hillmann A. Benigne Knochentumoren [Benign bone tumors]. Unfallchirurg. 2014 Oct;117(10):862. German. doi: 10.1007/s00113-014-2575-6. PMID: 25274383.
De Salvo, S.; Pavone, V.; Coco, S.; Dell’Agli, E.; Blatti, C.; Testa, G. Benign Bone Tumors: An Overview of What We Know Today. J. Clin. Med. 2022, 11, 699. https://doi.org/10.3390/jcm11030699
Özer, D.; Arıkan, Y.; Gür, V.; Gök, C.; Akman, Y.E. Chondroblastoma: An evaluation of the recurrences and functional outcomes following treatment. Acta Orthop. Traumatol. Turc. 2018, 52, 415–418.
Dobson MA, McDonald DJ, Wessell DE, Friedman MV. Imaging evaluation of treated benign bone tumours. J Med Imaging Radiat Oncol. 2015 Oct;59(5):599-604. doi: 10.1111/1754-9485.12329. Epub 2015 Jun 24. PMID: 26108970.
Puri A, Agarwal M. Treatment of giant cell tumor of bone: Current concepts. Indian J Orthop. 2007 Apr;41(2):101-8. doi: 10.4103/0019-5413.32039. PMID: 21139760; PMCID: PMC2989131.
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Reif TJ, Matthias J, Fragomen AT, Rozbruch SR. Limb Length Discrepancy and Angular Deformity due to Benign Bone Tumors and Tumor-like Lesions. J Am Acad Orthop Surg Glob Res Rev. 2021 Mar 10;5(3):e00214. doi: 10.5435/JAAOSGlobal-D-20-00214. PMID: 33720060; PMCID: PMC7954373.