Articles

Cases

Courses

WHO classification of tumors of bone

Last revised by Arlene Campos on 3 Jul 2024

Citation, DOI, disclosures and article data

Citation:

Deng F, Campos A, Yap J, et al. WHO classification of tumors of bone. Reference article, Radiopaedia.org (Accessed on 05 Oct 2024) https://doi.org/10.53347/rID-73979

DOI:

https://doi.org/10.53347/rID-73979

Permalink:

https://radiopaedia.org/articles/73979

rID:

73979

Article created:

30 Jan 2020, Francis Deng ◉

Disclosures:

At the time the article was created Francis Deng had no recorded disclosures.

View Francis Deng's current disclosures

Last revised:

3 Jul 2024, Arlene Campos ◉

Disclosures:

At the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.

View Arlene Campos's current disclosures

Revisions:

11 times, by 8 contributors - see full revision history and disclosures

Systems:

Musculoskeletal, Oncology

Sections:

Classifications

Synonyms:

Bone tumors (WHO classification)
WHO classification of bone tumors
Bone tumours (WHO classification)
WHO classification of bone tumours

The World Health Organization (WHO) classification of bone tumors is the most widely used pathologic classification system for such disorders. The revision, part of the 5^th edition of the WHO series, was published in 2020 and is reflected in the article below ¹.

osteochondroma
periosteal chondroma
enchondroma
chondromyxoid fibroma
osteochondromyxoma
subungual exostosis
bizarre parosteal osteochondromatous proliferation
synovial chondromatosis
chondroblastoma
central atypical cartilaginous tumor / chondrosarcoma (grade 1)
secondary peripheral atypical cartilaginous tumor / chondrosarcoma (grade 1)
central chondrosarcoma (grades 2-3)
secondary chondrosarcoma (grade 2-3)
periosteal chondrosarcoma
dedifferentiated chondrosarcoma
mesenchymal chondrosarcoma
clear cell chondrosarcoma

Osteogenic tumors

osteoma
osteoid osteoma
osteoblastoma
low-grade central osteosarcoma
osteosarcoma
- conventional osteosarcoma
- telangiectatic osteosarcoma
- small cell osteosacroma
parosteal osteosarcoma
periosteal osteosarcoma
high-grade surface osteosarcoma
secondary osteosarcoma

Fibrogenic tumors

Vascular tumors

Osteoclastic giant cell-rich tumors

Notochordal tumors

Other mesenchymal tumors of bone

Hematopoietic neoplasms

Changes from the prior version

Entities and variants

Entities include the following ¹:

chondrogenic tumors
- secondary peripheral atypical cartilaginous tumor / chondrosarcoma (grade 1)
- secondary chondrosarcoma (grade 2-3)
osteogenic tumors
- secondary osteosarcoma
notochordal tumors
- dedifferentiated chordoma
- poorly differentiated chordoma
other mesenchymal tumors of bone
- fibrocartilaginous mesenchymoma
- bone metastases

Other changes

Ewing sarcoma has been moved to a whole different chapter together with several other entities of undifferentiated small round cell sarcomas of soft tissue and bone
clearer differentiation of central and secondary peripheral chondrosarcoma variants:
- central atypical cartilaginous tumor / chondrosarcoma (grade 1)
- secondary peripheral atypical cartilaginous tumor / chondrosarcoma (grade 1)
- central chondrosarcoma (grades 2-3)
- secondary chondrosarcoma (grade 2-3)
non-ossifying fibroma and aneurysmal bone cyst have been classified as osteoclastic giant cell-rich tumors
Langerhans cell histiocytosis, Erdheim-Chester disease and Rosai-Dorfman disease have been classified as hematopoietic neoplasms of bone
myogenic, lipogenic, epithelial tumors and tumors of undefined neoplastic nature have been classified as other mesenchymal tumors of bone which also includes undifferentiated pleomorphic sarcoma
giant cell lesion of the small bones has been removed as a separate entity

References

Incoming Links

Promoted articles (advertising)

{"current_user":null,"inclusions":[{"imageId":53270842,"studyId":92261,"caseSlug":"bone-lesion-differential-diagnosis-illustrations","caption":"Figure 1: bone lesions below age 30","isStack":false,"diagnosticCertainty":"not_applicable","thumbnail":"https://prod-images-static.radiopaedia.org/images/53270842/235fea9ab77cd55b0f727100683769_big_gallery.jpeg"},{"imageId":53889482,"studyId":99516,"caseSlug":"osteochondroma-51","caption":"Case 1: osteochondroma","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/53889482/22_big_gallery.jpeg"},{"imageId":53270844,"studyId":94246,"caseSlug":"bone-lesion-differential-diagnosis-illustrations","caption":"Figure 2: bone lesions above age 30","isStack":false,"diagnosticCertainty":"not_applicable","thumbnail":"https://prod-images-static.radiopaedia.org/images/53270844/e0ca7369310c36bf23c58ccc2f0486_big_gallery.jpeg"},{"imageId":42009308,"studyId":70895,"caseSlug":"enchondroma-14","caption":"Case 2: enchondroma","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/42009308/fa33bf3c120469826a065ead90d39e_big_gallery.jpeg"},{"imageId":44713057,"studyId":73885,"caseSlug":"chondromyxoid-fibroma-2","caption":"Case 3: chondromyxoid fibroma","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/44713057/0d113ae5d208c81729f33c95dbf9b7_big_gallery.jpeg"},{"imageId":53570332,"studyId":96692,"caseSlug":"subungual-exostosis-7","caption":"Case 4: subungual exostosis","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/53570332/IMG-0001-00001_big_gallery.jpeg"},{"imageId":8106968,"studyId":31485,"caseSlug":"bizarre-parosteal-osteochondromatous-proliferation-nora-lesion-1","caption":"Case 5: bizarre parosteal osteochondromatous proliferation (Nora lesion)","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/8106968/b0d1ea972ae766ed7c668ca6b4dde1_big_gallery.jpeg"},{"imageId":54772923,"studyId":104980,"caseSlug":"synovial-chondromatosis-27","caption":"Case 6: synovial chondromatosis","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/54772923/synovial.PNG1_big_gallery.jpeg"},{"imageId":57143931,"studyId":117339,"caseSlug":"chondroblastoma-13","caption":"Case 7: chondroblastoma","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/57143931/931a0677ce6d0adb5859095bf9ca2342d7a3a14d0e0e879b5a50acf715ec28f1_big_gallery.jpeg"},{"imageId":8010839,"studyId":31305,"caseSlug":"chondrosarcoma-4","caption":"Case 8: chondrosarcoma","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/8010839/ca60ec9cc9566101df36ca89746aff_big_gallery.jpg"},{"imageId":25066,"studyId":7686,"caseSlug":"bone-island-1","caption":"Case 9: osteoma","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/25066/05fb8b344fb8855a3bea818af07eb0_big_gallery.jpeg"},{"imageId":5146203,"studyId":26107,"caseSlug":"osteoid-osteoma-13","caption":"Case 10: osteoid osteoma","isStack":true,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/5146203/ecfeb44be41e354ec758de35bebe39_big_gallery.jpg"},{"imageId":381313,"studyId":9854,"caseSlug":"osteoblastoma-1","caption":"Case 11: osteoblastoma","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/381313/d1142189360c276bc1d58319aaaee4_big_gallery.jpg"},{"imageId":50106728,"studyId":79168,"caseSlug":"osteosarcoma-24","caption":"Case 12: osteosarcoma","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/50106728/dd737f2c8b5fc38596a04803a8efe2_big_gallery.jpeg"},{"imageId":7227091,"studyId":29943,"caseSlug":"desmoplastic-fibroma","caption":"Case 13: desmoplastic fibroma","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/7227091/bf9e2c17bc0e4aa4034a8d5da8490d_big_gallery.jpg"},{"imageId":132959,"studyId":8306,"caseSlug":"vertebral-haemangioma","caption":"Case 14: hemangioma","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/132959/620b48113020b67deaa7898d987015_big_gallery.jpg"},{"imageId":17273294,"studyId":43661,"caseSlug":"aneurysmal-bone-cyst-16","caption":"Case 15: aneurysmal bone cyst","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/17273294/d5cfdfbf64a06037019e7bca325062_big_gallery.jpeg"},{"imageId":53575373,"studyId":12487,"caseSlug":"aneurysmal-bone-cyst-6","caption":"Case 16: aneurysmal bone cyst (MRI)","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/53575373/ca17fa65195f023038c6dacf740c53_big_gallery_big_gallery.jpeg"},{"imageId":569778,"studyId":11817,"caseSlug":"giant-cell-tumour-5","caption":"Case 17: giant cell tumor","isStack":false,"diagnosticCertainty":"possible","thumbnail":"https://prod-images-static.radiopaedia.org/images/569778/4602023887cbb89cc6271ede07d9f9_big_gallery.jpg"},{"imageId":546345,"studyId":11290,"caseSlug":"non-ossifying-fibroma-3","caption":"Case 18: non-ossifying fibroma","isStack":false,"diagnosticCertainty":"probable","thumbnail":"https://prod-images-static.radiopaedia.org/images/546345/db9d9d8467aefd133de0f991cd2460_big_gallery.jpg"},{"imageId":6261,"studyId":6597,"caseSlug":"chordoma-clivus-5","caption":"Case 19: chordoma","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/6261/cf90720652963679f2c90999c331da_big_gallery.jpeg"},{"imageId":18103926,"studyId":44558,"caseSlug":"osteofibrous-dysplasia-of-the-tibia","caption":"Case 20: osteofibrous dysplasia","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/18103926/0c1f1074cb258a795fff06e95eaf88_big_gallery.jpeg"},{"imageId":5554574,"studyId":27021,"caseSlug":"adamantinoma-1","caption":"Case 21: adamantinoma","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/5554574/5cc93c43226d6940ee4b8344a9a63e_big_gallery.jpg"},{"imageId":530301,"studyId":10882,"caseSlug":"unicameral-bone-cyst-9","caption":"Case 22: simple bone cyst","isStack":false,"diagnosticCertainty":"probable","thumbnail":"https://prod-images-static.radiopaedia.org/images/530301/f5198dbbefb7eb4382acfff0f861fe_big_gallery.jpg"},{"imageId":1191517,"studyId":14110,"caseSlug":"fibrous-dysplasia-in-tibia","caption":"Case 23: fibrous dysplasia","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/1191517/3b7b74201fae98f2a2a162533a7b7a_big_gallery.jpg"},{"imageId":31045849,"studyId":20394,"caseSlug":"calcaneal-lipoma-with-cockade-sign-2","caption":"Case 24: lipoma of bone","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/31045849/faa40f86bd88451970ccba56a7291b_big_gallery.jpeg"},{"imageId":7220593,"studyId":29921,"caseSlug":"malignant-fibrous-histiocytoma-of-the-humerus-1","caption":"Case 25: undifferentiated pleomorphic sarcoma","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/7220593/1f9c7f6a42608d1964f8c949382700_big_gallery.JPG"},{"imageId":54203267,"studyId":101631,"caseSlug":"sclerotic-bone-metastases-prostate-cancer-2","caption":"Case 26: bone metastasis","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/54203267/d50b47be6eeaa4e09f36fa323792f181be7b7c7cb2df663557f2c655077332a2_big_gallery.jpeg"},{"imageId":19444322,"studyId":46096,"caseSlug":"plasmacytoma-8","caption":"Case 27: solitary plasmacytoma of bone","isStack":true,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/19444322/0a93b4b7187ee86f3acb575e67805d_big_gallery.jpeg"},{"imageId":8713585,"studyId":32489,"caseSlug":"non-hodgkin-lymphoma-of-bone","caption":"Case 28: primary non-Hodgkin lymphoma of bone","isStack":false,"diagnosticCertainty":null,"thumbnail":"https://prod-images-static.radiopaedia.org/images/8713585/f9d418940e3d845818cb12eb69095a_big_gallery.jpg"},{"imageId":156819,"studyId":8898,"caseSlug":"langerhans-cell-histiocytosis-4","caption":"Case 29: Langerhans cell histiocytosis","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/156819/9f85f981e10c82e247dbe66dbfd8af99bb2f3fccfd33361f3b181bbf14be6264_big_gallery.jpeg"},{"imageId":409440,"studyId":10034,"caseSlug":"erdheim-chester-disease-with-skeletal-and-lung-involvement-1","caption":"Case 30: Erdheim-Chester disease","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/409440/6ff460d6e15c55e37189efff34714f_big_gallery.jpg"}],"ddx_inclusions":[],"lang":"us"}

Updating… Please wait.

Unable to process the form. Check for errors and try again.

Thank you for updating your details.