Differential diagnosis of benign pediatric bone tumors

• Aneurysmal bone cyst
• Chondroblastoma
• Chondromyxoid fibroma
• Cortical desmoid
• Enchondroma / Enchondromatosis – Maffucci syndrome / Enchondromatosis – Ollier Disease
• Fibrous cortical defect
• Fibrous dysplasia / Polyostotic fibrous dysplasia
• Giant cell tumor
• Osteochondroma
• Osteoid osteoma / Osteoblastoma
• Unicameral bone cyst

Approach to the differential diagnosis of benign bone tumors:

• Location (diaphysis, metaphysis, epiphysis, abut articular surface)
• Lytic or blastic
• Matrix (chondroid, osteoid, fibrous)
• Zone of transition (wide, narrow)
• Periosteal new bone and / or cortical destruction

In general, benign bone tumors tend to have a narrow zone of transition with no periosteal new bone formation or cortical destruction