Musculoskeletal Oncology — MCQs

Question 11: Which is the commonest true benign bone neoplasm?

• A. Hemangioma
• B. Osteoid osteoma (Correct Answer)
• C. Osteochondroma
• D. Enchondroma

Explanation: ***Osteoid osteoma*** - This is one of the most frequently encountered **true benign bone neoplasms**, characterized radiographically by a **nidus** surrounded by sclerotic bone. - It commonly presents with **nocturnal pain** relieved by NSAIDs, often affecting long bones and the posterior elements of the spine. *Hemangioma* - While relatively common, particularly in the **vertebral bodies** and skull, hemangiomas are vascular malformations rather than true primary bone-forming tumors. - They are often asymptomatic and discovered incidentally, appearing as a **"corduroy cloth" pattern** on imaging in the spine. *Osteochondroma* - This is the **most common benign bone tumor overall**, but it is a **cartilage-capped bony exostosis** arising from the external surface of a bone, not a true neoplasm originating within the bone matrix itself. - It is typically found near **growth plates** and can be solitary or multiple (hereditary multiple exostoses). *Enchondroma* - Enchondromas are common **cartilaginous neoplasms** found intramedullary, primarily in the small bones of the hands and feet or in long bones. - While frequent, they are not classified as true bone-forming tumors like osteoid osteoma and can be associated with syndromes like **Ollier's disease** or **Maffucci's syndrome**.