[General diagnostic work-up for benign tumors of the musculoskeletal system]

Benign bone tumors are heterogeneous and have different biological behaviors. Treatment requires knowledge of the principle diagnosis and clinical behavior to avoid, on the one hand, overtreatment and, on the other hand, incorrect diagnosis of a potentially malignant tumor.

Bone tumors of stage I (according to Enneking) should be observed clinically and radiologically. For stage II and stage III lesions, a biopsy should be performed, based on the corresponding oncological guidelines.

Soft tissue tumors have a different radiological behavior (especially in magnetic resonance images): while a lack of sharp cortical margins in bone tumors indicates an aggressive behavior, sharp margins in soft tissue tumors should not be misinterpreted as benign tumors. Subfascial soft tissue tumors, tumors larger than 2 cm, growing tumors, and persisting tumors after trauma require biopsy.