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Published on: September 9, 2020
Patterns and Timing of Local Recurrence in Benign Bone Tumors
Bradley R Melvin1, Yumeng Gao2, Abigail Grothe2
1Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
The Iowa Orthopaedic Journal
|July 28, 2026
Summary
Benign bone tumor recurrence varies by type. Osteoid osteomas and osteoblastomas recur symptomatically early, while giant cell tumors, aneurysmal bone cysts, and unicameral bone cysts often recur asymptomatically, requiring surveillance.
Area of Science:
- Orthopedic Surgery
- Oncology
- Radiology
Background:
- Benign bone tumors are diverse nonmalignant lesions.
- Surgical treatment is common for symptomatic or fracture-risk tumors.
- Limited data exists on recurrence timing and presentation across different benign bone tumor histologies, hindering standardized surveillance protocols.
Purpose of the Study:
- To analyze local recurrence patterns of surgically treated benign bone tumors based on histology.
- To define recurrence timing and presentation characteristics for various benign bone tumor types.
Main Methods:
- Retrospective cohort study of 329 curative-intent procedures for benign bone tumors (2010-2024).
- Included histologies: giant cell tumor (GCT), aneurysmal bone cyst (ABC), unicameral bone cyst (UBC), osteoid osteoma (OO), chondroblastoma (CB), osteoblastoma (OB), non-ossifying fibroma, chondromyxoid fibroma.
- Recurrence defined by histology or imaging; primary outcome was mode of presentation (symptomatic vs. radiographic).
Main Results:
- Forty-two recurrences (12.8%) were identified, with presentation varying significantly by histology (p = 0.001).
- Osteoid osteoma and osteoblastoma recurred exclusively symptomatically and early (within 1 year).
- Giant cell tumor, aneurysmal bone cyst, and unicameral bone cyst predominantly recurred asymptomatically, with most recurrences occurring within 3-5 years. Cement use in GCT was associated with lower recurrence than allograft.
Conclusions:
- Histology is a key determinant of benign bone tumor recurrence patterns.
- Symptomatic recurrences of osteoid osteoma and osteoblastoma suggest limited need for routine imaging surveillance.
- Asymptomatic recurrences of GCT, ABC, and UBC justify structured imaging surveillance for 3-5 years. Cement may reduce GCT recurrence.
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