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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
Recurrence patterns of benign bone tumors vary 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 and often surgically treated.
- Limited data exists on recurrence timing and presentation across different tumor types.
- Standardized surveillance protocols are lacking due to this data gap.
Purpose of the Study:
- To analyze recurrence patterns of locally recurrent benign bone tumors after surgical treatment.
- To define how recurrence timing and presentation differ based on tumor histology.
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), osteoblastoma (OB), etc.
- Primary outcome: symptomatic vs. radiographic recurrence; secondary outcomes: time to recurrence, bone filler type.
Main Results:
- 12.8% (42/329) of tumors recurred.
- Recurrence presentation varied significantly by histology (p=0.001).
- Osteoid osteoma and osteoblastoma recurred symptomatically within the first year; GCT, ABC, and UBC often recurred asymptomatically.
Conclusions:
- Histology is a key determinant of benign bone tumor recurrence patterns.
- Symptomatic recurrences of OO and OB suggest limited need for routine imaging.
- Asymptomatic recurrences of UBC, GCT, and ABC warrant 3-5 years of structured imaging surveillance.
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