ESSENTIALS
Tumors have a typical patient age range—<20,>40 years old—and a typical location in the skeleton—flat versus tubular bones, epiphyseal versus metaphyseal versus diaphyseal, or medullary versus cortical versus juxtacortical.
The margin of a lesion and type of periosteal reaction are indicators of lesion aggressiveness, but not necessarily of whether it is benign or malignant: A well-defined lesion with a sclerotic rim and thick unilamellar periosteal reaction is the most innocuous appearance, while a permeated pattern with spiculated periosteal reaction is the most aggressive.
The pattern of mineralization of the tumor matrix is often the clue to the type of tumor: Mineralization of chondral tissue is punctate, flocculent, or arclike, while mineralization of osseous tissue is fluffy and cloudlike.
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