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Characteristics of Benign and Malignant Bone Tumors Registered in the Hiroshima Tumor Tissue Registry, 1973-2012

Sugiyama, Hiromi, PhD1,a; Omonishi, Kunihiro, MD, PhD2; Yonehara, Shuji, MD, PhD3; Ozasa, Kotaro, MD, PhD1; Kajihara, Hiroki, MD, PhD4; Tsuya, Takafumi, MD, PhD4; Takeshima, Yukio, MD, PhD5 on behalf of the Hiroshima Tumor Tissue Registry Working Committee

doi: 10.2106/JBJS.OA.17.00064
Scientific Articles: PDF Only

Background: Reported information on the characteristics of benign bone tumors is disjointed, and the long-term trends in the occurrence of malignant bone tumors by histological type have not been reported in Japan. Our aim was to describe the characteristics of both benign and malignant bone tumors as described in cases registered in the Hiroshima Tumor Tissue Registry from 1973 to 2012.

Methods: Cases were identified with the International Classification of Diseases for Oncology (ICD-O-3) topography code C40-C41 (bones, joints, and articular cartilage), and histological types were classified according to the World Health Organization 2013 system. We described the distribution of the cases by behavior, sex, skeletal site of tumor occurrence, histological type, period at diagnosis (in 10-year groups), and age at diagnosis (in 10-year groups).

Results: We observed 2,542 benign bone tumors, 272 intermediate bone tumors, and 506 malignant bone tumors. We confirmed that 81.6% of benign bone tumors were chondrogenic, consisting primarily of osteochondromas and enchondromas. Giant cell tumor of bone was the most dominant type of intermediate tumor, whereas osteogenic tumors and chondrogenic tumors were the most dominant types of malignant tumors. Among malignant bone tumors, 41.7% of tumors occurred in the long bones of the lower limb, and there were different peaks of age at the time of diagnosis for osteogenic tumors and chondrogenic tumors. A similar distribution of histological types was seen throughout the 40-year observation period.

Conclusions: Osteochondroma and enchondroma differed in terms of the age of the patient at the time of diagnosis and the skeletal sites where the tumors most frequently occurred. Giant cell tumor had a large impact on occurrence as a common type of intermediate bone tumor.

Clinical Relevance: The results of the present study, based on pathological tissue registry data, provide knowledge about the epidemiological and pathological features of bone tumors in Japan.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

1Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Hiroshima, Japan

2Department of Pathology, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan

3Department of Pathology and Research Laboratory, Welfare Association Onomichi General Hospital, Onomichi, Hiroshima, Japan

4Hiroshima Prefecture Medical Association, Hiroshima, Hiroshima, Japan

5Department of Pathology, Institute of Biomedical and Health Sciences, Graduate School of Hiroshima University, Hiroshima, Hiroshima, Japan

E-mail address for H. Sugiyama:

* The Hiroshima Tumor Tissue Registry Working Committee includes all authors of the present study as well as Koji Arihiro, Kouichi Ichimura, Mai Utada, Atsuko Sadakane, Yukie Kan, Ikuko Ogawa, Mayumi Kaneko, Hideo Tanaka, Hideshi Kawakami, Kazuya Kuraoka, Naomi Sasaki, Kazuhiro Sentani, Yutaka Daimaru, Yoshiro Tachiyama, Tomohiro Toji, Hirofumi Nakayama, Takashi Nishisaka, Megumu Fujihara, Koichi Mandai, Yuki Hirai, Jun Noma, and Hiroyasu Yamada.

Investigation performed at the Hiroshima Prefecture Medical Association and the Radiation Effects Research Foundation, Hiroshima, Japan

Disclosure: This study was conducted by the Hiroshima Tumor Tissue Registry Working Committee, which was operated by the Hiroshima Prefecture Medical Association with cooperation and financial support of Hiroshima Prefecture and the Radiation Effects Research Foundation. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

© 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The Journal of Bone and Joint Surgery, Incorporated.