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Duerr, Hans Roland (2018): Entartungsrisiko von gutartigen Knochenläsionen. In: Onkologe, Vol. 24, No. 3: pp. 208-215
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Some benign bone lesions, such as a subset of tumors and non-neoplastic lesions, have in some cases a significant risk of malignant dedifferentiation. The knowledge about this is essential as patients' management and guidance must be adapted accordingly. The aim of this article is to name the specific lesions and to present the relative risks and the potential malignant course. From the existing literature and clinical experience, those bone lesions were identified that have a proven or a suspected potential for secondary malignancy. This was then evaluated in a dedicated literature review. Evidence of dedifferentiation or secondary malignancy was found in cartilaginous exostoses, enchondromatosis, Paget's disease, fibrous dysplasia, osteofibrous dysplasia, bone infarction, osteomyelitis, and synovial chondromatosis. For notochordal tumors, osteoblastomas and aneurysmal bone cysts, the currently available data are not convincing. There are benign lesions that can dedifferentiate into secondary malignancy with an incidence of up to 40%. This must be mentioned in the patient consultation. Lesion-adapted follow-up investigations, such as whole-body magnetic resonance imaging (MRI) in multiple chondroid lesions may be expensive but justifiable in those cases.