Abstract
Background/Objectives: Benign bone tumors and tumor-like conditions are commonly encountered in the pediatric population, often discovered incidentally during radiographic evaluation or presenting with symptoms such as pain, swelling, or pathologic fractures. Despite their benign nature, these lesions can significantly impact bone integrity and function. The objective of this study was to characterize the epidemiology, histopathological spectrum and management of benign bone tumors in a pediatric population. Methods: We conducted a retrospective observational single-center study of pediatric patients diagnosed with benign bone tumors or tumor-like lesions between 2013 and 2023. Clinical presentations, radiological findings, histopathological diagnoses, and treatment modalities were reviewed. Biopsy results and surgical indications were analyzed to assess diagnostic yield and therapeutic strategies. Results: Among the 253 biopsies performed, 220 cases (86.6%) were diagnosed as benign tumors, with osteochondromas being the most common (62.3%). The majority of cases involved the appendicular skeleton, with a male predominance. Simple bone cysts, aneurysmal bone cysts, and nonossifying fibromas were also frequently observed. Pathological fractures were documented in 5.45% of cases. Surgical intervention was indicated in patients with symptomatic lesions, pathological fractures, or radiological signs of structural instability. Conclusions: Benign bone tumors and tumor-like lesions in pediatric patients, although non-malignant, may lead to significant skeletal complications. Our findings highlight the importance of structured diagnostic evaluation and individualized treatment planning based on lesion type, location and clinical presentation. Early radiological assessment combined with histopathological confirmation plays a key role in preventing complications and optimizing outcomes. A multidisciplinary approach remains essential in the comprehensive management of these conditions.