Resumen: Bone tumors are considered difficult to diagnose by most pathologists as they are rare, have overlapping morphology, need radiological correlation, and the usefulness of immunohistochemistry is limited to a relative small number of differential diagnosis, making conventional morphology and knowledge of clinicoradiological presentation the cornerstones of the diagnosis. Three main groups of bone tumors are identified: (i) tumors with specific translocations combined with a relatively simple karyotype involving chromosomal translocations (Ewing sarcoma, aneurysmal bone cyst, mesenchymal chondrosarcoma), (ii) tumors with specific gene mutations or amplifications or deletions (chondrosarcoma, giant cell tumor of bone, chondroblastoma, fibrous dysplasia, chordoma osteochondroma), and (iii) sarcomas with genetic instability and as a consequence complex karyotypes (osteosarcoma). An accurate diagnosis is essential to guide the surgeons hands, predict clinical outcome and for multimodal treatment decision-making.
