Primary bone tumors are uncommon and this has certainly contributed to the scarcity of data about their relative frequency, and to the limited understanding of the risk factors. Overall, bone sarcomas account for 0.2% of all malignancies, and the adjusted incidence rate for all bone and joint malignancies is 0.9 per 100,000 persons per year, while the 5-year overall survival rate is 67.9% .Although the incidence of benign bone tumors is higher than the incidence of primary malignant tumors, it is likely that benign lesions are underestimated because they often are asymptomatic and not clinically recognized. In addition, primary bone tumors are outnumbered by metastases from carcinomas, melanoma, or hematologic malignancies, such as plasmacytoma. Imaging characterization of focal bone lesions can be challenging. Focal bone lesions have a broad differential diagnosis, including benign and malignant neoplasms, metabolic disorders, degenerative changes, and tumor-like conditions . The accurate differentiation between benign and malignant bone tumors is paramount for optimal patient management, with a considerable impact on prognosis and survival rates. The relapse-free survival of sarcoma patients is significantly better when treatment is guided by a multidisciplinary committee