**2. Clinical evaluation**

History and physical examination are the initial approaches for any patient suspected of having a bone neoplasm (**Table 1**). Data, such as age (isolated corresponds to the most important data [10]), time of complaint, presence of pain, location of the lesion, and personal and family history of cancer, may provide important information for


### **Table 1.**

*Systematic evaluation.*

clinical reasoning and diagnostic management [10–13]; although the physical examination is generally nonspecific [14]. Often the suspicion of a bone neoplasm occurs only due to an accidental finding of some imaging test [1].

About only malignant primary bone neoplasms, these are more common between 0 and 20 years of age (for patients under 5 years old, the diagnosis of metastases of neuroblastoma is more common). Osteosarcoma and Ewing's sarcoma are more common between 5 and 20 years of age. In patients over 40 years of age, secondary malignancies (metastases) and multiple myeloma are the most common diagnosis [15].
