With few exceptions, the clinical symptoms of bone tumors are very nonspecific. Pain, swelling and restricted mobility can also be caused by countless other pathological processes, so that the relevant anamnestic information is only partially useful.
Bone pain belongs to the somatic pain and, in contrast to neurogenic or visceral pain, is usually described as dull or pulling. However, in addition to the quality of the pain, the intensity and temporal occurrence over the course of the day can provide helpful information. Night pain and a positive aspirin test, for example, can provide concrete evidence of the presence of an osteodiosteoma. The time course of the symptoms can allow conclusions about the biological behavior. For example, benign tumors usually grow much slower than aggressive, malignant neoplasms. However, exceptions to the rule, such as synovial sarcoma, may feign false certainty.
A pathologic fracture may also represent initial manifestation of a previously unknown bone lesion, both benign and malignant, in a previously asymptomatic individual. Often benign bone tumors appear as incidental findings, but should be further clarified even if the patient is free of symptoms. If an aggressive bone lesion or a rapidly growing soft tissue tumor is found, questions should always be asked about possible B-symptomatology.
Although the symptoms of malignant bone tumors are initially usually intermittent and occur at rest, the pain usually increases continuously in intensity and duration until there is also regular night pain and the pain radiates to adjacent joints. Because most bone tumors arise within the bone, swelling usually does not become apparent until the cortical bone is breached and the tumor extends under or through the periosteum.

However, because of the very nonspecific history and symptoms, a long time often passes before an aggressive tumor is correctly diagnosed. A delay in the specific diagnosis and treatment of these lesions can have serious consequences, as the size of the tumor is a prognostically important factor for recurrence-free survival.