The differential diagnosis for a vertebral body mass is broad and may range from a completely benign, sclerotic enostosis (bone island) to a malignant primary bone tumor.
Broadly, these lesions can be separated into:
non-neoplastic lesions
secondary metastatic disease
Non-neoplastic lesions
aneurysmal bone cyst (<2%)
neural arch (60%); vertebral body (40%)
Brown tumor (an osteoclast reaction in hyperparathyroidism)
enostosis
vertebral hemangioma