Dear Editor 1. Introduction Radiographic imaging and pathological results are the two most critical methods for clinicians to distinguish between benign and malignant bone tumors. Fan Yang et al. [1] assessed the performance of ChatGPT3.5 in diagnosing benign and malignant bone tumors through imaging reports, highlighting the potential application of artificial intelligence (AI) technology in medical imaging diagnosis, particularly in enhancing diagnostic efficiency and reducing missed diagnoses. However, they did not evaluate the performance of ChatGPT in pathological images. To fill this gap, we evaluated the preliminary ability of ChatGPT4o in discerning bone tumors through pathological images and to optimize secondary prevention of malignant bone tumors in remote grassroots orthopedic settings. The study seeks to improve the diagnostic and treatment capabilities of remote grassroots doctors, assisting clinicians in early screening, diagnosis, and treatment. Additionally, it aims to ensure timely referral of patients to higher-level hospitals when constrained by objective conditions, thereby enhancing cancer cure rates and survival rates.