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Chondroma: X-Ray Shows

Chondroma is a benign tumor of hyaline cartilage that usually occurs in bones formed through endochondral ossification. It most commonly appears in the hands, feet, femur, tibia or humerus near the metaphysis. Chondromas may be solitary or multiple lesions and are often asymptomatic, discovered incidentally on x-ray. X-rays show a well-defined radiolucent area at the bone junction that may have flecks of calcification. While typically benign, there is a small risk of malignant transformation, especially in multiple or enlarging lesions or those in older patients. Treatment involves curettage and bone grafting if the lesion is enlarging or causes fractures.

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57 views

Chondroma: X-Ray Shows

Chondroma is a benign tumor of hyaline cartilage that usually occurs in bones formed through endochondral ossification. It most commonly appears in the hands, feet, femur, tibia or humerus near the metaphysis. Chondromas may be solitary or multiple lesions and are often asymptomatic, discovered incidentally on x-ray. X-rays show a well-defined radiolucent area at the bone junction that may have flecks of calcification. While typically benign, there is a small risk of malignant transformation, especially in multiple or enlarging lesions or those in older patients. Treatment involves curettage and bone grafting if the lesion is enlarging or causes fractures.

Uploaded by

Md Ahsanuzzaman Pinku
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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Chondroma

Introduction:
Chondromas are benign tumors of hyaline cartilage that usually
occur in bones of enchondral origin
 Enchodroma – solitary lesion arise within the medullary cavity
 Ecchondroma – solitary lesion on the surface of bone, called subperiosteal or
juxtacortical chondromas
 Ollier disease - A syndrome of multiple enchondromas or enchondromatosis
 Maffucci syndrome - .enchondromatosis is associated with soft-tissue

Pathogenesis:
Islands of cartilage may persist in the metaphyses of bones formed by
endochondral ossification; sometimes they grow and take on the
characteristics of a benign tumour.

Incidence:
Age; any age but mostly in young people
Site: any bone preformed in cartilage
But frequently occurs in the bones of the hands and foot
May appear in the femur, tibia, and humerus
Usually in the metaphysis

Clinical presentation:
Usually asymptomatic and are discovered incidentally on x-ray or
after a pathological fracture. Lesions may be solitary or multiple and
part of a generalized dysplasia.
X-ray shows
A well-defined, centrally placed radiolucent area at the junction of
metaphysis and diaphysis; sometimes the bone is slightly
expanded. There is no reactive bone formation.
In mature lesions - flecks or wisps of calcification within the lucent area
(pathognomonic)
 During the active phase in adolescence, the lesion may slowly enlarge.
 In the inactive or latent phase in adulthood, the cartilaginous tissue may calcify
in a diffuse punctate or stippled configuration. These calcifications sometimes appear
on the radiograph as subtle “smoke ring” or “ring and arc” images.
 As the lesion matures, it develops a more reactive margin.
 do not enlarge after skeletal maturity
 Enchondromas resemble bone infarcts

Pathology
Gross: pearly-white cartilaginous tissue, with a central area of
degeneration and calcification.
Histologically: appearances are those of simple hyaline cartilage.

It can be difficult to distinguish between an active benign enchondroma and a lowgrade


malignant chondrosarcoma on the basis of histologic examination alone.
Therefore, if there is radiographic evidence of full-thickness cortical destruction (not
just endosteal scalloping from within) or MRI appearance of a soft tissue mass, this
may provide evidence that the lesion is a chondrosarcoma.
Treatment:
Asymptomatic solitary lesion – no treatment. Follow up
Enlarging or pathological fracture – curettage and fill the defect with bone
graft or cement
Recurrence rate – high
Prognosis:
There is a small but significant risk of malignant change –
 Solitary lesions - probably -<2% (hardly ever in a
child)
 Multiple lesions (Ollier’s disease) - 30 %
 Maffucci’s syndrome - 100 % (associated
haemangiomas)

Signs of malignant transformation


Patients over 30 years are:
(1) The onset of pain;
(2) Enlargement of the lesion; and
(3) Cortical erosion.
 biopsy is of little help in this regard as the cartilage usually looks
benign during the early stages of malignant transformation.
 If the other features are present, and especially in older patients
o treated as a stage IA malignancy;
o the biopsy then serves chiefly to confirm the fact that it is a
cartilage tumour.

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