Enchondroma

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Enchondroma
Enchondroma - very high mag.jpg
Micrograph of an enchondroma. H&E stain.

Enchondroma is a type of benign bone tumor belonging to the group of cartilage tumors. [1] [2] There may be no symptoms, [3] or it may present typically in the short tubular bones of the hands with a swelling, pain or pathological fracture. [4]

Contents

Diagnosis is by X-ray, CT scan and sometimes MRI. [4] Most occur as a less than three centimetre size single tumor. When several occur in one long bone or several bones, the syndrome is called enchondromatosis. [4]

Where there are no symptoms, treatment is often not needed. [4] If treatment is required, curettage may be performed. [4] Less than 1% become malignant, unless part of a syndrome. [4]

They comprise around 30% of cartilage tumors. [5] 90% of tumors in the hand are enchondromas. [6]

Symptoms and signs

X-ray showing an enchondroma in the femur. Enchondrom Femur Roentgen.JPG
X-ray showing an enchondroma in the femur.
MRI T1 showing an enchondroma in the femur. Enchondrom Femur T1 sag.png
MRI T1 showing an enchondroma in the femur.

Individuals with an enchondroma often have no symptoms at all. The following are the most common symptoms of an enchondroma. However, each individual may experience symptoms differently. Symptoms may include:[ citation needed ]

The symptoms of enchondroma may resemble other medical conditions or problems.

Associated conditions

An enchondroma may occur as an individual tumor or several tumors. The conditions that involve multiple lesions include the following:[ citation needed ]

Cause

While the exact cause of enchondroma is not known, it is believed to occur either as an overgrowth of the cartilage that lines the ends of the bones, or as a persistent growth of original, embryonic cartilage.[ citation needed ]

Pathophysiology

Enchondroma is a type of benign bone tumor that originates from cartilage. The exact etiology of it is not known. An enchondroma most often affects the cartilage that lines the inside of the bones. The bones most often involved with this benign tumor are the miniature long bones of the hands and feet. It may, however, also involve other bones such as the femur, humerus, or tibia. While it may affect an individual at any age, it is most common in adulthood. The occurrence between males and females is equal. It is not very likely that the enchondroma will grow back in the same spot; the rate is less than ten percent.[ citation needed ]

Diagnosis

Because an individual with an enchondroma has few symptoms, diagnosis is sometimes made during a routine physical examination, or if the presence of the tumor leads to a fracture. In addition to a complete medical history and physical examination, diagnostic procedures for enchondroma may include the following:[ citation needed ]

Differentiating an enchondroma from a bone infarct on plain film may be difficult. Generally, an enchondroma commonly causes endosteal scalloping while an infarct will not. An infarct usually has a well-defined, sclerotic serpentine border, while an enchondroma will not. When differentiating an enchondroma from a chondrosarcoma, the radiographic image may be equivocal; however, periostitis is not usually seen with an uncomplicated enchondroma.[ citation needed ]

Treatment

Specific treatment for enchondroma is determined by a physician based on the age, overall health, and medical history of the patient. Other considerations include:

Treatment may include:

If there is no sign of bone weakening or growth of the tumor, observation only may be suggested. However, follow-up with repeat x-rays may be necessary. Some types of enchondromas can develop into malignant, or cancerous, bone tumors later. Careful follow-up with a physician may be recommended.

See also

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References

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  2. "ICD-11 - ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Retrieved 19 July 2021.
  3. Suster, David; Hung, Yin Pun; Nielsen, G. Petur (1 January 2020). "Differential Diagnosis of Cartilaginous Lesions of Bone". Archives of Pathology & Laboratory Medicine. 144 (1): 71–82. doi: 10.5858/arpa.2019-0441-RA . ISSN   0003-9985. PMID   31877083.
  4. 1 2 3 4 5 6 WHO Classification of Tumours Editorial Board, ed. (2020). "Enchondroma". Soft Tissue and Bone Tumours: WHO Classification of Tumours. Vol. 3 (5th ed.). Lyon (France): International Agency for Research on Cancer. pp. 353–355. ISBN   978-92-832-4503-2.
  5. Engel, Hannes; Herget, Georg W.; Füllgraf, Hannah; Sutter, Reto; Benndorf, Matthias; Bamberg, Fabian; Jungmann, Pia M. (March 2021). "Chondrogenic Bone Tumors: The Importance of Imaging Characteristics". RöFo: Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin. 193 (3): 262–275. doi: 10.1055/a-1288-1209 . ISSN   1438-9010. PMID   33152784.
  6. Pal, Julie; Wallman, Jackie (2019). "33. Ganglions and tumours of the hands and wrist". In Wietlisbach, Christine M. (ed.). Cooper'sFundamentals of Hand Therapy E-Book: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity. St. Louis, Missouri: Elsevier. p. 441. ISBN   978-0-323-52479-7.
  7. Wang XL, De Beuckeleer LH, De Schepper AM, Van Marck E (2001). "Low-grade chondrosarcoma vs enchondroma: challenges in diagnosis and management". European Radiology. 11 (6): 1054–1057. doi:10.1007/s003300000651. PMID   11419152. S2CID   34059862.