WordNet

benign slow-growing tumor of cartilaginous cells at the ends of tubular bones (especially in the hands and feet)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/04/19 18:08:23」(JST)

wiki en

X-ray showing an enchondroma in the femur.

MRI T1 showing an enchondroma in the femur.

An enchondroma is a cartilage cyst found in the bone marrow. Typically, enchondroma is discovered on a X-ray scan. Enchondromas have a characteristic appearance on Magnetic Resonance Imaging (MRI) as well. They have also been reported to cause increased uptake on PET examination.

Presentation

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.

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.

Associated conditions

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

Ollier disease (enchondromatosis) - when multiple sites in the body develop the tumors. Ollier disease is very rare.

Maffucci's syndrome - a combination of multiple tumors and angiomas (benign tumors made up of blood vessels).

Symptoms

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:

Pain that may occur at the site of the tumor if the tumor is very large, or if the affected bone has weakened causing a fracture of the affected bone
Enlargement of the affected finger
Slow bone growth in the affected area

The symptoms of enchondroma may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

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:

x-ray - On plain film, an enchondroma may be found in any bone formed from cartilage. They are lytic lesions that usually contain calcified chondroid matrix (a "rings and arcs" pattern of calcification), except in the phalanges. They may be central, eccentric, expansile or nonexpansile.

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.

radionuclide bone scan - a nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints; to detect bone diseases and tumors; to determine the cause of bone pain or inflammation. This test is to rule out any infection or fractures.
magnetic resonance imaging (MRI)^[1] - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities of the spinal cord and nerves.
computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

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:

extent of the disease
tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
opinion or preference of the patient

Treatment may include:

surgery (in some cases, when bone weakening is present or fractures occur)
bone grafting - a surgical procedure in which healthy bone is transplanted from another part of the patient's body into the affected area.

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.

References

^ 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.

External links

Enchondroma Radiology

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 小児および思春期における良性骨腫瘍の概要 overview of benign bone tumors in children and adolescents
2. 成人における膝関節腫瘍のX線評価 radiologic evaluation of knee tumors in adults
3. 軟骨肉腫 chondrosarcoma
4. 爪の生検：適応および手技 nail biopsy indications and techniques
5. オズグッド-シュラッター病（脛骨粗面剥離） osgood schlatter disease tibial tuberosity avulsion

English Journal

Function After Injection of Benign Bone Lesions with a Bioceramic.

Fillingham YA, Lenart BA, Gitelis S.SourceDepartment of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison Street, Chicago, IL, 60612, USA.
Clinical orthopaedics and related research.Clin Orthop Relat Res.2012 Jan 31. [Epub ahead of print]
BACKGROUND: A novel calcium sulfate-calcium phosphate composite injectable bone graft substitute has been approved by the FDA for filling bone defects in a nonweightbearing application based on preclinical studies. Its utility has not been documented in the literature.QUESTIONS/PURPOSES: We therefor
PMID 22290129

Enchondroma vs. chondrosarcoma: A simple, easy-to-use, new magnetic resonance sign.

Vanel D, Kreshak J, Larousserie F, Alberghini M, Mirra J, De Paolis M, Picci P.SourceDepartment of Research, Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Pathology, Istituto Ortopedico Rizzoli, Bologna, Italy.
European journal of radiology.Eur J Radiol.2012 Jan 5. [Epub ahead of print]
INTRODUCTION: There is no clear radiologic or pathologic agreement on the differences between enchondroma and conventional chondrosarcoma, which has huge therapeutic consequences. Microscopically, an enchondroma is composed of "islands of intramedullary hyaline cartilage surrounded by marrow fat", a
PMID 22227263

Similar cytogenetic findings in two synchronous secondary peripheral chondrosarcomas in a patient with multiple osteochondromas.

Kyriazoglou AI, Dimitriadis E, Arnogiannaki N, Brandal P, Heim S, Pandis N.SourceDepartment of Genetics, Saint Savvas Hospital, Athens, Greece.
Cancer genetics.Cancer Genet.2011 Dec;204(12):677-81.
Secondary peripheral chondrosarcoma is a malignant chondroid tumor arising in a benign precursor, either an osteochondroma or an enchondroma. Multiple osteochondromas syndrome (MO) is an autosomal dominant skeletal disorder associated with bony growths in the form of osteochondromas that occasionall
PMID 22285020