What Is an Enchondroma?
Endogenous chondroma is called a central type if it occurs inside the bone, and is called a marginal type (periosteal chondroma) if it occurs on the bone surface. The disease can be a single lesion or multiple lesions (endogenous chondromatosis). The disease can also be accompanied by soft tissue hemangiomas (Maffucci syndrome). Solitary endogenous chondroma grows slowly, has a small volume, and can be asymptomatic for a long time. Multiple endogenous chondroma has symptoms and signs in early childhood, leading to limb shortening and bending deformities.
Basic Information
- English name
- endogenous chondroma
- Visiting department
- orthopedics
- Common causes
- Caused by embryonic ectopic tissue
- Common symptoms
- Solitary: Slow growth, small volume, long-term asymptomatic. Multiple: Symptoms and signs in early childhood, leading to shortened limbs and deformities.
Causes of endogenous chondroma
- Endogenous chondroma is a tumor caused by ectopic embryonic tissue.
Clinical manifestations of endogenous chondroma
- Solitary endogenous chondroma grows slowly, has a small volume, and can be asymptomatic for a long time. Tubular endogenous chondroma of the hands and feet often results in deformities of the fingers or toes, local swelling and pain due to bone expansion stimulation, or pain due to pathological fractures. In the long bones of the extremities, most of the endogenous chondroma are asymptomatic, Fractures due to other diseases or pathologies were only discovered during radiographs.
- Multiple endogenous chondroma shows symptoms and signs in early childhood and can cause limb shortening and flexion deformities. In the hand, the lesion is spherical or nodular in swelling. When the lesion is severe, the fingers are shortened and off-axis, and there is generally no pain. On the metaphysis of the limb, there may be a slight swelling. With the development of bones, short lesions appear. Shrink deformity.
Endogenous chondroma examination
- 1. X-ray inspection
- The X-ray of endogenous chondroma is a round or oval low-density lesion at the metaphysis, located in the center, occupying the entire medullary cavity, and calcification can be seen in the translucent area of bone destruction. The short tubular bones can invade the entire bone and have a fusiform swelling, and the long bone tumor tissue can invade the inner edge of the bone cortex to produce a furrow. Multiple endogenous chondroma lesions are common in the metaphysis, and the metaphysis is irregularly widened early, with speckles and strips of calcification.
- 2. Radionuclide scanning
- Scanning radionuclide of endogenous chondroma showed that the active phase 2 radionuclide uptake increased. During malignant transformation, the radionuclide uptake increased significantly.
- 3.CT inspection
- The CT section of endogenous chondroma showed expansive changes, low-density lesions, and speckled calcifications in the center.
- 4.MRI examination
- MRI of endogenous chondroma showed low signal on the T 1 weighted image, and the lesions were oblong or oval-shaped multilocular, with well-defined boundaries. On the T 2 weighted image, there was a clear high signal. Low signal. After strengthening, it can be strengthened in a ring shape or irregular shape.
- 5. Pathological examination
- (1) Endochondroma seen with the naked eye is blue-gray lobed, with mucus-like degeneration and chalk-like small granular calcifications, and a well-defined cortical bone-like reaction layer at the boundary with bone and bone marrow.
- (2) Endochondroma seen under the microscope forms a leaf-like structure with abundant cells. There are often two cells in a pit. On the periphery of the lesion, there is a thin layer of mature cartilage internalized bone around the leaflet. bone. The histological signs of malignant transformation into low-grade malignant chondrosarcoma are: peripheral chondrocytes with nodular and cluster-like distribution suddenly become sheet-like, younger cells, with less cytoplasm, visible binuclear cells, and occasional mitosis.
Diagnosis of endogenous chondroma
- The main points of diagnosis of endogenous chondroma are as follows:
- 1. Endogenous chondroma of the hands and feet often causes deformities of the fingers or toes, which can cause fractures;
- 2. X-ray showed round or oval-shaped, irregular, nodular low-density lesions with a little calcification inside, and irregular "scallop-like" translucent areas at the junction with the cortex;
- 3. The tumors seen under the microscope form a leaf-like structure from active proliferative cartilage, and the chondrocytes are arranged in a "cluster" or "fancy pattern", separated by an acellular, mature alkaline matrix. At the periphery of the lesion, there is a thin layer of mature bone generated from cartilage internalized bone around the leaflet. The cartilage nodules proliferate into the medullary cavity around the lesion and produce serrated marks in the inner layer of bone cortex.
Differential diagnosis of endogenous chondroma
- Endogenous chondroma should be distinguished from diseases such as giant cell tumor of bone, chondroblastoma, aneurysmal bone cyst, and abnormal bone fibrosis.
Endogenous chondroma treatment
- Non-surgical treatment
- Asymptomatic endogenous chondroma confined to the hand does not require any special treatment. Patients are advised to seek medical attention promptly when the tumor appears painful or develops rapidly.
- 2. Surgical treatment
- (1) Except for articular cartilage, the inner wall of endogenous chondroma should be thoroughly scraped except for articular cartilage. After scraping, the inner wall should be completely inactivated with 95% ethanol and carbolic acid. Autologous bone, allogeneic bone or Artificial bone grafts can also be filled with bone cement. The implanted bone particles should be small, fill the medullary cavity as much as possible, return the open bone fragments to the original place, carefully suture the periosteal flap, and perform a histopathological examination after the lesion is scraped. In children, the lesions are active, and the recurrence rate after scraping is 30%; in adults, the lesions are at rest and the recurrence rate is extremely low.
- (2) Extensive tumor resection When the pathological examination of endogenous chondroma has malignant changes, especially those located in the trunk bone or near the trunk bone, a thorough extensive tumor resection should be actively adopted.