Enchondroma consists of regular lobules and mature connective tissue with low cellularity; well-differentiated chondrosarcoma is composed of irregular lobules with highly cellular fibrous tissue. Enchondroma | Radiology Case | Radiopaedia.org The initial diagnosis for the lesion was enchondroma, however biopsy was obtained for fear of chondrosarcoma which confirmed the benign nature. Multiple enchondromas: may produce severe deformities; associated with chondrosarcomatous . The most important histologic feature for discriminating between them is a growth pattern. This ranges from a fetal type to mature hyaline cartilage and mirrors its imaging characteristics.The benign chondroid tumors represent some of the most encountered incidental bone lesions, with osteochondroma the most frequent benign bone tumor. Left: There is a non-displaced fracture through the base For more information, click on the link if you see this icon, Usually solitary, although they can occur as multiple lesions in syndromes to be discussed, Arise from ectopic rests of hyaline cartilage, Most common site is small bones of the hands and feet, Also occur in the humerus, femur, tibia and ribs, In long bones, their calcification is similar to an intramedullary bone infarct, Bone infarcts tend to have a well-circumscribed, sclerotic margin, May fracture or, rarely, undergo malignant transformation, On CT, lucent regions in an otherwise dense enchondroma suggest malignancy, Rapid growth of lesion or pain not related to a pathologic fracture may suggest malignant transformation, Usually asymptomatic and found serendipitously, May be associated with pain and swelling which should raise suspicion of either a pathologic fracture or, less likely, malignant transformation, Malignant transformation almost never occurs in the hands and feet, Conventional radiography is the study of first choice, Usually have some internal calcification and endosteal thinning, Internal calcifications tend to resemble “rings and arcs” of cartilage calcification, Numerous internal foci with high-signal intensity on T2, Multiple enchondromas occur in Ollier's disease, Enchondromas are frequently larger than with solitary enchondroma, May have limb shortening of affected limb, May have Madelung’s deformity of the wrist, Greater incidence of malignant transformation because there are more lesions present (25-50%), Enchondromas associated with cavernous hemangiomas of soft tissues is called Maffucci’s Syndrome, Multiple hemangiomas usually in extremities (digits), Greater than solitary enchondroma, less than Ollier’s, Hemangioma may become sarcoma in 5% of cases, For more information, click on the link if you see this icon. This is known as an enchondroma protuberans, and may either be seen sporadically or as part of Ollier disease 2. The other chondromas are mainly distributed in the long bones, with preference for the femur. can still result in pathological fractures (with prophylactic internal fixation in this case) increased uptake on bone scan can be seen with enchondromas particularly with underlying pathological fracture or cortical expansion in small bones. A 20-year-old female referred to our hospital complaining of progressive sustained left forearm pain with a . The lesion is well-defined with normal marrow fat interposed between the cartilaginous lobules . As the lesion is asymptomatic, it was left for follow up only. Enchondromatosis, also known as Ollier disease (see Terminology section), is a non-hereditary, sporadic, skeletal disorder characterized by multiple enchondromas principally located in the metaphyseal regions. We report a case of enchondroma protuberans originating in the left ulnar bone of a young woman. There may be no symptoms, or it may present typically in the short tubular bones of the hands with a swelling, pain or pathological fracture. Fundet i bogen – Side 1067Enchondroma . A lytic lesion in the phalanges is most commonly an enchondroma . This is the only location in the skeleton where an enchondroma does not contain calcified chondroid matrix . These most often present with pathologic ... An enchondroma most often affects the cartilage that lines the inside of the bones. Enchondroma. located in the medullary cavity. Enchondroma is a fairly common benign cartilaginaous lesion which may present as an entirely lytic lesion without any calcification, as a dense calcified lesion or as a mixed leson with osteolysis and calcifications. A and B, . It may also affect other bones such as the femur (thighbone), humerus (upper arm bone), or tibia (one of the two lower leg bones). Enchondroma is a fairly common benign cartilaginaous lesion which may present as an entirely lytic lesion without any calcification, as a dense calcified lesion or as a mixed leson with osteolysis and calcifications. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Magesh, M. Enchondroma. Enchondroma vs low grade chondrosarcoma Last revised by Dr Dai Roberts on 07 Feb 2021 Enchondroma Radiology Reference Article Radiopaedia . Sharp irregular (popcorn-like) contours. Differentiating between an enchondroma vs low-grade chondrosarcoma can be challenging 1. Clinical: Because of its slow growth, minimal peritumoral reaction, and avascularity . Low-grade chondrosarcoma may show similar cytological features with those of enchondroma. Enchondroma (en-kon-DRO-ma) is a type of benign (noncancerous) tumor that begins in the cartilage found inside the bones. This is a classic appearance of an enchondroma in a phalanx on radiographs. Multiple enchondromas: may produce severe deformities; associated with chondrosarcomatous . Clinical: Because of its slow growth, minimal peritumoral reaction, and avascularity . Discussion. Fundet i bogen – Side 94However, the concurrent use of conventional radiology is substantial when CT or MR images of bone tumors are interpreted. ... Adkins MC (2004) Radiographic differentiation of enchondroma from low-grade chondrosarcoma in the fibula. Associated synovitis with mild effusion noted. History: 35 year old male with hand pain. In the phalanges of the hand it frequently presents with a fracture. This appearance is indicative of a lesion of cartilaginous differentiation . Radiopaedia. Background Enchondroma protuberans (EP) is rare, benign cartilaginous bone tumor arising from the intramedullary cavity of long bones and usually protrudes beyond the cortex with an exophytic growth pattern resembling osteochondroma. In the absence of a fracture, a painful enchondroma is considered malignant until proven otherwise. Enchondroma. 18 . Enchondroma protuberans is an extremely rare benign cartilaginous bone tumor. There is no pathologic fracture. Sites: small bones of hands and feet (rare in thumb or ribs) 70% solitary; 30% multiple. Large non-aggressive intramedullary lesion of the distal femur shaft with osseous (T1-hyperintense) and chondral (T2-hyperintense) components. This volume includes succinct overviews of trauma, arthritis, and tumor and tumor-like conditions. Fig. George Nomikos, Anthony G. Ryan, Peter L. Munk, and Mark Murphey. Presentation of Case . Lessons: Enchondroma protuberans is a rare form of benign enchondroma. 1Department of Radiology, Walter Reed Army Medical Center, Washington, DC 20306. Right: A well-defined, slightly expansile, lytic lesion is seen in the proximal phalanx (white circle) through which the fracture has occurred. This appearance is indicative of a lesion of cartilaginous differentiation . Most enchondromas areasymptomatic but may present as pathological fractures. Enchondromas are benign lesions made up of hyaline cartilage that arise within medullary bone. eral, enchondroma protuberans describes a lesion that protrudes outward from one side of an affected bone and radiographically mimics an osteochondroma or chondrosarcoma [6, 7]. Pearls and Pitfalls in Musculoskeletal Imaging will help you spot artifacts, mimics and other unusual conditions, enabling you to avoid misdiagnosis and prevent mismanagement. An essential diagnostic tool for radiologists at every level. (accessed on 11 Nov 2021) https://doi.org/10.53347/rID-14913. Radiology department of the Onze Lieve Vrouwe Gasthuis, Amsterdam and the Rijnland hospital, Leiderdorp, the Netherlands. Enchondroma Radiology. As the lesion is asymptomatic, it was left for follow up only. Today the study of the hand concerns only 2%-4% of the activity of radiology. It nevertheless reveals an amazing quantity and variety of pathology. That is the reason for this work. Enchondromas are difficult to differentiate from low grade chondrosarcoma by radiology. Case study, Radiopaedia.org. Fundet i bogen – Side 61... presence of fibrous bands at tumor-marrow interface suggests malignancy (DDx from atypical enchondroma) Histo: arises from chondroblasts (tumor osteoid is never formed) Age: median 45 years; 50% >40 years; 10% in children (rapidly ... A 45-year-old woman with rheumatoid arthritis was incidentally noted to have a lesion in the left fibular head. a well-defined lytic lesion in the hand is almost always an enchondroma. Radiographic features Rings and arcs pattern of the chondral components on T2-weighted and contrast-enhanced T1-weighted images. Fundet i bogen – Side 258Discussion Enchondroma is a common benign cartilaginous tumour most commonly seen in the tubular bones (50% in hands and feet) ofpatients under the age of 30 years. The cardinal radiological features are listed below: • Central lesion ... most common location is the hand. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Open communication between the radiology . On the penultimate day of the course, the best case presentation is held at the American Film . This study reports on a rare case of EP arising from the . Most common site is small bones of the hands and feet. Objectives . Features that should raise suspicion of low-grade chondrosarcoma include a size over 5-6 cm, pain, and endosteal scalloping. Usually solitary, although they can occur as multiple lesions in syndromes to be discussed. male:female ratio is 1:1. . 4. . 1 Department of Radiology, School of Medicine, Wonkwang University, Iksan, Korea. When several occur in one long bone or several bones . By Martin Timchur Radiographic Findings: AP and lateral conventional radiographs demonstrate a 33x16mm subtle collection of disorganised punctate calcification in the medullary bone of the left distal femoral metadiaphysis. In the phalanges of the hand it frequently presents with a fracture. The study included 96 patients with cartilage type lesions suggestive of an enchondroma (E) or an low grade chondrosarcoma (LGC) according to the clinical and . Fundet i bogen – Side 1008Regardless of the location of bone tumors, the initial imaging modality should be plain radiography. ... 32.3.2 Enchondroma Enchondroma is a benign cartilaginous tumor which can occur in the pediatric population. Radiology images. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. General considerations. Enchondroma protuberans: rare, exaggeratedly eccentric enchondroma resembling osteochondroma radiologically ( Hum Pathol 1982;13:734 ) Radiology description. Case study, Radiopaedia.org. The enchondroma is composed of well-circumscribed nodules of benign hyaline cartilage. Findings . Doesn't invade the cortex. Fundet i bogen – Side 251However, the presence of a predominately low signal intensity lesion on the MRI makes this much less likely. ... benign cartilaginous tumors; it is more common than chondromyxoid fibroma but rarer than enchondroma or osteochondroma. . Rings and arcs pattern of the chondral components on T2-weighted and contrast-enhanced T1-weighted images. . Info. Osteoblastoma is a rare, benign bone tumour accounting for 14% of bone tumours .It most commonly affects people within the first four decades of life with a larger probability of it occurring in the second and third decades .Although any bone can be involved, osteoblastoma arises predominantly in the axial skeleton with spinal lesions constituting one-third of reported cases . Enchondroma. Link to this Page…. Associated pain should raise suspicion for pathologic fracture ( Fig 1 ), which, if nondisplaced, may be better characterized on CT images than on radiographs. Mirra et al 9 showed that tissue pattern can be used for making a distinction between enchondroma and chondrosarcoma of the bones. Editor's Note.—RadioGraphics continues to publish radiologic-pathologic case material selected from the American Institute for Radiologic Pathology (AIRP) "best case" presentations. The nuclei of the chondrocytes are small and uniformly round with condensed chromatin. This is the appearance of an enchondroma on MRI. Although most enchondromas occur in the hands and are characteris-tically lytic, the chondroid matrix of an enchondroma in the metadiaphyseal region of a long bone typically contains fl oc- Associated pain should raise suspicion for pathologic fracture ( Fig 1 ), which, if nondisplaced, may be better characterized on CT images than on radiographs. A well-defined lobulated intramedullary T2, STIR hyperintense and T1 hypointense lesion with multiple areas of signal drop within noted in the lower diaphyses of the right femur with variable enhancement. Fundet i bogen – Side 314Multiple enchondromas may occur in three distinct disorders : ollier's disease : non - hereditary , multiple enchondromas , unilateral Maffucci syndrome : non - hereditary , multiple enchondromas and haemangioma Metachondromatosis ... 2Department of Radiologic Pathology, Armed Forces . Fundet i bogen – Side 38223.2: MRI (T1W fat sat), Axial section of the same patient shows clear demonstration of continuity of marrow and cortex of host bone into osteochondroma with covering ... Enchondroma Enchondromas accounts for 12 percent of benign bone ... Right: A well-defined, slightly expansile, lytic lesion is seen in the proximal phalanx (white circle) through which the fracture has occurred. A comprehensive two-volume textbook for residents in pathology, radiology, and orthopedic surgery. Enchondromas are the second most common benign tumor of bones (after osteochondroma) and most common benign tumor of… Enchondroma Radiology - OrthopaedicsOne Images - OrthopaedicsOne. Enchondroma is a solitary, benign, intramedullary cartilage tumor that is often found in the short tubular bones of the hands and feet, distal femur, and proximal humerus. Peak age is 10-30 years.Location: Tubular bones (hand, foot): 50% Femur, tibia, humerus Radiog. It often affects the tiny long bones of the hands and feet. 20-50 year olds. 3—Minute enchondroma or cartilage rest in distal femur of 33-year-old man with knee pain associated with quadriceps and patellar tendon tendinopathy. Fundet i bogen – Side 61... 50 % radiographically Radiographic Features Geographic radiolucency May expand or deform bone Usually centrally ... of function of a limb Radiographic Features • Identical to solitary enchondroma , but there are multiple lesions The ... Frequently it is a coincidental finding. Enchondroma is the most common bone tumor of the hands. Sharp irregular (popcorn-like) contours. Although enchondroma protuberans is a type of enchondroma, it produces images that differ from those of enchondroma. They are frequently asymptomatic and have very low malignant potential if sporadic and solitary. Benign cartilaginous tumor. Left: There is a non-displaced fracture through the base of the proximal phalanx of the 4th toe (white arrow). To evaluate demographic and radiographic features that may differentiate between enchondroma and low-grade chondrosarcoma of the fibula. Typical MRI apperance of a partly ossified enchondroma. Sagittal T1. Enchondroma is a benign cartilaginous neoplasm in the medullary cavity. Therefore, regardless of any imaging feature, if pain is present, a chondrosarcoma must be excluded. Enchondroma. Lesions located near the shoulder or the pelvis may have a higher risk of . Enchondroma with pathologic fracture. Frequently it is a coincidental finding. ENCHONDROMA • Enchondromas (or chondromas) are a relatively common benign medullary cartilaginous neoplasm with benign imaging features. Infarcts are densely sclerotic with serpiginous border, whereas chondrosarcoma depends more on clinical features and is difficult to differentiate . There is an expansile, lytic lesion of the metacarpal of the index finger (white arrows) containing amorphous matrix calcifications. Each chapter is written by an acknowledged expert in the field, and a wealth of illustrative material is included. This book will be of great value to musculoskeletal and general radiologists, orthopedic surgeons, and oncologists. Enchondroma Enchondroma is a benign intramedul-lary tumor consisting of hyaline cartilage. It is the most common lesion in the phalanges, i.e. Fundet i bogen – Side 133In the hands and feet, enchondromas present as palpable swelling with or without pain. ... Radiologic Features and Gross Pathology Radiographic findings of enchondroma of the hand and foot are characterized by a sharply defined border, ... There is no surrounding lucency, cortical destruction, periosteal reaction or soft tissue mass. enchondroma demographics. Enchondroma. You can use Radiopaedia cases in a variety of ways to help you learn and teach. A well-defined small calcified area with rings and arcs appearance noted in the lower diaphyses of right femur with a narrow zone of transition. Arise from ectopic rests of hyaline cartilage. Develops in the medullary cavity. May be due to displaced growth plate. Most occur as a less than three centimetre size single tumor. Fundet i bogen – Side 307Figure 10.34 Ollier's syndrome: frontal radiographs of hands and frontal pelvic radiograph. Multiple lucent enchondromas are present in the short bones of the hands, pelvic bones and long bones. The enchondromas typically stabilize or ... Definition / general. Microscopically, an enchondroma is composed of "islands of intramedullary hyaline cartilage surrounded by marrow fat", and a chondrosarcoma a "diffuse cartilaginous replacement (invasion) of the marrow which leads to . Fundet i bogen – Side 210Enchondroma These are relatively common lesions accounting for 10% of benign bone tumors. Usually found between the ages of 10 and 40 years, they are twice as common in male patients. They classically occur in the small bones of the ... Enchondroma is a common benign chondrogenic tumor, which typically occurs in the short bones of hands and feet. The real incidence of chondroma outside the hand is underestimated, as most of these lesions are asymptomatic. History: 35 year old male with hand pain. a well-defined lytic lesion in the hand is almost always an enchondroma. Enchondroma | Radiology Case | Radiopaedia.org. asymptomatic but may present as pathological fractures. Rarely, binucleate forms are present. Rarely an enchondroma may extend through the cortex and demonstrate an exophytic growth pattern. No aggressive features such as cortical destruction, periosteal reaction, or soft tissue involvement. Fundet i bogen – Side 13Multiple lytic lesions in the hand—multiple enchondromas—are seen in this patient. ... pain) serve as a bet- ter indicator than radiographic findings, and indeed pain in an apparent enchondroma should warrant surgical investigation. Fundet i bogen – Side 147MDa,b,* Chondroma Enchondroma Chondrosarcoma Cartilage Pathology Radiology b Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, FL, * Corresponding author. Department of Pathology ... This is the most common benign tumour of small bones of hands and feet; other locations such as long tubular bones (proximal humerus, distal femur, proximal tibia) are rare. To evaluate demographic and radiographic features that may differentiate between enchondroma and low-grade chondrosarcoma of the fibula. Enchondroma: coronal T1 weighted MRI of the knee in the same patient reveals the lesion is homogeneously hypointense, compatible with an enchondroma. Fundet i bogen – Side 161On MRI, enchondromas have low signal on T1-weighted and proton density images but high signal on T2-weighted images FIGURE 9.7. Enchondroma. A: Coronal T1-weighted MRI shows low signal. FIGURE 9.6. Enchondroma with lucent matrix ... Age 20 - 49 years, no gender preference. The radiographs of ninety-three histologically-confirmed cartilaginous tumors of the fibula were retrospectively reviewed along with demographic formation as to patient age and gender. This book provides essential, internationally applicable information in the area of orthopedic pathology with emphasis on practical diagnostic aspects, including many illustrations: roentgenograms, CT-scans, MRI, scintigraphies, as well as ... . . The pur-pose of this study was to report the imaging Most enchondromas are. The purpose of the BACTIP is to provide the radiology community with a tool with which to assess central cartilage tumours and thereby highlight those cases appropriate for . For these same photos without the arrows, click here and here. This is a classic appearance of an enchondroma in a phalanx on radiographs. There is no surrounding lucency, cortical destruction, periosteal reaction or soft tissue mass. ADVERTISEMENT: Supporters see fewer/no ads. There is a lytic lesion of the middle phalanx of the ring finger (white arrow) with amorphous calcified matrix within it. Enchondroma of distal femur. Material and Method . Enchondroma is the most common benign tumor of the hand. Fundet i bogen – Side 12histologic differentiation.2 Magnetic resonance imaging (MRI) criteria for benign versus malignant includes lack of a soft tissue mass and no surrounding T2 highsignal edema in benign enchondromas. Because an enchondroma can ... Radiology department of the Onze Lieve Vrouwe Gasthuis, Amsterdam and the Rijnland hospital, Leiderdorp, the Netherlands. Enchondroma. Introduction: There is no clear radiologic or pathologic agreement on the differences between enchondroma and conventional chondrosarcoma, which has huge therapeutic consequences. Enchondroma is a benign intramedullary tumor consisting of hyaline cartilage. of the proximal phalanx of the 4th toe (white arrow). Enchondroma is the second most common benign tumor of bone, constituting approximately 10% of all benign bone tumors and representing the most common tumor of the short tubular bones of the hand. Fundet i bogen – Side 64Common Benign Tumors Solitary enchondroma ( Fig . 8a , b ) Site of Origin and Preferred Locations Cartilaginous tumor within the medullary cavity , single or multiple . Short tubular bones of the hand ( 50 % ) , femur , humerus , foot ... locations of enchondroma. EPIDEMIOLOGY • Enchondromas are most frequently diagnosed in childhood to early adulthood with a peak incidence of 10-30 years. Fundet i bogenThis should be followed by MRI with contrast whose primary role is to identify extension into bone marrow, ... CMF- fibroma m Chondromyxoid Osteosarcoma Chondrosarcoma Enchondroma Infections Ewing's sarcoma SBC S ABC Enchondroma Fibrous ... The other chondromas are mainly distributed in the long bones, with preference for the femur. Enchondroma with pathologic fracture. Enchondroma is the second commonest benign bone tumour, particularly common in the hands and feet, but also frequently seen around the knee and in the proximal humerus.