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The Bone & Joint Journal May 2021Chondrosarcoma is the second most common primary sarcoma of bone: conventional chondrosarcoma accounts for 85% of all cases. Conventional chondrosarcoma may be central...
AIMS
Chondrosarcoma is the second most common primary sarcoma of bone: conventional chondrosarcoma accounts for 85% of all cases. Conventional chondrosarcoma may be central or peripheral. Most studies group central and peripheral chondrosarcomas together, although there is growing evidence that their clinical behaviour and prognosis differ. The aims of this study were to analyze any differences in characteristics between central and peripheral chondrosarcomas and to investigate the incidence and role of different syndromes.
METHODS
Data from two international tertiary referral sarcoma centres between January 1995 and December 2018 were retrospectively reviewed. The study population consisted of 714 patients with surgically treated conventional chondrosarcoma of the pelvis and limbs.
RESULTS
In patients with Ollier's disease and Mafucci's syndrome, 12/20 (60%) and 2/5 (60%) of malignancies, respectively, were in the limbs, most frequently in the proximal humerus, proximal tibia, and in the hands and feet. In patients with hereditary multiple exostosis (HME), 20/29 (69.0%) of chondrosarcomas were in the pelvis and scapula, specifically in the ilium in 13/29 (44.8%) and the scapula in 3/29 (10.3%). In central chondrosarcoma, survival of patients with Ollier's disease and non-syndromic patients was the same (p = 0.805). In peripheral chondrosarcoma, survival among HME patients was similar (p = 0.676) in patients with tumours of the pelvis and limbs.
CONCLUSION
Both central and peripheral chondrosarcoma have specific characteristics. HME is frequently seen in patients with a peripheral chondrosarcoma, in whom tumours are commonly located in the ilium and scapula. The incidence of Ollier's disease is uncommon in patients with a central chondrosarcoma. Disease-specific survival is equal in different subtypes after adjustment for histological grade. The local recurrence-free survival is the same for different locations and subtypes after adjustment for surgical margin. Cite this article: 2021;103-B(5):984-990.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Neoplasms; Child; Chondrosarcoma; Enchondromatosis; Exostoses, Multiple Hereditary; Female; Humans; Male; Middle Aged; Osteochondrodysplasias; Retrospective Studies
PubMed: 33934657
DOI: 10.1302/0301-620X.103B5.BJJ-2020-1082.R2 -
Journal of Inherited Metabolic Disease Jan 2020There are many metabolic disorders that present with bone phenotypes. In some cases, the pathological bone symptoms are the main features of the disease whereas in... (Review)
Review
There are many metabolic disorders that present with bone phenotypes. In some cases, the pathological bone symptoms are the main features of the disease whereas in others they are a secondary characteristic. In general, the generation of the bone problems in these disorders is not well understood and the therapeutic options for them are scarce. Bone development occurs in the early stages of embryonic development where the bone formation, or osteogenesis, takes place. This osteogenesis can be produced through the direct transformation of the pre-existing mesenchymal cells into bone tissue (intramembranous ossification) or by the replacement of the cartilage by bone (endochondral ossification). In contrast, bone remodeling takes place during the bone's growth, after the bone development, and continues throughout the whole life. The remodeling involves the removal of mineralized bone by osteoclasts followed by the formation of bone matrix by the osteoblasts, which subsequently becomes mineralized. In some metabolic diseases, bone pathological features are associated with bone development problems but in others they are associated with bone remodeling. Here, we describe three examples of impaired bone development or remodeling in metabolic diseases, including work by others and the results from our research. In particular, we will focus on hereditary multiple exostosis (or osteochondromatosis), Gaucher disease, and the susceptibility to atypical femoral fracture in patients treated with bisphosphonates for several years.
Topics: Animals; Bone Development; Bone Remodeling; Cartilage; Chondrocytes; Diphosphonates; Exostoses, Multiple Hereditary; Femoral Fractures; Gaucher Disease; Humans; Metabolic Diseases; Osteoclasts; Osteogenesis
PubMed: 30942483
DOI: 10.1002/jimd.12097 -
Cureus Apr 2023A 13-year-old girl presented with an apparent classic osteochondroma. Because she was skeletally immature, the decision was made to observe the lesion. She returned to...
A 13-year-old girl presented with an apparent classic osteochondroma. Because she was skeletally immature, the decision was made to observe the lesion. She returned to the clinic at age 17 for unrelated reasons and was noted to no longer have the palpable mass. Magnetic resonance imaging confirmed resolution of the osteochondroma. The age range of this case fits with reported cases of childhood osteochondromas. The mechanism of resolution has been theorized to be incorporation of the lesion back into the bone during remodeling, fractures, or pseudoaneurysms. An initial period of observation is thus recommended with new patients.
PubMed: 37197114
DOI: 10.7759/cureus.37565 -
Malaysian Orthopaedic Journal Mar 2023Spinal osteochondroma is rare. The purpose of this study is to examine the clinical characteristics and surgical treatment outcomes of 11 patients with spinal...
INTRODUCTION
Spinal osteochondroma is rare. The purpose of this study is to examine the clinical characteristics and surgical treatment outcomes of 11 patients with spinal osteochondroma.
MATERIALS AND METHODS
The study included 11 patients with spinal osteochondroma. In these patients, we examined the onset level, onset site, initial symptoms, surgical procedure, outcomes and complications.
RESULTS
Of the 11 patients, 9 presented with solitary tumours, and 2 had multiple. The mean post-operative observation period was six years and two months. The onset level was the cervical spine in eight patients, thoracic in two, and lumbar in one. The most common onset site was the posterior elements. The initial presentation was myelopathy in seven patients, radiculopathy in two, neck pain in one and feeling of mass in one. All patients underwent excision of the tumour, and depending on the tumour onset site, additional posterior or anterior decompression with or without fusion was performed. There was no recurrence in all patients. Intra-operative complications included dura tear and oesophageal injury in one patient with cervical onset, while post-operative complications included C5 palsy in one patient.
CONCLUSIONS
In this study, surgical excision for osteochondroma of the spine were excellent with no recurrence of the tumour.
PubMed: 37064635
DOI: 10.5704/MOJ.2303.014 -
Japanese Journal of Radiology Jul 2022The purpose of this study was to determine imaging features of reactive bursitis secondary to osteochondroma.
PURPOSE
The purpose of this study was to determine imaging features of reactive bursitis secondary to osteochondroma.
MATERIALS AND METHODS
Fourteen patients with reactive bursitis secondary to osteochondroma were retrospectively reviewed.
RESULTS
The 14 patients were 11 males and 3 females ranging in age from 18 to 67 years (mean, 33.6 years). The locations were as follows: scapula (n = 2), lesser trochanter (n = 6), greater trochanter (n = 1), distal femur (n = 2), distal fibula (n = 1), iliac bone (n = 2). On CT, six bursae were hypodense and 1 was isodense compared to muscle. All bursae had a thickened wall, 6 contained multiple villous projections and septa. Five bursae contained a few calcifications. On enhanced CT, the bursa displayed mild enhancement of the wall, villous projections, and septa. On MRI, one bursa was hypointense, three were hyperintense, and 5 were isointense relative to muscles on T1-weighted images. All bursae were hyperintense relative to muscles on T2-weighted images. All bursae had a thickened wall, eight contained multiple villous projections and septa. In five bursae, a few fatty villous projections can be seen within the bursa. On enhanced MRI, all bursae displayed avid enhancement of the bursal wall, villous projections, and septa.
CONCLUSIONS
Reactive bursitis secondary to osteochondroma most often occurred in young male adults. The most common involved site is lesser trochanter. The imaging features is that of an irregular, thick-walled fluid-filled bursa overlying an osteochondroma that containing multiple villous projections and septa. Calcification and/or lipoma arborescens may be developed within the bursa. On contrast-enhanced images, the bursa shows enhancement of the bursal wall, villous projections and septa.
Topics: Adolescent; Adult; Aged; Bone Neoplasms; Bursa, Synovial; Bursitis; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Osteochondroma; Retrospective Studies; Young Adult
PubMed: 35224687
DOI: 10.1007/s11604-022-01255-4 -
Spinal Cord Series and Cases May 2020Osteochondromas are benign bone tumors which occur as solitary lesions or as part of the syndrome multiple hereditary exostoses. While most osteochondromas occur in the...
INTRODUCTION
Osteochondromas are benign bone tumors which occur as solitary lesions or as part of the syndrome multiple hereditary exostoses. While most osteochondromas occur in the appendicular skeleton, they can also occur in the spine. Most lesions are asymptomatic however some may encroach on the spinal cord or the nerve roots causing neurological symptoms. While most patients with osteochondromas undergo laminectomy without fusion, laminectomy with fusion is indicated in appropriately selected cases of spinal decompression.
CASE PRESENTATION
We present a case of a 32-year-old male with history of multiple hereditary exostoses who presented with symptoms of bilateral upper extremity numbness and complaints of gait imbalance and multiple falls. He reported rapid progression of his symptoms during the 10 days before presentation. Computed tomography of the cervical spine revealed a lobulated bony tumor along the inner margin of the cervical 4 lamina. He underwent cervical 3 and 4 laminectomies, partial cervical 2 and 5 laminectomies and cervical 3-5 mass screw placement. Pathology was consistent with osteochondroma. The patient's symptoms had markedly improved at follow-up.
CONCLUSION
According to our literature review, osteochondromas most commonly occur at cervical 2 and cervical 5. We present a case of an osteochondroma at a less common level, cervical 4. While most osteochondromas are addressed with laminectomy without arthrodesis, the decision of whether arthrodesis is necessary should be considered in all patients with osteochondroma as with any cervical decompression.
Topics: Adult; Arthrodesis; Cervical Vertebrae; Clinical Decision-Making; Humans; Male; Osteochondroma; Spinal Neoplasms
PubMed: 32467563
DOI: 10.1038/s41394-020-0292-7 -
Pediatric Emergency Care Jan 2022Intermittent claudication is very uncommon in children and adolescents. We describe the case of a 14-year-old adolescent girl experiencing left calf pain for a year that...
Intermittent claudication is very uncommon in children and adolescents. We describe the case of a 14-year-old adolescent girl experiencing left calf pain for a year that occurs during running and becomes unbearable after around 2 km. She was ultimately diagnosed with extrinsic compression of the popliteal artery caused by an osteocartilaginous exostosis (osteochondroma) originating from the fibula.
Topics: Adolescent; Bone Neoplasms; Child; Female; Fibula; Humans; Intermittent Claudication; Osteochondroma; Popliteal Artery
PubMed: 33048899
DOI: 10.1097/PEC.0000000000002178 -
Experimental and Therapeutic Medicine Jan 2022Osteochondroma represents a bone outgrowth covered by cartilaginous tissue and localized on the external surface of the bone. The incidence of osteochondroma is 20-35%...
Osteochondroma represents a bone outgrowth covered by cartilaginous tissue and localized on the external surface of the bone. The incidence of osteochondroma is 20-35% of all pediatric benign tumors. Osteochondromas can be present in solitary or multiple forms and usually occur in the metaphysis of long bones in immature skeletons. The present study aimed to retrospectively determine the association between imaging diagnostic accuracy and histopathological examinations, which are the main methods of diagnosis for this type of tumor. A total of 66 patients presenting with radiological aspects of osteochondroma were initially selected; however, only the 56 patients who had a positive histopathological diagnosis of osteochondroma were eventually included in this study. Patient characteristics were taken into consideration and included age, sex, lesion localization, lesion imaging semiotics and histopathological aspects. Osteochondromas are generally asymptomatic lesions that are often incidentally diagnosed after trauma, which makes it difficult to determine the exact incidence of this pathology.
PubMed: 34976145
DOI: 10.3892/etm.2021.11026 -
The Journal of Craniofacial Surgery Oct 2022The present study aimed to investigate the clinical efficacy of simultaneous management of condylar osteochondroma and its secondary dentofacial deformities using an...
PURPOSE
The present study aimed to investigate the clinical efficacy of simultaneous management of condylar osteochondroma and its secondary dentofacial deformities using an intraoral surgical approach.
METHODS
Six patients with condylar osteochondroma were treated with intraoral vertical ramus osteotomies and condylar resection. The free rising branch was used for reconstructing the temporomandibular joint. The simultaneous orthognathic surgery and plastic surgery were performed sequentially to correct the secondary dentofacial deformities. The indexes of aesthetic symmetry, occlusion relationship, temporomandibular joint function, condylar height, and volume change were assessed in the subsequential follow up.
RESULTS
The mean follow up period was 31 months. All patients had no tumor recurrence. The ipsilateral joint function, occlusal relationship, and facial symmetry were satisfied. The ipsilateral condylar reconstruction had no obvious bone resorption and the ramus height was maintained well. Postoperative assessment showed the preoperative design was accurately fulfilled.
CONCLUSIONS
The simultaneous condylar osteochondroma resection and temporomandibular joint reconstruction using intraoral approach avoids extraoral scars and correct facial asymmetry without compromising the long-term joint function and occlusal relationship.
Topics: Dentofacial Deformities; Esthetics, Dental; Humans; Mandibular Condyle; Mandibular Neoplasms; Neoplasm Recurrence, Local; Orthognathic Surgical Procedures; Osteochondroma
PubMed: 35119412
DOI: 10.1097/SCS.0000000000008515 -
BMJ Case Reports Aug 2019Osteochondroma is the most common type of benign bone tumour. It is a benign chondrogenic lesion derived from aberrant cartilage from the perichondral ring, and it...
Osteochondroma is the most common type of benign bone tumour. It is a benign chondrogenic lesion derived from aberrant cartilage from the perichondral ring, and it commonly presents in the proximal humerus, proximal femur and knee. Osteochondroma is usually solitary but can be multiple with patients with hereditary multiple exostoses. Malignant changes happen in approximately 1% of cases. Osteochondroma usually causes local pain or swelling. We discuss a unique case of an osteochondroma that highlights the fact that osteochondroma can occur in the most unlikely places, and they should be properly visualised via radiography to evaluate any extensions and compromised surrounding structures before surgical intervention.
Topics: Acromioclavicular Joint; Bone Neoplasms; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Osteochondroma; Range of Motion, Articular; Tomography, X-Ray Computed
PubMed: 31444263
DOI: 10.1136/bcr-2019-230246