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Primary bone tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Jennifer N Murphy, Steven L J James, Murali Sundaram, A Mark Davies
The differentiation of enchondroma from low-grade chondrosarcoma is often a challenge for both radiologists and pathologists. The presence of permeation is histologically diagnostic for chondrosarcoma. However, difficulties arise when permeation is not identified histologically in a lesion which demonstrates atypical imaging features. Studies have shown that tumour length, endosteal scalloping, cortical destruction, bone expansion, bone marrow oedema, predominant intermediate T1 signal, multilobulated appearance on contrast-enhanced T1 imaging, soft tissue mass/abnormal soft tissue signal, and pain attributed to the lesion were differentiating features between enchondroma and low-grade chondrosarcoma (45,50). DCE-MRI has not been shown to differentiate between enchondroma and low-grade chondrosarcoma (45).
Musculoskeletal tumours
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Enchondroma (Figure 37.17) is a benign cartilaginous neoplasm within the intramedullary cavity of bone. Approximately 50% are in the hands and feet: enchondromas are the most common bone tumours in the hand. Although they can present with pain, swelling or pathological fracture, many are entirely asymptomatic and are detected incidentally. Patchy calcification, expansion and scalloping can be visible on radiographs, but some are only diagnosed on magnetic resonance imaging (MRI) scan.
Tumours
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Jonathan Stevenson, Michael Parry
The diagnosis of an enchondroma can usually be made with X-rays (Figure 9.12). Occasionally, biopsy will be required if the diagnosis is unclear. Treatment is usually not required although, occasionally in the hand, the lesion may be removed through curettage, particularly if there is pain or pathological fracture. Serial X-rays may be helpful if there is a suspicion of a grade 1 chondrosarcoma, as enchondromas in skeletal maturity do not grow.
Can MRI differentiate between atypical cartilaginous tumors and high-grade chondrosarcoma? A systematic review
Published in Acta Orthopaedica, 2020
Claudia Deckers, Maarten J Steyvers, Gerjon Hannink, H W Bart Schreuder, Jacky W J de Rooy, Ingrid C M Van Der Geest
During the most recent decades research has focused mainly on differentiating enchondroma from chondrosarcoma (Choi et al. 2013, Douis et al. 2014, Crim et al. 2015, Lisson et al. 2018). New insights have shown that both enchondroma and ACT located in the long bones can be observed without treatment (Deckers et al. 2016, Sampath Kumar et al. 2016, Chung et al. 2018). These insights make the differentiation between ACT and HGCS clinically relevant. Currently, literature on differentiating ACT from HGCS is sparse and clear radiologic criteria are lacking. Therefore, we performed a systematic review to provide an overview of MRI characteristics used to date to differentiate between ACT and HGCS.
The national incidence of chondrosarcoma of bone; a review
Published in Acta Oncologica, 2023
Joachim Thorkildsen, Tor Åge Myklebust
A further unique feature of CS is its well-established inter-and intra-observer variability in assessment by radiologists, pathologists and clinicians [31–33]. This is most evident at the lower level of disease aggressiveness, in distinguishing between benign enchondroma and grade 1 CS or ACT. At the same time, central chondroid lesions of the skeleton appear in approximately 2–3% of routinely performed radiological examinations of the knee and shoulder [34,35]. There is no uniform accepted practice for the assessment or follow-up of these lesions. It is methodically likely that this spectrum of disease is central to any difference in reporting.
Malignant transformation of a phalangeal enchondroma into a recurrent grade II chondrosarcoma requiring successive transcarpal amputations: a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Ceyran Hamoudi, Benjamin Bouillet, Antoine Martins
A 66-year-old Caucasian man with no significant medical history was referred to our department of hand surgery and treated for an enchondroma of the proximal phalanx of the fourth ray of the left hand with curettage and bone filling using a cancellous allograft. Anatomopathological analysis revealed an enchondroma without malignancy.