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1.
Skeletal Radiol ; 52(5): 1057-1061, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36773084

RESUMEN

Herein, a 30-year-old Caucasian female who presented with a persistent pain in the right pelvic region due to an enchondroma and treated with RF ablation is described. An initial MRI of the pelvis revealed a well-circumscribed lesion in the right inferior ischiopubic ramus with a maximum diameter of 9.5 mm. The final diagnosis was established by a percutaneous CT-guided bone biopsy, which excluded malignancy and revealed an enchondroma. About a month after the biopsy, a percutaneous radiofrequency ablation (RFA) of the lesion was performed. The symptoms resolved completely gradually 2 months after the treatment and a follow-up imaging with MRI showed complete resolution of the pathological enhancement indicating necrosis of the lesion. RFA has not been previously reported as a treatment option of enchondromas found in flat bones of the pelvis and could be a safe alternative minimally invasive treatment option in such cases, avoiding major operations.


Asunto(s)
Condroma , Pelvis , Ablación por Radiofrecuencia , Adulto , Femenino , Humanos , Biopsia , Condroma/diagnóstico por imagen , Condroma/cirugía , Pelvis/diagnóstico por imagen , Pelvis/cirugía , Resultado del Tratamiento
2.
J Hand Surg Am ; 48(5): 512.e1-512.e7, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-35115192

RESUMEN

PURPOSE: The approach to the treatment of enchondromas of the hand is varied, and there is no clear consensus on graft source, fixation, or need for intraoperative adjuvant therapy. We reviewed a cohort of patients who underwent curettage and bone grafting with cancellous allograft chips without internal fixation or adjuvant therapy and reported on postoperative range of motion (ROM) and recurrence rates. METHODS: We performed a retrospective review of patients who underwent surgical treatment for hand enchondroma over a 23-year period. We collected information on demographics and presenting enchondroma characteristics, including Takigawa classification and presence of pathologic fracture or associated syndromes. Patients were treated with open biopsy with curettage and grafting with cancellous allograft chips. Postoperative ROM, complications, and recurrences were recorded. RESULTS: Our series included 111 enchondromas in 104 patients. Seventeen of 104 patients (16%) had a diagnosis of Ollier disease. Average length of follow-up was 3.1 years. Eighty-one percent of patients achieved full ROM. Treatment of patients who presented with preoperative pathologic fracture resulted in a greater frequency of reduced postoperative ROM at 28% (9/32) compared to 15% (11/72) of those patients who did not present with preoperative pathologic fracture. Local recurrence developed in 5 of 50 (10%) patients with a minimum of 2 years of follow-up. Local recurrence occurred at higher-than-average rates in patients with giant form Takigawa classification (43%, 3/7) and Ollier disease (23%, 3/13). CONCLUSIONS: Treatment of enchondromas with biopsy, curettage, and allograft results in full ROM in 81% of patients. Patients with preoperative pathologic fracture should be advised of a greater risk of postoperative extension deficit. Recurrence remains rare and is associated with syndromic presentation and giant form lesions. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.


Asunto(s)
Neoplasias Óseas , Condroma , Encondromatosis , Fracturas Espontáneas , Humanos , Fracturas Espontáneas/etiología , Fracturas Espontáneas/cirugía , Neoplasias Óseas/cirugía , Neoplasias Óseas/patología , Encondromatosis/cirugía , Legrado/efectos adversos , Condroma/cirugía , Complicaciones Posoperatorias/cirugía , Rango del Movimiento Articular , Estudios Retrospectivos , Resultado del Tratamiento
3.
J Craniofac Surg ; 34(5): e501-e503, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37220670

RESUMEN

Soft tissue chondromas are benign tumors, generally of the hands or feet, very rarely of the head and neck region. Repeated microtrauma may be as an initiating factor. The authors describe a case of a soft tissue chondroma of the chin in a 58-year-old male who had used a continuous positive airway pressure face mask for obstructive sleep apnea for 3 years. The patient presented with a hard mass on his chin for 1 year. Computed tomography imaging showed a heterogeneous enhancing mass, with calcification in the subcutaneous layer. Intraoperatively, the mass was beneath the mentalis muscle and abutted the mental nerve, without bone involvement. The diagnosis was a soft tissue chondroma. The patient recovered fully, without recurrence. The primary cause of soft tissue chondromas is unknown. The authors consider that continuous use of a continuous positive airway pressure face mask may play a role in the etiology.


Asunto(s)
Condroma , Neoplasias de los Tejidos Blandos , Masculino , Humanos , Persona de Mediana Edad , Mentón/cirugía , Mentón/patología , Neoplasias de los Tejidos Blandos/patología , Condroma/diagnóstico por imagen , Condroma/cirugía , Mano , Tomografía Computarizada por Rayos X
4.
Arch Orthop Trauma Surg ; 143(8): 4899-4905, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36813947

RESUMEN

INTRODUCTION: The conventional treatment of enchondromas is the open surgery with curettage of lesions. Osteoscopic surgery is a minimally invasive endoscopic approach for lesions inside bone. The aim of this study was to evaluate the feasibility of the osteoscopic surgery in comparison with the conventional open surgery for patients with foot enchondromas. MATERIALS AND METHODS: A retrospective cohort study comparing patients with foot enchondromas treated with osteoscopic or open surgery from 2000 to 2019. Functional evaluations were based on both the AOFAS score and the Musculoskeletal Tumor Society (MSTS) functional rate. Complication and local recurrence were evaluated. RESULTS: Seventeen patients underwent endoscopic surgery, and eight patients underwent open surgery. The AOFAS score was higher in the osteoscopic group than the open group at 1 and 2 weeks after surgery (mean, 89.18 vs 67.25 [p = 0.001], 93.88 vs 79.38 [p = 0.004]). The MSTS functional rate was also higher in the osteoscopic group than the open group at 1 and 2 weeks after surgery (mean, 81.96 vs 59.58% [p = 0.00], 90.98 vs 75.00% [p = 0.02]). No statistical differences were found after 1-month of surgery. The osteoscopic group had lower complication rate than the open group (12 vs 50%; p = 0.04). No local recurrence was found in any groups. CONCLUSION: The osteoscopic surgery is feasible to provide earlier functional recovery and fewer complications than the open surgery.


Asunto(s)
Neoplasias Óseas , Condroma , Humanos , Resultado del Tratamiento , Estudios Retrospectivos , Neoplasias Óseas/cirugía , Neoplasias Óseas/patología , Pie/cirugía , Condroma/cirugía , Condroma/patología , Legrado
5.
Medicina (Kaunas) ; 59(5)2023 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-37241074

RESUMEN

Periarticular chondromas are common in the humerus and femur but rarely occur in the temporomandibular joint. We report a case of a chondroma in the anterior part of the ear. One year prior to his visit, a 53-year-old man became aware of swelling in the right cheek region which gradually increased in size. In the anterior part of the right ear, there was a palpable 25 mm tumor, elastic and hard, with poor mobility and without tenderness. A contrast-enhanced computed tomography CT showed a mass lesion with diffuse calcification or ossification in the upper pole of the parotid gland and areas of poor contrast within. A magnetic resonance imaging showed a low-signal mass lesion at the parotid gland with some high signals in both T1 and T2. Fine-needle aspiration cytology did not lead to diagnosis. Using a nerve monitoring system, the tumor was resected with normal tissue of the upper pole of the parotid gland in the same way as for a benign parotid tumor. Distinguishing between pleomorphic adenoma, including diffuse microcalcification of the parotid gland and cartilaginous tumors of the temporomandibular joint, may be sometimes difficult. In such cases, surgical resection may be a beneficial treatment option.


Asunto(s)
Condroma , Neoplasias de la Parótida , Masculino , Humanos , Persona de Mediana Edad , Glándula Parótida/patología , Glándula Parótida/cirugía , Neoplasias de la Parótida/diagnóstico , Neoplasias de la Parótida/patología , Neoplasias de la Parótida/cirugía , Condroma/diagnóstico por imagen , Condroma/cirugía , Articulación Temporomandibular/diagnóstico por imagen , Biopsia con Aguja Fina/métodos
6.
Ann Chir Plast Esthet ; 68(3): 213-217, 2023 Jun.
Artículo en Francés | MEDLINE | ID: mdl-36522237

RESUMEN

Chondromas are the most frequent benign tumors of the skeleton. The surgical treatment of these tumors consists of curettage of the tumor, which may be associated with a filling of the defect. One of the filling techniques uses bone substitutes. The primary objective was to evaluate the resorption of phosphocalcic injectable cements and their evolution in bone sites. The secondary objectives were to evaluate the function of the finger and to look for a possible recurrence of the chondroma. We performed a bi-centric study and reviewed 13 patients with 14 phalanx or metacarpal chondromas operated on by phosphocalcic cement filling technique with a minimum follow-up of 2years. An X-ray at the longest follow-up was performed as well as a QDASH, a "finger score" and a measurement of the amplitudes. Cement disappearance was observed in 100% of 5 patients. An average of 30% of cement remained at the last follow-up (0-80%). The disappearance of cement was significantly inversely proportional to the time since the last radiograph (P<0.01). On average, total disappearance of cement was found at about 6years postoperatively. The mean QDASH score was 6.1 (0; 40.91). The mean finger score was 3 (0-24). The disappearance of the cement seems to occur in the medium term after its installation but does not predict the functional recovery and satisfaction of patients operated on for the cure of a chondroma of the hand.


Asunto(s)
Neoplasias Óseas , Condroma , Huesos del Metacarpo , Humanos , Estudios Retrospectivos , Neoplasias Óseas/cirugía , Cementos para Huesos , Condroma/cirugía , Legrado/métodos
7.
J Surg Oncol ; 125(2): 273-281, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34586629

RESUMEN

BACKGROUND AND OBJECTIVES: The "four-quadrant approach" (FQA) for triage of benign enchondromas (E) and low-grade malignant chondrosarcomas (LGC) divides patients into treatment categories based on the presence or absence of pain and observation of aggressive or benign radiographic features. This article evaluates the usefulness of the FQA in predicting E versus LGC and operative versus nonoperative outcome. METHODS: Patients had working diagnosis of E or LGC, 1-year minimum follow-up, imaging, clinical data, outcomes, and no radiographic evidence of high-grade chondrosarcoma. Statistical analysis determined whether quadrant distribution correlated to E versus LGC and operative versus nonoperative intervention. RESULTS: Of 56 lesions (49 patients), 9 were LGC and 47 E. Twenty-five lesions (all 9 LGC, 16 E) were treated operatively and 31 (all E) nonoperatively. There were statistically significant correlations between quadrant distribution and both tumor type (p = 1.9 × 10-6 ) and operative intervention (p = 6.28 × 10-6 ). CONCLUSIONS: The FQA is a promising diagnostic tool to distinguish between E and LGC hyaline cartilage tumors, along with determining operative versus nonoperative intervention. Prospective evaluation is warranted.


Asunto(s)
Condroma/diagnóstico , Condrosarcoma/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Condroma/patología , Condroma/cirugía , Condrosarcoma/patología , Condrosarcoma/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Triaje , Adulto Joven
8.
J Pediatr Orthop ; 42(7): e788-e792, 2022 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-35575990

RESUMEN

BACKGROUND: Multiple enchondromas in the pediatric hand is a relatively rare occurrence and the literature regarding its incidence and treatment is sparse. Within this rare subset of patients, we identified a unique cohort in which lesions are confined to multiple bones in a single ray or adjacent rays within a single nerve distribution. We review the clinical and pathologic characteristics and describe the indications for and outcomes of treatment in this unique subset of patients as well as offer conjectures about its occurrence. METHODS: Institutional review board (IRB)-approved retrospective multicenter study between 2010 and 2018 identified subjects with isolated multiple enchondromas and minimum 2-year follow-up. Data analyzed included demographics, lesion quantification and localization, symptoms and/or fracture(s), treatment of lesion(s), complications, recurrence, and presence of malignant transformation. RESULTS: Ten patients were evaluated with average age at presentation of 9 years (range: 4 to 16) and mean clinical follow-up of 6 years (range: 2.8 to 8.6). Five subjects had multiple ray involvement in a single nerve distribution and 5 had single ray involvement with an average of 4 lesions noted per subject (range: 2 to 8). All children in the study had histopathologic-proven enchondromas and underwent operative curettage±bone grafting. Indications for surgical intervention included persistent pain, multiple prior pathologic fractures, impending fracture and deformity. During the study period three subjects experienced pathologic fracture treated successfully with immobilization. Recurrence was noted in 40% at an average of 105 weeks postoperatively (range: 24 to 260) and appears higher than that reported in the literature. No case of malignant transformation was observed during the study period. CONCLUSIONS: A rare subset of pediatric patients with multiple enchondromas of the hand is described with lesions limited to a single ray or single nerve distribution. Further awareness of this unique subset of patients may increase our understanding of the disease and improve patient outcomes. LEVEL OF EVIDENCE: Level IV-therapeutic (case series).


Asunto(s)
Condroma , Encondromatosis , Fracturas Óseas , Fracturas Espontáneas , Niño , Condroma/diagnóstico , Condroma/patología , Condroma/cirugía , Legrado , Encondromatosis/complicaciones , Encondromatosis/diagnóstico por imagen , Encondromatosis/cirugía , Fracturas Óseas/cirugía , Fracturas Espontáneas/etiología , Mano , Humanos , Estudios Multicéntricos como Asunto , Estudios Retrospectivos
9.
J Surg Oncol ; 123(8): 1821-1827, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33713465

RESUMEN

BACKGROUND AND OBJECTIVES: Intralesional surgical treatment is the preferred therapy for atypical cartilaginous tumors (ACTs) of the long bones in many institutions. However, the literature is still controversial regarding intralesional treatment versus wide resection. Due to the relative rarity of these tumors, studies reporting on the results of intralesional treatment are often small sample studies. METHODS: We retrospectively analyzed the oncological results of 55 enchondromas, 119 ACTs, and 5 chondrosarcomas grade 2 (CS2) treated with curettage and cryosurgery between the years 2004 and 2017 at our institution. The median follow-up period was 53 months (range, 24-169 months). RESULTS: In total, seven cases (three ACT, four CS2) recurred. Residual tumor was detected in 20 cases. Three cases underwent secondary curettage and cryosurgery due to local recurrence. Four cases underwent wide resection and reconstruction due to local recurrence with aggressive imaging characteristics. In total, 20 postoperative complications were seen. CONCLUSION: Curettage and cryosurgery for enchondroma and ACT show very good oncological results with a low recurrence rate and acceptable complication rate. Curettage and cryosurgery is reliable as a surgical treatment for enchondroma and ACT. Further research should define the criteria for determining which specific cartilaginous tumors necessitate surgical treatment.


Asunto(s)
Neoplasias Óseas/cirugía , Condroma/cirugía , Condrosarcoma/cirugía , Criocirugía , Legrado , Recurrencia Local de Neoplasia/epidemiología , Adolescente , Adulto , Anciano , Neoplasias Óseas/patología , Niño , Condroma/patología , Condrosarcoma/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasia Residual , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
10.
Skeletal Radiol ; 50(3): 603-607, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32844242

RESUMEN

"Acral FibroChondroMyxoid tumor" (AFCMT) is a recently described distinctive subtype of acral soft tissue tumor that typically arises on the fingers and toes. We herein present the unreported imaging features of AFCMT in a 44-year-old woman. This otherwise healthy patient was referred for a painful, slow-growing, soft tissue mass in the middle finger of her right hand. Initial radiographs and computed tomography showed a small lesion centered in the soft tissue of the ulnar aspect of the proximal phalanx, associated with scalloping of the underlying bone. Magnetic resonance imaging confirmed the presence of a well-circumscribed soft tissue tumor that exhibited relatively high T2-weighted signal intensity and marked enhancement after contrast administration. Subsequent excisional biopsy was performed. Histologically, the tumor was characterized by an abundant stroma displaying fibrous, chondroid, and myxoid areas. By immunohistochemistry, tumor cells stained for CD34, ERG, and focally S100 protein. RNA-sequencing allowed detection of THBS1-ADGFR5 gene fusion which confirmed the diagnosis of AFCMT. At 2-year follow-up, the patient remains free of recurrence. AFCMT is a previously unrecognized entity that may mimic chondroma and should be considered in the differential diagnosis of soft tissue tumors with cartilaginous or myxoid stroma in the extremities.


Asunto(s)
Condroma , Neoplasias de los Tejidos Blandos , Adulto , Condroma/diagnóstico por imagen , Condroma/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Recurrencia Local de Neoplasia , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/cirugía , Dedos del Pie
11.
Ann Plast Surg ; 87(3): 260-264, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-33661226

RESUMEN

PURPOSE: The aims of this study were to evaluate the degree of cortical thinning and the tumor area in simple radiographs in patients with enchondroma of the hand combined with pathologic fracture and to determine the surgical outcome of simultaneous tumor curettage and internal fixation of fracture. METHODS: We enrolled 23 bone lesions of 21 patients diagnosed with enchondroma of the hand. Of them, 9 bone lesions of 8 patients had pathologic fracture. We evaluated the degree of cortical thinning and tumor area in simple radiographs and compared them between patients with and without pathologic fracture. For patients with pathologic fracture, we performed curettage of the tumor through the fracture site and fixed the fracture using K-wires. We then evaluated the clinical outcome of these patients using the visual analog scale to measure pain intensity and Takigawa's criteria 1 year after surgery. RESULTS: There was a significant difference in the degree of cortical thinning between the 2 groups (P < 0.001); however, there was no significant difference in the percentage of tumor area (P = 0.259). The average time from surgery to bony union was 8.5 weeks in patients with pathologic fracture. The patients reported that they could return to their previous activities of daily living within 12 weeks of surgery. The average visual analog scale score was 0.6 at 1 year after surgery, and 6 patients were graded as excellent and 2 as good according to Takigawa's criteria. CONCLUSIONS: Cortical thinning seems to be related to pathologic fracture. Our scoring system for cortical thinning may be helpful in evaluating the risk for pathologic fracture. Early 1-stage surgical treatment for pathologic hand fracture with enchondroma is a very useful method with satisfactory outcomes that could shorten the treatment period.


Asunto(s)
Neoplasias Óseas , Condroma , Fracturas Espontáneas , Actividades Cotidianas , Neoplasias Óseas/complicaciones , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/cirugía , Condroma/diagnóstico por imagen , Condroma/cirugía , Fijación Interna de Fracturas , Fracturas Espontáneas/diagnóstico por imagen , Fracturas Espontáneas/etiología , Fracturas Espontáneas/cirugía , Mano , Humanos , Resultado del Tratamiento
12.
J Craniofac Surg ; 31(7): e720-e722, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32604309

RESUMEN

Chondroma in the area of the spheno-ethmoidal junction is very rare. A 29-year-old male patient with chronic rhinosinusitis with nasal polyps was arranged for a preoperative computed tomography scan, and a lesion was accidentally found in his spheno-ethmoidal junction and involved the skull base. Combined with MRI, the lesion was misdiagnosed as fungal sinusitis. However, no fungal lesions were found during the operation, and cartilage tissue was confirmed only after some bone was ground away under the guidance of a surgical navigation system. Our case indicates that chondroma is easily misdiagnosed as fungal sinusitis when it appears in the sinuses and should be carefully distinguished from fungal sinusitis. Moreover, when lesions involve the skull base, surgical navigation systems are useful in accurately locating lesions.


Asunto(s)
Condroma/diagnóstico por imagen , Hueso Etmoides/diagnóstico por imagen , Senos Paranasales/diagnóstico por imagen , Adulto , Condroma/complicaciones , Condroma/cirugía , Hueso Etmoides/patología , Humanos , Masculino , Micosis , Pólipos Nasales/etiología , Pólipos Nasales/cirugía , Senos Paranasales/patología , Senos Paranasales/cirugía , Sinusitis/etiología , Tomografía Computarizada por Rayos X
13.
Eur J Orthop Surg Traumatol ; 30(1): 97-102, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31422474

RESUMEN

PURPOSE: The aim of this study is to describe outcomes of incidental chondral tumours in the shoulder referred to our Bone Tumour Unit (BTU). METHODS: Our hospital radiology database was searched using the filtered terms "enchondroma", "low-grade chondral tumour", "chondrosarcoma" with "humerus", "arm", "shoulder", "scapula" and "clavicle". Case note review of results assessed primary reasons for referral, radiological diagnosis, recommended management with subsequent reviews and outcomes, either in clinic or surveillance scan reports. RESULTS: Ninety-nine patients had full case note review, mean age 54.5 years (range 18-84 years). Mean follow-up was 41.7 months (range 1-265 months). Over 50% of patients were referred for shoulder pain. Three patients had high-grade chondrosarcoma. Forty-three patients had interval scans, none showing any changes. Thirty-five patients had surgery for their lesions with one recurrence. Forty-four patients had alternative diagnoses made on clinical and radiological examination. At most recent follow-up, 70% of these patients were asymptomatic after physiotherapy/surgical attention to their alternative diagnoses. CONCLUSIONS: Chondral lesions in the shoulder have low risk of malignant transformation and are rarely responsible for shoulder symptoms. We recommend patients be referred to a dedicated BTU for surveillance if there are any concerning features, but to proceed with management for any alternative diagnosis.


Asunto(s)
Neoplasias Óseas/patología , Transformación Celular Neoplásica/patología , Condroma/patología , Condrosarcoma/patología , Hallazgos Incidentales , Articulación del Hombro/patología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/epidemiología , Neoplasias Óseas/cirugía , Condroma/diagnóstico por imagen , Condroma/epidemiología , Condroma/cirugía , Condrosarcoma/diagnóstico por imagen , Condrosarcoma/epidemiología , Condrosarcoma/cirugía , Bases de Datos Factuales , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Distribución por Sexo , Articulación del Hombro/diagnóstico por imagen , Articulación del Hombro/cirugía , Tasa de Supervivencia , Tomografía Computarizada por Rayos X/métodos , Reino Unido
14.
Eur J Orthop Surg Traumatol ; 30(1): 25-30, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31502011

RESUMEN

INTRODUCTION: Studies focusing on enchondroma and atypical cartilaginous tumour (ACT) of the pelvis are lacking. The purpose of this study was to verify possible clinical and radiological findings with regard to distinguishing enchondromas from ACT of the pelvis. In addition, this study analysed functional and oncological outcomes in patients with enchondromas or ACT of the pelvis treated with curettage or resection. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 21 patients with confirmed enchondroma or ACT of the pelvis treated by curettage or resection from 1985 to 2018. The minimum follow-up was 18 months. The relationship between clinical and radiological factors and tumour type or local recurrence was assessed using Fisher exact test and Mann-Whitney U test. RESULTS: Endosteal scalloping (p = 0.039), tumour size (0.005) and age (0.006) were shown to statistically favour ACT over enchondroma; by contrast, enchondroma and ACT patients had no difference in pain frequency (p = 0.5528). All patients with enchondroma had no local recurrence; in contrast, local recurrence occurred in one patient with ACT, initially treated with resection. The patient with local recurrence had a disease progression with a higher histological grade than the original tumour. Patients treated with curettage had better functional outcomes than patients treated with resection (p = 0.001). DISCUSSION: Endosteal scalloping, tumour size and age could be helpful in the differential diagnosis between enchondroma and ACT of the pelvis. In addition, our study showed that ACT of the pelvis can be safely treated with curettage due to a low risk of local recurrence and better functional results compared with resection. In case of recurrence, we suggest to treat these patients with resection for the risk of disease progression.


Asunto(s)
Enfermedades de los Cartílagos/diagnóstico por imagen , Enfermedades de los Cartílagos/patología , Condroma/diagnóstico por imagen , Condroma/cirugía , Legrado/métodos , Huesos Pélvicos/patología , Adulto , Biopsia con Aguja , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/patología , Neoplasias Óseas/cirugía , Enfermedades de los Cartílagos/cirugía , Condroma/patología , Estudios de Cohortes , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Osteotomía/métodos , Huesos Pélvicos/diagnóstico por imagen , Huesos Pélvicos/cirugía , Estudios Retrospectivos , Estadísticas no Paramétricas , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Adulto Joven
15.
Neuropathology ; 39(6): 461-466, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31584218

RESUMEN

Chondroma is a benign cartilage-forming tumor which usually occurs in small bones of extremities but occasionally occurs in the brain. Usually, intracranial chondromas originate from skull base; however, chondroma of the falx cerebri is a very rare condition. We here report a rare case of falcine chondroma in a 19-year-old man who had normal physical examination without signs of any syndromic disorder. The neuroimaging findings were inconclusive, and the diagnosis was based on histopathological examination. The purpose of this paper is to raise attention about intracranial chondromas and suggest that chondroma must be ruled out in any patient presenting with masses arising from the falx.


Asunto(s)
Condroma/diagnóstico por imagen , Condroma/cirugía , Duramadre/diagnóstico por imagen , Duramadre/cirugía , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/cirugía , Humanos , Masculino , Adulto Joven
16.
Skeletal Radiol ; 48(5): 823-830, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30498967

RESUMEN

Chondromyxoid fibroma (CMF) is a rare benign bone neoplasm that typically occurs in young adults. Juxtacortical or surface-type CMF are rarer still and we present the case of a surface-type CMF in a 78-year-old woman, with only one other case described in a patient of a similar age previously. This patient was an otherwise healthy woman who presented for evaluation of a palpable lump in the anterior proximal tibia. Initial radiographs obtained demonstrated a focal soft tissue fullness immediately anterior to the anterior cortex of the proximal tibia, which contained faint chondroid-like matrix internally. There was associated scalloping of the anterior tibial cortex. MRI confirmed the presence of a juxtacortical, enhancing lesion. Subsequent excisional biopsy was performed and histopathology demonstrated features, which was consistent with surface-type CMF. At a 6-month follow-up the patient remained free of recurrence. In a patient of this age, paraosteal chondrosarcoma should be excluded. Surface-type CMF, although rare, has been described in older patients and while it is unlikely to feature in a list of differential considerations on initial imaging, awareness of the entity is important.


Asunto(s)
Neoplasias Óseas/diagnóstico por imagen , Condroma/diagnóstico por imagen , Fibroma/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Tibia/diagnóstico por imagen , Anciano , Biopsia , Neoplasias Óseas/patología , Neoplasias Óseas/cirugía , Condroma/patología , Condroma/cirugía , Diagnóstico Diferencial , Femenino , Fibroma/patología , Fibroma/cirugía , Humanos , Tibia/patología , Tibia/cirugía
17.
J Craniofac Surg ; 30(4): e315-e317, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30845089

RESUMEN

INTRODUCTION: Chondromas are rare mesenchymal benign tumors that are most often encountered in pelvis and ribs, and rarely in head and neck region. They account for about 10% of all benign chondroid proliferations and the rarest occurrence of soft tissue chondromas is within oral cavity. CASE: A 10-year-old female patient was referred to our Clinic because of moderate speech impairment, swallowing disturbances and foreign body sensation in tongue. On clinical examination and MRI scans, hard, painless, clearly demarcated submucosal mass was observed on the left side of the tongue. Surgery was perfomed using intraoral incision approach, and the tumor was completly removed. Histopathological examination of the specimen was positive for chondroma. CONCLUSION: Chondromas benign tumors of mature hyaline cartillage localized in soft tissues of head and neck region. Growing slowly, and painlessly, they remain silent for some period, until reaching certain dimensions, and becoming symptomatous. Magnetic resonance imaging scan provides complete information about localization, size, growth of the tissue, and contributes significantly to the decision of appropriate surgical approach.


Asunto(s)
Condroma , Neoplasias de la Lengua , Niño , Condroma/diagnóstico por imagen , Condroma/cirugía , Femenino , Humanos , Imagen por Resonancia Magnética , Lengua/diagnóstico por imagen , Lengua/cirugía , Neoplasias de la Lengua/diagnóstico por imagen , Neoplasias de la Lengua/cirugía
18.
World J Surg Oncol ; 16(1): 209, 2018 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-30333040

RESUMEN

BACKGROUND: Chondroma is a slowly growing, benign cartilaginous tumor which predominantly occurs in long bones of the hands and feet. Primary mediastinal chondroma is rare, especially with Horner's syndrome. CASE PRESENTATION: We reported the case of a 31-year-old woman with a posterior mediastinum mass associated with Horner's syndrome. After complete dissection of the mass, a pathological diagnosis of the primary mediastinal chondroma was rendered. The patient has shown no local recurrence or distal disease in a 3.5-year follow-up period. CONCLUSIONS: The preoperative diagnosis of chondroma should combine various examinations for comprehensive evaluation. Complete surgical resection should be the first choice of the treatment due to the risk of malignancy.


Asunto(s)
Condroma/patología , Síndrome de Horner/patología , Neoplasias del Mediastino/patología , Adulto , Condroma/complicaciones , Condroma/cirugía , Femenino , Síndrome de Horner/complicaciones , Síndrome de Horner/cirugía , Humanos , Neoplasias del Mediastino/complicaciones , Neoplasias del Mediastino/cirugía , Pronóstico
19.
World J Surg Oncol ; 16(1): 139, 2018 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-30005680

RESUMEN

BACKGROUND: Enchondromas and atypical cartilaginous tumors (ACT) are often located at the proximal humerus. Most lesions can be followed conservatively, but surgical resection may alleviate pain, avoid pathological fractures, and prevent transformation into higher grade chondrosarcomas. Rigorous intralesional resection and filling with polymethylmethacrylate bone cement has been proposed for enchondromas but also for ACT, as an alternative for extralesional resection. We intended to analyze radiological, clinical, and functional outcome of this strategy and compare bone cement without osteosynthesis to bone cement compound osteosynthesis, which has not been analyzed so far. METHODS: We retrospectively analyzed 42 consecutive patients (mean follow-up 73 months; range 8-224) after curettage and bone cement filling with or without osteosynthesis. Exclusion criteria were Ollier's disease and cancellous bone filling. Twenty-five patients only received bone cement. Seventeen patients received additional proximal humerus plate for compound osteosynthesis to increase stability after curettage. Demographics and radiological and clinical outcome were analyzed including surgery time, blood loss, hospitalization, recurrences, and complications. An additional telephone interview at the final follow-up assessed postoperative satisfaction, pain, and function in the quick disabilities of the arm, shoulder, and hand (DASH) score and the Musculoskeletal Tumor Society (MSTS) score. Statistics included the Student T tests, Mann-Whitney U tests, and chi-square tests. RESULTS: No osteosynthesis compared to compound osteosynthesis showed smaller tumors (4.2 (± 1.5) cm versus 6.6 (± 3.0) cm; p = 0.005) and smaller bone cement fillings after curettage (5.7 (± 2.1) cm versus 9.6 (± 3.2) cm; p = 0.0001). A score evaluating preoperative scalloping and soft-tissue extension did not significantly differ (1.9 (± 0.9) versus 2.0 (± 1.0); rating scale 0-4; p = 0.7). Both groups showed high satisfaction (9.2 (± 1.5) versus 9.2 (± 0.9); p = 0.5) and low pain (1.0(±1.7) versus 1.9(±1.8); p = 0.1) in a rating scale from 0 to 10. Clinical and functional outcome was excellent for both groups in the DASH score (6.0 (± 11.8) versus 11.0 (± 13.2); rating scale 0-100; p = 0.2) and the MSTS score (29.0 (± 1.7) versus 28.7 (± 1.1); rating scale 0-30; p = 0.3). One enchondroma recurrence was found in the group without osteosynthesis. Complications (one fracture and one intra-articular screw) were only detected after osteosynthesis. Osteosynthesis had longer surgery time (70 (± 21) min versus 127 (± 22) min; p < 0.0001), more blood loss (220 (± 130) ml versus 460 (± 210) ml; p < 0.0001), and longer stay in the hospital (6 (± 2) days versus 8 (± 2) days; p = 0.004). CONCLUSIONS: Intralesional tumor resection was oncologically safe and clinically successful with or without osteosynthesis. Osteosynthesis did not reduce the risk for fracture but was more invasive.


Asunto(s)
Neoplasias Óseas/cirugía , Cartílago Articular/cirugía , Condroma/cirugía , Húmero/cirugía , Adulto , Cementos para Huesos , Cartílago Articular/patología , Cementación , Legrado , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Hombro/patología , Hombro/cirugía , Resultado del Tratamiento
20.
Kyobu Geka ; 71(11): 976-979, 2018 10.
Artículo en Japonés | MEDLINE | ID: mdl-30310015

RESUMEN

A 66-year-old man was pointed out a nodular shadow in the right lower lobe by chest computed tomography (CT) 4 years ago. Since the size of the shadow has been increasing for 4 years, he hospitalized for surgery. Partial resection of the right lower lobe was performed. Histopathologically, the tumor was composed of cartilage tissue without epithelial components, and was diagnosed as a chondroma. Postoperative course was uneventful and there has been no recurrence at 1 years and 8 months after surgery.


Asunto(s)
Condroma , Neoplasias Pulmonares , Anciano , Condroma/diagnóstico por imagen , Condroma/patología , Condroma/cirugía , Humanos , Pulmón/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Masculino , Tomografía Computarizada por Rayos X
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