Risk factors for Bone Tumor - Osteochondroma include:
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
The signs and symptoms of Osteochondroma include:
The tumor most commonly occurs around the knee joint, other locations include:
The diagnosis of Osteochondroma is made as follows:
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
The complications of Osteochondromas include:
It is estimated that very small fraction of individuals may have recurrence after surgery (2% recurrence - according to Mayo Clinic).
When a pathologist examines Osteochondroma grossly and microscopically, the following features are noted:
Macroscopic (gross) findings:
Sessile Osteochondromas are semicircular tumors and have a thin cartilage cap. The periosteum from the affected bone forms a thin membrane around the tumor. Irregular calcification lines differentiate cartilage from cancellous bone. The tumor contains fatty and hematopoietic marrow that reflects the condition of the affected bone. With a pedunculated Osteochondroma, the lesion has the appearance of a mushroom with a bony stalk and a cap or cartilaginous tissue. To appreciate the full thickness of the cartilaginous cap, it is important to cut the lesion perpendicular to the stalk.
Microscopic (histopathology) findings:
A thin pink membrane surrounds the outermost portion of the cap, representing the periosteum that has been lifted-off the bone. Both bone and cartilage should be seen in a single section, otherwise a chondrosarcoma should be considered, due to the extensive amount of cartilage. Clusters ofchondrocytes in lacunae make up the cartilaginous cap, and abundant chondroid matrices are present between the clusters. As seen in epiphyseal plates, the chondrocytes towards the base are arranged in columns, and bony trabeculae arise from the cartilage plate.
Differential diagnosis:
Subungual exostosis, bizarre parosteal osteochondromatous proliferation, and secondary chondrosarcoma are included in the differential diagnosis. The distal phalanx is involved in subungual exostosis and presents as a rapidly-growing mass. However, Osteochondromas are rarely seen in subungual locations, and the bone has a mature appearance not seen in subungual exostosis. Bizarre parosteal osteochondromatous proliferation usually involves the small bones of the hand and has a blue pattern of calcification not seen in Osteochondromas. If an Osteochondroma becomes malignant, it is typically an osteosarcoma. Secondary sarcoma should be suspected, if there is a soft tissue mass showing irregular mineralization.
On a radiologist examinationof the X-rays, the following features may be seen:
Findings include a pedunculated or sessile projection from the bone surface. The cortex and the medullary cavity are continuous with the involved bone. At the site of the Osteochondroma, the affected bone is typically (unusually) wide, and if the tumor is pedunculated, it will normally point away from the nearest joint.
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