Diagnostics and treatment of enchondromas
DOI:
https://doi.org/10.6016/ZdravVestn.3226Keywords:
enchondroma, biopsy, incidental finding, BACTIP guidelinesAbstract
Enchondromas are benign intramedullary tumours of mature hyaline cartilage, accounting for 10–25% among all benign bone tumours.They are present in almost 3% of magnetic resonance examinations of knees and shoulders as an asymptomatic random finding. This paper presents epidemiology, clinical picture, imaging diagnostics, differential diagnostics, biopsy indications, histopathology, clinical monitoring, and treatment of enchondromas. Randomly discovered asymptomatic intramedullary solitary enchondromas in long bones mainly do not require treatment, as the risk of subsequent malignant alteration is less than 1%. Enchondromas in small bones of hands and feet are treated by excochleation biopsy due to a high risk of pathological fracture. Cartilaginous tumours exhibiting growth, local pain, or aggressive radiological characteristics require treatment at a tertiary facility with a possible biopsy and decision on observation/discharge/resection. The most complex clinical challenge is distinguishing common enchondromas from rare atypical cartilage tumors and even rarer chondrosarcomas, whereby the BACTIP guidelines can be very useful.
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