enchondroma
Introduction
Introduction to endogenous chondroma Endogenous chondroma can occur in the bone, also known as the central type (endogenous chondroma), and the bone surface is also called the marginal type (periosteal chondroma), which can be a single lesion or multiple (endocarcinoma). Chondromas can also be associated with soft tissue hemangioma (Maffucci syndrome). basic knowledge The proportion of illness: 0.0006% Susceptible people: no specific population Mode of infection: non-infectious Complications: fracture
Cause
Endogenous chondromatosis
(1) Causes of the disease
It is a tumor caused by embryonic ectopic tissue.
(two) pathogenesis
1. Gross examination: The specimens obtained by surgical curettage show that the tumor tissue is light blue hyaline cartilage with firm texture, but it can also become soft due to mucoid degeneration. The bone cortex of the affected bone often has a swelling change, and the cortical bone is thin. Such as eggshell, the intima surface of the cortical bone is lobulated due to tumor erosion, single endogenous chondroma lesions are small, but in long tubular bones, lesions are sometimes larger, should pay attention to the larger cartilage lesions The greater the likelihood of chondrosarcoma.
2. Microscopy: Most endogenous chondromas are composed of many hyaline cartilage lobes, which are well formed in the lobes. These chondrocytes are typically small, pale, and cytoplasmic. There are small and round stained nucleus, and occasionally there are binuclear cells. If these cells are many, the possibility of chondrosarcoma should be considered, especially when such tumors do not occur in the hands and feet, endogenous chondromas often have Calcification zone, in which cells can be characterized as degenerative or necrotic, with enlarged, irregularly rich nuclei, should be noted in the examination, do not mistake it for chondrosarcoma, the degree of maturity of cells in endochondroma Large, especially in children and adolescents, often see a large number of cells, with an abundance of atypical nucleus and binuclear cells, the above characteristics are generally used to distinguish between benign endochondroma and chondrosarcoma histological features However, these characteristics can not be used to diagnose cartilage tumors in the hands and feet. The diagnosis of radiology in this area is more important. Single endogenous cartilage The cortical bone erosion and destruction of tumor expansion occurs into the soft tissue, it is indicative of malignant transformation.
Prevention
Endogenous chondroma prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease. Develop good habits, stop smoking and limit alcohol. Do not drink alcohol. Smoke and alcohol are extremely acidic and acidic substances. People who smoke and drink for a long time can easily lead to acidic body. Don't eat too much salty and spicy food, don't eat food that is overheated, too cold, expired and deteriorated; those who are frail or have certain genetic genes should eat some cancer-preventing foods and alkaline substances with high alkalinity as appropriate. Food, keep a good mental state.
Complication
Endogenous chondroma complications Complications
Can be complicated by pathological fractures.
Symptom
Endogenous chondroma symptoms common symptoms periosteal reaction calcification slow growth
Single-shot endogenous chondroma is a tumor in the medullary cavity. It is composed of transparent cartilage lobule. The age of onset is usually 30 to 40 years old. The ratio of male to female is the same. The patient usually has no special symptoms or painless swelling. Seek medical treatment, if there is pathological fracture, pain can occur. Tumors are often found when taking X-ray films. Pain symptoms appear in long tubular bones, pelvis and scapula. It should be noted whether there is malignant change and generally no systemic symptoms.
Predilection sites: Generally speaking, the bones invaded by endogenous chondromas are rarely invaded by chondrosarcoma. About 40% to 65% of single endogenous chondromas occur in the hands and occur in the feet. In the hand, the proximal phalanx is the best site, accounting for 40% to 50% of cases, followed by the metacarpal (about 15% to 30%), and the middle phalanx is 20% to 30%, rarely located in the distal phalanx ( About 5% to 15%), the incidence of each finger is the most middle finger, followed by the ring, the little finger, the indicator again, the thumb is the least, the carpal bone is rare (less than 2%), in the foot, the incidence is about All of the endogenous chondromas were 6%, and the predilection sites were phalanges, humerus, and talus.
The incidence of endogenous chondroma in the long tubular bone is about 25%, and the incidence of upper limbs is more than that of the lower limbs. The typical parts are the tibia, the femur, the tibia, and the tibia are the sites of chondrosarcoma, while the endogenous chondromas occur in the tibia. Only 3%, skull, facial bone, humerus, calcaneus, sternum, scapula, ulna and spine are rare sites of infection.
An endogenous chondroma that occurs in a long tubular bone, usually at the center of the metaphyseal end. When the callus is closed, the site of the tumor can be moved toward the diaphysis or metaphysis, and in the center of the short tubular bone at the foot and foot.
Examine
Endogenous chondroma examination
Single-shot endogenous chondroma on the X-ray is typical: often a confined, well-defined, elliptical transparent shadow with a lobulated shape, often centered, cortical thinning, around the tumor There is a thin layer of hyperplastic sclerosis, and scattered sand-like densification points are visible in the shadows. This is the main feature of the chondroma in the X-ray (Fig. 1), a single endogenous chondroma that occurs in the metacarpal or humerus. The X-ray features are basically similar to the phalanx, but the tumor has a large shadow, often biased toward the bone end, and the cortical bone is also more prominent. A single endogenous chondroma occurs in the long bone trunk, often showing a central or eccentric pith. Intracavitary lesions, osteolytic lesions of different sizes, accompanied by calcification shadows, often with lobular erosion at the edge of the cortical bone, single endogenous chondroma located in flat or irregular bone, often without typical performance, single Difficulty in diagnosis by X-ray, single-end endogenous chondroma sometimes combined with pathological fracture, is also one of the characteristics of X-ray.
Diagnosis
Diagnosis and identification of endogenous chondroma
diagnosis
Adolescent patients are more common, the predilection is the hand, the foot bone, the tumor grows slowly, can last for several years or ten years, the local mass, the pain is not obvious, the X-ray film shows the osteolytic destruction in the medullary cavity, sometimes there is calcification Spot, cortical bone is thinned and there is no periosteal reaction.
Differential diagnosis
1. Bone cyst: occurs mostly in adolescents, with the most common femur and femur. It is located at the metaphysis, connected or separated from the tarsal plate. Pathological fractures often occur. X-ray films are also limited to osteolytic destruction, but more transparent. The capsule cavity is a cavity containing a small amount of liquid, the wall of the capsule is fibrous tissue and new bone tissue, and occasionally multinucleated giant cells are seen under the microscope.
2. Fiber abnormal proliferation: more than 10 to 30 years old, with femur, tibia, ribs more common, symptoms are not obvious, often with pathological fractures, X-ray examination for localized osteolytic destruction, lesions are frosted glass Pathological examination showed that the tumor tissue was grayish white, hard and tough as rubber, with gravel-like objects inside, and fibrous tissue and metaplastic bone under the microscope.
