Benign Bone Tumours Flashcards
Describe osteochondroma.
A benign lesion derived from aberrant cartilage from the perichondral ring; the most common benign bone tumour
What is the aetiology of osteochondroma?
- Common in adolescents and young adults (10-20 years)
- Can be caused by trauma
- Can be solitary or multiple
- Multiple osteochondromata can occur as an autosomal dominant hereditary disorder - Multiple Hereditary Exostosis (MHE)
What is the pathophysiology of osteochondroma?
produces a bony outgrowth on the external surface with a cartilaginous cap
What is the clinical presentation of osteochondroma?
- Painless, hard lump
- Commonly occur near the knee - distal femur/proximal tibia
- May be symptoms with activity - pain from tendons, numbness from nerve compression
What is the investigation for osteochondroma?
Imaging (x-ray, MRI) - cartilage capped ossified pedicle
What is seen on this x-ray?
Osteochondroma
What is the management of osteochondroma?
- Close observation - small risk of malignant transformation (<1%) so any lesion growing in size or causing pain may require excision
- In MHE there are more tumours so higher change of malignancy
What is an enchondroma?
Intramedullary and usually metaphyseal cartilaginous tumour caused by failure of normal enchondral ossification at the growth plate; 2nd most common benign bone tumour
What is the aetiology of enchondroma?
Most commonly presents 20-50 years old
What is the typical presentation of enchondroma?
- Can occur in the femur, humerus, tibia and small bones of the hand and feet
- Many are incidental and usually asymptomatic but they can weaken the bone leading to pathological fracture
What are the investigations for enchondroma?
- Imaging - x-ray, further imaging if needed
- Lesion is usually lucent on imaging but can undergo mineralisation with a patchy sclerotic appearance
What is seen on this x-ray?
Enchondroma
What is the management of enchondroma?
Once a fracture has healed or if there is a risk of impending fracture they may be scraped out (curettage) and filled with bone graft to strengthen the bone
What is a simple bone cyst?
Single cavity benign fluid filled cyst in a bone.
What is the aetiology of a simple bone cyst?
Probably a growth defect in the physis and are therefore metaphyseal in long bones (usually in proximal humerus and femur), although they can occur in the talus or calcaneus
What is the presentation of a simple bone cyst?
May be asymptomatic and an incidental finding (usually x-ray of child/YA) but can weaken the bone leading to pathological fracture
What is the investigations of a simple bone cyst?
May be asymptomatic and an incidental finding (usually x-ray of child/YA) but can weaken the bone leading to pathological fracture
What is seen in these images?
Simple bone cyst