OSTEOCHONDROMA - BENIGN TUMOR Flashcards
DEFINE
IT IS A DEVELOPMENTAL MALFORMATION THAN TRUE NEOPLASM . CAUSED DUE TO MISDIRECTED GROWTH OF PORTION OF PHYSEAL PLATE .
ETIOPATHOGENESIS
CAUSED DUE TO MISDIRECTED GROWTH OF PORTION OF PHYSEAL PLATE .
THOUGH TUMOUR ORIGINATES AT PHYSEAL PLATE , IT GETS LEFT BEHIND AT METAPHYSIS .
TUMOR HAS CAP OF HYALINE CARTILAGE 1-3 MM THICK .
THE CORTEX AND MEDULLA IS CONTINUOUS WITH HOST BONE .
THE TUMOUR GROWS TOWARDS DIAPHYSIS .
MAY BE PEDUNCULATED OR SESSILE.
MAY BE SOLITARY OR MULTIPLE
SEX
MALE
AGE
GROWTH PERIOD < 20 YEARS
SITE
GROWING ENDS OF LONG BONES =
PROXIMAL HUMERUS , DISTAL FEMUR , PROXIMAL TIBIA , DISTAL TIBIA, PROXIMAL FIBULA, DISTAL FIBULA
LOCATION
METAPHYSIS OF ANY BONE DEVELOPING BY ENDOCHONDRAL OSSIFICATION.
SYMPTOMS
PAINLESS
SWELLING
PAIN IF COMPLICATIONS LIKE FRACTURE , MALIGNANT TRANSFORMATION , BURSITIS, IMPINGEMENT OF NEIGHBORING STRUCTURES LIKE NERVE, VESSELS, MUSCLES.
SIGNS
NON TENDER ,
PALPABLE SWELLING FIXED TO BONE
RESTRICTED MOVEMENT DUE TO MECHANICAL BLOCK
GROWTH DISTURBANCE
X RAY
MUSHROOM SHAPED OUTGROWTH AT METAPHYSIS , EIITHER SESILE OR PEDUNCULATED.
CONTINUOUS WITH THE CORTEX AND MEDULLA OF HOST BONE
TOUMOR LOOKS RELATIVELY SMALL ON XRAY BECAUSE IT IS COVERED WITH HYALINE CARTILAGE
OTHER NAME
EXOSTOSIS
TREATMENT
USUALLY NOT REQUIRED UNLESS CPMPLICATION OCCUR .
IF SO, THEN COMPLETE EXCISION OF TUMOUR .
EXCISION TO BE POSTPONED TILL ADOLESCENCE DUE TO RISK OF DAMAGE TO PHYSIS AND RECURRENCE
MULTIPLE HEREDITARY EXOSTOSIS
AUTOSOMAL DOMINANT TRAIT ( INVOLVES CHROMOSOME 8,11,19), MARKED BY SKELETAL DEFORMITY AND DISABILITY.
ALSO KA DIAPHYSIALACLASIS
CLINICAL FEATURES
PAIN (DUE TO PRESSURE ON NEIGHBOURING STRUCTURES)
ASSOCIATED WITH DWARFISM
MULTIPLE BONY LUMPS
DEFORMITY PRESENT
RESTRICTED MOVEMENT
X RAY
CLASSICAL TRUMPET SHAPED METAPHYSIS AND BONY PROJECTIONS FROM IT.
DEFORMITIES: BOWING OF RADIUM , ANKLE VALGUM, GENU VALGUM
TREATMENT
EXCISION
CORRECTIVE OSTEOTOMY
MANAGEMENT FOR MALIGNANT CHANGES
