Osteochondroma overview: Difference between revisions
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==Natural History, Complications and Prognosis== | ==Natural History, Complications and Prognosis== | ||
If left untreated, patients with osteochondroma may progress to develop | If left untreated, patients with osteochondroma may progress to develop overlying [[bursitis]], vascular compromise, and rise to malignant chondrosarcoma. Common complications of osteochondroma include [[fracture]], osseous deformation, and [[growth]] arrest. Prognosis is generally regarded as good after surgical excision. The [[recurrence]] rate of osteochondroma is 2%.<ref name="pmid10992031">{{cite journal |vauthors=Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH |title=Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation |journal=Radiographics : a Review Publication of the Radiological Society of North America, Inc |volume=20 |issue=5 |pages=1407–34 |year=2000 |pmid=10992031 |doi=10.1148/radiographics.20.5.g00se171407 |url=http://pubs.rsna.org/doi/10.1148/radiographics.20.5.g00se171407?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed}}</ref> | ||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 21:32, 27 January 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
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Overview
Osteochondroma (also known as osteocartilaginous exostosis) is a benign bone tumor that consists of cartilage and bone. Osteochondromas arise from cartilage, which is normally involved in the mechanical support of the bone. These tumors take the form of cartilage-capped bony projections or outgrowth on the surface of bones, also known as exostoses.[1] Osteochondroma is the most common benign bone tumor and usually occurs in the metaphyseal region of the long bones. Development of osteochondromas is the result of the developmental anomaly of skeletal growth.The majority of these tumors present as solitary, non hereditary lesions (85%). Osteochondromas are usually found in adolescents and children. Men and women are equally affected. The incidence of osteochondroma is approximately 0.9 per 100,000 individuals. If left untreated, progression occurs slow and is then followed by malignant transformation. The treatment choice for osteochondroma is surgical removal of solitary lesion or partial excision of the outgrowth, when symptoms cause motion limitations or nerve and blood vessel impingements.
Historical Perspective
Osteochondroma was first described by Henry L. Jaffe, an American pathologist, in 1952.[2]
Classification
Osteochondromas may be classified into 2 subtypes: solitary osteochondromas (non-hereditary) and multiple osteochondromas (hereditary).[3]
Pathophysiology
Osteochondroma arises from the cartilage cells (chondrocytes), which are normally involved in the mechanical support of the bone. The pathogenesis of osteochondroma consists of abnormal outgrowth of bone and cartilage, associated with the aberrant development of the growth plate.[3] Genes involved in the pathogenesis of osteochondroma include EXT1 and EXT2 genes. Osteochondroma is associated with a number of syndromes that include Langer-Giedion syndrome, Potocki-Shaffer syndrome, and metachondromatosis syndrome. On gross pathology, osteochondromas may have a "mushroom-like shape", the tumoral size ranges from 1 to 2 cm, they are normally conformed located on the metaphysial region of the affected bone.[4] On microscopic histopathological analysis, osteochondroma shows cartilage cells growing in columns with a lobular arrangement.[5]
Causes
There are no established direct causes for osteochondroma. The development of hereditary multiple osteochondroma may be the result of multiple genetic mutations.
Differentiating Osteoid Osteoma from other Diseases
Osteochondroma must be differentiated from other diseases that cause a bone growth after malunited fracture, bony deformity or mechanical joint problems such as enchondroma, chondroblastoma, and periosteal chondroma.
Epidemiology and Demographics
Osteochondroma is the most common benign bone tumor among general population. The incidence of osteochondroma is approximately 0.9 per 100,000 individuals in the general population. The incidence of osteochondroma decreases with age; the median age at diagnosis is between 10 to 13 years. Males and females are equally affected with osteochondroma. Osteochondroma usually affects individuals of the Caucasian race.
Risk Factors
Common risk factors in the development of osteochondromas, include: previous trauma to the growth plate, exposure to previous radiation, and congenital limb anomalies.[6]
Screening
According to the the Canadian Society of Cancer, there is insufficient evidence to recommend routine screening for osteochondroma.[7]
Natural History, Complications and Prognosis
If left untreated, patients with osteochondroma may progress to develop overlying bursitis, vascular compromise, and rise to malignant chondrosarcoma. Common complications of osteochondroma include fracture, osseous deformation, and growth arrest. Prognosis is generally regarded as good after surgical excision. The recurrence rate of osteochondroma is 2%.[6]
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Surgery is the mainstay of therapy for osteochondroma.
Primary Prevention
Secondary Prevention
References
- ↑ Panagiotis, Kitsoulis; Vassiliki Galani; Kalliopi Stefanaki; Georgios Paraskevas; Georgios Karatzias; Niki John Agnantis; Maria Bai (October 2008). "Osteochondromas: Review of the Clinical, Radiological and Pathological Features". In Vivo. 22 (5): 633–646. Retrieved 22 March 2014.
- ↑ Tumors and Tumorous Conditions of the Bones and Joints by Henry L. Jaffe, Philadelphia, Lea and Febiger 1958
- ↑ 3.0 3.1 Kitsoulis P, Galani V, Stefanaki K, Paraskevas G, Karatzias G, Agnantis NJ, Bai M (2008). "Osteochondromas: review of the clinical, radiological and pathological features". In Vivo (Athens, Greece). 22 (5): 633–46. PMID 18853760.
- ↑ Osteochondroma. Libre Pathology. http://librepathology.org/wiki/index.php/Osteochondroma Accessed on January 27, 2015
- ↑ Porter DE, Simpson AH (1999). <119::AID-PATH321>3.0.CO;2-N "The neoplastic pathogenesis of solitary and multiple osteochondromas". The Journal of Pathology. 188 (2): 119–25. doi:10.1002/(SICI)1096-9896(199906)188:2<119::AID-PATH321>3.0.CO;2-N. PMID 10398153.
- ↑ 6.0 6.1 Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH (2000). "Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation". Radiographics : a Review Publication of the Radiological Society of North America, Inc. 20 (5): 1407–34. doi:10.1148/radiographics.20.5.g00se171407. PMID 10992031.
- ↑ Osteochondroma. Candian Society of Cancer. http://www.cancer.ca/en/cancer-information/cancer-type/bone/bone-cancer/benign-tumours/?region=bc Accessed on January 27, 2016