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Chondroma
by: Dr.Faris mohsin al-abeedi
Chondroma
rare, slow-growing tumors that arise from the cartilaginous portions of bones. In the cranial region, this includes the bones of the skull base and paranasal sinuses.
These benign tumors are composed of mature cartilage. As they grow they may destroy bone or cause an overgrowth of bone. They also may compress the brain but will not invade it.
Rarely, these tumors progress to chondrosarcomas, a cancerous form of chondromas .
the progress to chondrosarcomas, a cancerous form of chondromas.
“ in the rib “
The tumor is usually seen between the ages of 20 to 40 years. Affects males and females equally. The most common location of the tumor is the upper part of the humerus or arm bone.
:These tumors are of types
*those located eccentrically in the bone are called Chondroma (common in large bones)
*those located in the centre of the bone called Enchondroma
*Ecchondroma: This kind of chondroma forms at the surface of the bone
.
those located in the centre of the bone called
Enchondroma
The following are the most common symptoms of chondroma. However, each individual may experience symptoms differently.When a chondroma develops, it may cause any or all of the following:
*visual changes*headache
*And it can be asymtomatic
Symptoms of a chondroma bones of the skull:
” In other body sites “in geniral
Most usual symptom is the presence of swelling or the sensation of a lump which is fixed to the underlying bone. Pain may appear as the tumor grows and impinges on the surrounding structures. The tumor may remain symptomless and may go undetected. Such tumors may be found when a
x ray is taken for some other condition.
Diagnosis of a chondroma:
In addition to a complete medical history and physical examination, diagnostic procedures for chondroma may include X-ray, CT scan or MRI to determine the size and location of the tumor.
Etiology:
While the exact cause is not known, it is believed to occur either as an overgrowth of the cartilage that lines the ends of the bones, or as a persistent growth of original, embryonic cartilage
Clinical Presentation/ Complications
*Painless swelling of a digit* Pathologic fracture
*Malignant transformation
Signs and Symptoms of Malignant Transformation
*Pain* Enlarging lesion* Pathological fracture* Soft tissue mass
* Disappearance of preexisting calcifications
:Histopathology
Chondroma is a benign cartilaginous tumor, encapsulated, with a lobular growing pattern. Tumor cells (chondrocytes, cartilaginous cells) resemble normal cells and produce the cartilaginous matrix (amorphous, basophilic material). Characteristic are the vascular axes within the tumor, which make the distinction with normal hyaline cartilage.
Treatmint: : For the skull chondroma
*Surgery, usually endonasal endoscopic surgery, is the most common treatment for chondromas.Radiation therapy may be performed after surgery
Treatment on the other sites may include:
*surgery (in some cases, when bone weakening is present or fractures occur)*bone grafting - a surgical procedure in which healthy bone is transplanted
from another part of the patient's body into the affected area.
If there is no sign of bone weakening or growth of the tumor, observation only may be suggested. However, follow-up with repeat x-rays may be necessary. Some types of enchondromas can develop into malignant, or cancerous, bone tumors later. Careful follow-up with a physician may be recommended.
of this condition is by surgery. During surgery the whole tumor is removed along with a rim of normal bone. The defect that remains is then filled with a bone graft. If a rim of normal bone is not removed then it is highly probable that the tumor may grow again
Prognosis is dependent on tumor location, tumor size, and the overall health of the patient. Typically, the tumors are symptomatic and present no complications after skeletal maturity. Functional survival is possible for nearly all patients with the disease unless it develops into malignant chondrosarcoma, which it rarely does
Prognosis:
Differential Diagnosis:*Aneurysmal bone cyst* Giant cell tumor* Solitary bone cyst* Fibrous dysplasia* Bone infarct
*Low-grade chondrosarcoma