Chondoma is a type of benign tumor that originates in cartilage tissue. Chondomas most often develop in long bones - they can grow both inside and superficially. Many chondromas do not cause any symptoms and are detected completely by chance. Since chondroma is a benign neoplasm, there are not always indications for its aggressive treatment. Find out what types of chondroids are, how is chondroma manifested and what is the diagnosis and treatment of chondromas.

Chondomais a benign neoplasm originating from cartilage tissue. Cartilage is a subtype of connective tissue characterized by great flexibility and strength. Cartilage tissue is adapted to perform supporting functions and is an important element of the locomotor system - it covers the articular surfaces, creates joints between bones and places of attachment for soft tissues.

There are 3 basic types of cartilage tissue, differing in structure and, consequently, their destination and place of occurrence. In the human body we find:

  • elastic cartilage tissue, characterized by the greatest flexibility - it builds, among others, internal skeleton of the auricle
  • fibrous cartilage tissue of the highest strength - it occurs in places of high loads, it builds, among others, intervertebral discs in the spine
  • hyaline cartilage tissue, the most common - covers the articular surfaces of the bones, builds rib attachments to the sternum and forms the cartilaginous skeleton of the respiratory tract (trachea, bronchi)

Chondoma is a type of neoplasm originating from the vitreous cartilage. Chondoma is a benign tumor - this means that its cells are very similar to properly built cartilage tissue. Chondomas are usually limited in size and do not aggressively infiltrate surrounding tissue. Both the structure and localization of chondomas are similar to the physiologically occurring hyaline cartilage. Chondomas are most often found around long bones, especially in the limbs.

Chrzęstniak - types

The basic division of chondomas is made on the basis of their location in relation to the bones. Chondomas can be located inside the bone - then we are talking about chondroidsintraosseous (Latin enchondroma). The second option is to locate them outside the bone - such chondomas are called periosteal tumors (Latin ecchondroma, chondroma periostale). There are also rare cases of cartilage not in bone but in soft tissues such as tendons and periarticular ligaments.

Here are the most important features of each type of chondroma:

  • intraosseous chondroma- the most common localization of this subtype of chondroma is the hand and foot. It is much less common in the larger long bones - the humerus, femur and tibia. It is believed that the cause of endosseous chondroids is because cartilage cells "escape" from the root of the bone towards the inner canal of the bone. The displaced cartilage cells multiply, creating a focus of cartilage tissue inside the bone - this is how endosseous chondroma is formed.
  • periosteal chondroma- this type of chondroma is formed not inside, but outside of the bone. Cartilage cells usually multiply between the bone and the periosteum that covers it. Periosteal chondomas are much rarer than intraosseous ones. They are also characterized by a different location - the periosteal type is most often found in long bones, including the humerus.
  • soft tissue chondroma- is a rare type of chondroma that occurs outside of the bones (for this reason it is sometimes called extra-skeletal chondroma). Soft tissue cartilage can occur in the joint area - most often in the wrist and ankle, as well as in the soft tissues of the hands and feet. Because they clearly differ in consistency from the surrounding structures, they can be felt by patients as thickenings or hard subcutaneous lumps.

Chrzęstniak - risk factors

The exact cause of chondroma, as with many other cancers, remains unknown. Most chondomas develop in patients between the ages of 10 and 40.

The only known risk factor is genetic syndromes in which the prevalence of chondrosis is much higher than in the general population. An example of such a disease isOllier syndrome- a disease characterized by the presence of multiple endosseous chondomas.

Multiple chondroidscause bone deformities and can be a disability. Chondomas arising from this syndrome also have an increased risk of developing into more malignant neoplasms. Ollier syndrome is congenital and its background is genetic - for this reason the disease is treated,for now, only symptomatically.

Chrzęstniak - symptoms

Chondomas can cause symptoms of varying severity - from a complete absence of symptoms to severe he alth complications. The symptoms of chondrosis have a lot to do with its type and location.

Endosseous chondomas , and thus developing inside the bones, are very often completely asymptomatic. Most of this type of chondroids are detected accidentally during imaging tests (e.g. X-rays) performed for other indications.

Large endosteal chondroidswith a relaxing type of growth, on the other hand, can weaken the bone structure in which they develop. In such cases, the so-called pathological fractures, i.e. fractures caused by a relatively minor trauma. Such a complication is most common in large-sized chondroids or in multiple chondromas. It is also worth knowing that the inner part of the bone where endosseous chondromas develop is not innervated by sensation. For this reason, the vast majority of endosseous chondomas do not cause pain. Changes causing bone pain (especially at night) should be an indication for further diagnosis - they are a typical feature of more malignant bone tumors.

Periosteal chondromas , due to the growth on the bone surface, have completely different symptoms. They rarely lead to the weakening of the internal bone structure, but unlike endosseous chondomas, they can be felt under the skin surface. Periosteal chondromas can form hard lumps as well as provoke local swelling. Similar symptoms are produced by chondomas of soft tissues. If they are located in the area of ​​tendons or periarticular ligaments, they may cause disturbances in the functioning of these structures. In such cases, the first symptom may be pain when making certain movements.

Chrzęstniak - diagnostics

The basic tools for the diagnosis of chondroma are medical history and imaging tests. Chondoma should be suspected when lesions are painless, with typical localization (metaphyses of long bones, especially hands and feet), usually not causing any discomfort.

In imaging tests, the chondomas do not show any signs of malignancy - they do not damage the surrounding tissues or cause the so-called periosteal reactions typical of malignant changes. Repeatable results of imaging tests are also indicative of a benign nature of the lesions. If, in imaging tests performed at regular intervals, the lesion does not increase in size, change its outline or otherwise change.changes, it is most likely a benign change.

It is also worth remembering that various types of imaging tests can be used to diagnose bone changes - X-rays, computed tomography and magnetic resonance imaging. For example, magnetic resonance imaging is useful in the diagnosis of soft tissue chondomas, while computed tomography allows for precise visualization of changes in the bone structure.

In doubtful cases, the diagnosis is based on the histopathological examination of the material obtained during the lesion removal surgery or (less frequently) the material obtained from the biopsy.

Chrzęstniak - treatment

The optimal type of treatment for chondroma is determined individually for each patient. Factors influencing the choice of therapy include: size and size of chondoma, clinical symptoms, and the presence of possible complications.

Small, asymptomatic chondomas are often left untreated - they just need to be monitored regularly. If the chondroma causes a significant change in the bone structure, has developed complications (e.g. pathological fractures) or there are any suspicions that the lesion is malignant, surgical removal is recommended.

Bone cavities after removal of the chondoma are filled with bone grafts.

Chrzęstniak - prognosis

Chondoma as a benign neoplasm is associated with a good prognosis in most cases. Many asymptomatic chondroids do not require any treatment and do not change with long-term follow-up. Symptomatic chondomas should be removed - surgery combined with rehabilitation usually allows you to regain full fitness.

In some patients, the chondromas may have a tendency to recur. In such cases, careful observation is recommended, as there are relapses combined with transformation into more malignant types of neoplasms. Similar suspicions should be raised by changes in chondroma in radiological examinations or the sudden appearance of symptoms (e.g. pain or pathological fractures).

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Category:

Oncology