Osteochondroma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Osteochondroma must be differentiated from other diseases that cause bone deformity, bone growth, overlying bursitis, and mechanical joint problems such as enchondroma, chondroblastoma, periosteal chondroma, and chondromyxoid fibroma.[1]

Differentiating Osteochondroma from other Diseases

  • The table below summarizes the findings that differentiate osteochondroma from other conditions that cause bone deformity, bone growth, overlying bursitis, and mechanical joint problems.[1][2][3][4][5]
Disease Malignant lesion in patients

> 40 years

chondrogenic Histology Sacral lesions in elderly Treatment is wide resection alone
Chondrosarcoma + + + +
Metastic disease + - + -
Lymphoma + - + -
Myeloma + - + -
Malignant Fibrous Histiocytoma + - + -
Secondary sarcoma + - - -
Enchondroma - + - -
Periosteal chondroma - + - -
Osteochondroma - + - -
Parosteal osteosarcoma - - - +
Adamantinoma - - - +
Chordoma - - - +
Squamous cell carcinoma - - - +


Differential Diagnosis Similar Features Differentiating Features
Enchondroma
  • Benign cartilaginous neoplasm
  • Usually found in children, enchondromas are asymptomatic
  • These tumors arise from remnants of the growth plate
  • Located in the metaphyseal region
  • Imaging features, such as:
  • Endosteal scalloping
  • Well circumscribed mass
  • Lytic lesions
Chondroblastoma
  • Benign cartilaginous neoplasm
  • Affects young patients
  • Located on long bones
  • They arise in the epiphysis or apophysis of a long bone
  • Classical location is the upper one-third of the tibia
Periosteal chondroma
  • Benign cartilaginous neoplasm
  • Commonly located on the proximal humerus and distal femur
  • Affects young patients
  • Symptomps are usually present for a long period of time
  • Imaging features, include:
  • No stalk or peduncle as in an osteochondroma
Chondromyxoid fibroma
  • Benign cartilaginous neoplasm
  • Located in the metaphyseal region of long bones
  • Occur in young adults (second and third decades)
  • Usually located in the tibia

References

  1. ↑ 1.0 1.1 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.
  2. ↑ Peabody, Terrance (2014). Orthopaedic oncology : primary and metastatic tumors of the skeletal system. Cham: Springer. ISBN 9783319073224.
  3. ↑ Czerniak, Bogdan (2016). Dorfman and Czerniak's bone tumors. Philadelphia, PA: Elsevier/Saunders. ISBN 9780323023962.
  4. ↑ Frassica FJ, Unni KK, Beabout JW, Sim FH (1986). "Dedifferentiated chondrosarcoma. A report of the clinicopathological features and treatment of seventy-eight cases". J Bone Joint Surg Am. 68 (8): 1197–205. PMID 3021775.
  5. ↑ Björnsson J, McLeod RA, Unni KK, Ilstrup DM, Pritchard DJ (1998). "Primary chondrosarcoma of long bones and limb girdles". Cancer. 83 (10): 2105–19. PMID 9827715.

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