Chondroma surgery: Difference between revisions

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{{Chondroma}}
{{Chondroma}}
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{{CMG}};{{AE}} {{Rohan}}


==Overview==
==Overview==
Surgery is not the first-line treatment option for patients with asymptomatic, [[benign]] chondromas. Surgical [[resection]] is usually reserved for patients at risk with either [[malignant]] transformation or pathological [[fracture]]s.<ref>Enchondroma.Radiopedia. http://radiopaedia.org/articles/enchondroma Accessed on January 3, 2016.</ref><ref>Juxtacortical chondroma.Radiopedia http://radiopaedia.org/articles/juxta-cortical-chondroma. Accessed on January 3, 2016.</ref> 
Surgery is not the first-line treatment option for patients with [[asymptomatic]] and benign chondroma. [[Surgery]] is usually reserved for patients with either [[malignant transformation]] and pathological fracture.


==Surgery==
==Surgery==
*Surgery is not the first-line treatment option for patients with asymptomatic, [[benign]] chondromas.
*Surgery is not the first-line treatment option for patients with [[asymptomatic]] and benign chondroma. [[Surgery]] is usually reserved for patients with either:<ref name="pmid18074822">{{cite journal| author=Semenova LA, Bulycheva IV| title=[Chondromas (enchondroma, periosteal chondroma, enchondromatosis)]. | journal=Arkh Patol | year= 2007 | volume= 69 | issue= 5 | pages= 45-8 | pmid=18074822 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18074822  }} </ref><ref>{{cite book | last = Peabody | first = Terrance | title = Orthopaedic oncology : primary and metastatic tumors of the skeletal system | publisher = Springer | location = Cham | year = 2014 | isbn = 9783319073224 }}</ref><ref name="pmid19278317">{{cite journal| author=Fahim DK, Johnson KK, Whitehead WE, Curry DJ, Luerssen TG, Jea A| title=Periosteal chondroma of the pediatric cervical spine. | journal=J Neurosurg Pediatr | year= 2009 | volume= 3 | issue= 2 | pages= 151-6 | pmid=19278317 | doi=10.3171/2008.11.PEDS08231 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19278317  }} </ref><ref name="pmid15886513">{{cite journal| author=Agrawal A, Dwivedi SP, Joshi R, Gangane N| title=Osteochondroma of the sacrum with a correlative radiographic and histological evaluation. | journal=Pediatr Neurosurg | year= 2005 | volume= 41 | issue= 1 | pages= 46-8 | pmid=15886513 | doi=10.1159/000084865 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15886513  }} </ref><ref name="pmid22627638">{{cite journal| author=Akansu B, Atık E, Altintaş S, Kalaci A, Canda S| title=Periosteal chondroma of the ischium; an unusual location. | journal=Turk Patoloji Derg | year= 2012 | volume= 28 | issue= 2 | pages= 172-4 | pmid=22627638 | doi=10.5146/tjpath.2012.01119 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22627638  }} </ref>
*Surgical resection is usually reserved for patients at risk with either [[malignant]] transformation or pathological [[fracture]]s.
**[[Malignant transformation]]  
*In the setting of a [[fracture]], the bone may be allowed to heal. If necessary, a [[curettage]] and [[bone graft]]ing may be performed at a later time.  
**Pathological [[fracture]]
*Once resected, lesions usually do not recur.
 
===Enchondroma===
*Enchondromas of the long bones are usually asymptomatic and do not require treatment. Treatment consists of observation with serial [[Radiography|radiographs]].
*[[Curettage]] and [[histopathologic]] evaluation is usually reserved for patients with either:
**Uncertain diagnosis
**Lytic lesions
**Symptomatic and borderline in size
**Suspicious lesions For patients with [[Pathologic fracture|pathologic fractures]]  
*[[Curettage]] and [[grafting]] with optional internal fixation may be considered for multiple [[Bone fracture|fractures]], impending [[Bone fracture|fracture]], or painful lesions.
*Enchondroma usually does not progress or recur.
 
===Periosteal Chondroma===
*Juxtacortical [[Chondrosarcoma|chondrosarcomas]] can clinically and [[Radiological|radiologically]] mimic these tumors.
*Wide local [[excision]] with [[bone grafting]] is a curative procedure for patients with [[periosteal chondroma]] with or without internal fixation is performed.  
*Recurrence is unlikely.
 
===Synovial Chondroma===
*In [[synovial]] chondroma, depending on the symptoms, removal of loose bodies is required.
*In symptomatic patients with synovial chondroma, [[synovectomy]] is helpful to control the disease.


==References==
==References==

Latest revision as of 19:34, 17 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

Surgery is not the first-line treatment option for patients with asymptomatic and benign chondroma. Surgery is usually reserved for patients with either malignant transformation and pathological fracture.

Surgery

Enchondroma

  • Enchondromas of the long bones are usually asymptomatic and do not require treatment. Treatment consists of observation with serial radiographs.
  • Curettage and histopathologic evaluation is usually reserved for patients with either:
    • Uncertain diagnosis
    • Lytic lesions
    • Symptomatic and borderline in size
    • Suspicious lesions For patients with pathologic fractures
  • Curettage and grafting with optional internal fixation may be considered for multiple fractures, impending fracture, or painful lesions.
  • Enchondroma usually does not progress or recur.

Periosteal Chondroma

Synovial Chondroma

  • In synovial chondroma, depending on the symptoms, removal of loose bodies is required.
  • In symptomatic patients with synovial chondroma, synovectomy is helpful to control the disease.

References

  1. Semenova LA, Bulycheva IV (2007). "[Chondromas (enchondroma, periosteal chondroma, enchondromatosis)]". Arkh Patol. 69 (5): 45–8. PMID 18074822.
  2. Peabody, Terrance (2014). Orthopaedic oncology : primary and metastatic tumors of the skeletal system. Cham: Springer. ISBN 9783319073224.
  3. Fahim DK, Johnson KK, Whitehead WE, Curry DJ, Luerssen TG, Jea A (2009). "Periosteal chondroma of the pediatric cervical spine". J Neurosurg Pediatr. 3 (2): 151–6. doi:10.3171/2008.11.PEDS08231. PMID 19278317.
  4. Agrawal A, Dwivedi SP, Joshi R, Gangane N (2005). "Osteochondroma of the sacrum with a correlative radiographic and histological evaluation". Pediatr Neurosurg. 41 (1): 46–8. doi:10.1159/000084865. PMID 15886513.
  5. Akansu B, Atık E, Altintaş S, Kalaci A, Canda S (2012). "Periosteal chondroma of the ischium; an unusual location". Turk Patoloji Derg. 28 (2): 172–4. doi:10.5146/tjpath.2012.01119. PMID 22627638.


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