Osteochondroma (Bone Tumor)

Osteochondromas occur as solitary osteochondroma (exostosis osteocartilaginous) or as multiple osteochondromatosis. These are discussed separately.
 
Solitary osteochondroma

Solitary osteochondroma is a developmental anomaly of the bone. It occurs when part of the growth plate an outgrowth on the surface of the bone formed. This bone outgrowth may or may not have a stem. If a stalk is present, the structure is called pedunculated. If no stalk is present, it is called sitting.

An osteochondroma can grow to a child or adolescent. The growth is usually not at the end of the term.

Solitary osteochondromas are thought to be the most common noncancerous (benign) bone tumors. They account for 35 percent to 40 percent of all benign bone tumors.

Solitary osteochondroma is diagnosed in patients aged 10 to 30 It occurs equally in men and women. It does not cause injuries. It is assumed that occur during skeletal growth, when bone grows away from the growth plate rather than in accordance with its terms. Since the cause of the solitary osteochondroma is unknown, doctors have not been able to find a way to prevent it.


Symptoms

The most common symptom of an osteochondroma is a painless bump near the joints. The knee and shoulder are involved more frequently.

Solitary osteochondroma can at the ends of a long bone and along the pelvis and the bones that are found in the shoulder. If the stalk of a pedunculated osteochondroma breaks, pain and swelling may begin immediately.

An osteochondroma may be less of a tendon. If it is, can engage the tissue of the tumor causing activity associated with pain.

An osteochondroma can be in the vicinity of a nerve or blood vessels such as behind the knee. If it is, it may be numbness and tingling in the extremities. A tumor pressing on a blood vessel can cause periodic changes in blood flow. This can cause loss of pulse or color changes of the limb. Changes in blood flow due to osteochondroma is rare.

Diagnosis

A plane X-ray shows the bone growth. A magnetic resonance imaging (MRI) can be used to look for cartilage on the surface of the bone growth. Such cartilage in an adult patient should be examined for cancer if it is larger than two centimeters in size, or if there is pain. A computed tomography (CT) can also be used.

Treatment
Conservative therapy

Most of the time is solitary osteochondroma is not removed surgically. The doctor will be watching carefully. He or she may want to take X-rays regularly to keep track of all changes.
Surgical treatment

When surgery is recommended, it is best to wait until growth is complete (a mature skeleton by X-ray analysis) before a solitary osteochondroma. This reduces the chance of the tumor is growing again.

Surgery may be considered if the osteochondroma:

    * Is the pain with activity
    * Pressure on a nerve or blood vessel
    * Has a large cap of cartilage

The osteochondroma is removed at the level of normal bone. Some are removed in the interior of the bone also.


Radiographs of the proximal fibula of a 15-year-old girl presenting a painless, firm lateral support leg mass. Links: AP a well-marginated bony lesion at the proximal fibula superimposed, but it shows the side view (middle) the continuity of the medullary cavity of the bone shows the center of the lesion. Right, Computed tomography shows the medullary space in continuity with the lesion and a small cartilage cap, both of which are characteristic of an exostosis. The arrows show the osteochondroma.

 Orthopaedic Knowledge Update. Courtesy of Richards BS (ed) Paediatric be reproduced Rosemont, IL, American Academy of Orthopaedic Surgeons, 1996.)

 Preoperative (left) and postoperative (right) CT of a 25-year-old man with sciatica. Osteochondroma of the sacrum was incidentally discovered during CT scan of the spine performed to assess the sciatica. Cut into the postoperative scan, detect metal clips of the site of resection. The osteochondroma was seen to displace the sacral plexus. Postoperatively, the patient decided to completely sciatica. The arrow shows the osteochondroma.

 Treatment of benign bone tumors, in Beaty JH (eds): with permission from Aboulafia AJ, Temple TH, Scully SP Instructional Course Lectures reproduced .. Volume 51 Rosemont, IL, American Academy of Orthopaedic Surgeons, 2002)

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