An extra-osseous intra-articular osteochondroma of the elbow (original) (raw)
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Para-articular/extra-osseous osteochondroma of the knee
The Knee, 1999
An unusual case of osteochondroma arising in the soft tissues adjacent to the knee is presented. The controversy arises from the confusion of this mass with giant synovial chondromatosis or the more dangerous chondrosarcomas. Preoperatively, CT scans can demonstrate that these lesions are isolated to the soft tissues, and there is no connection to bone; this can be confirmed at surgery. Detailed histological analysis is important to rule out malignant changes. The distinction is important to avoid unnecessary aggression in surgery, as these are benign lesions with a good prognosis after local excision.
Giant intra-articular extrasynovial osteochondroma of the knee: a report of two cases
The open orthopaedics journal, 2011
We report two cases of a giant extrasynovial osteochondroma of the knee located in the infrapatellar fat pad region, in two females who were 58 and 71 years old respectively. Both patients had noticed the mass many years before our first clinical observation. In both patients, at physical examination a solid, firm and hard mass was palpable in the anterior part of the knee in Hoffa's fat pad region, and the range of motion of the knee was severely restricted and painful. CT scan examination with 3D-reconstruction showed two large, calcified neoformations behind the patellar tendon, between the apex of the patella and the proximal third of the tibia. In both cases, the mass was completely resected surgically through an anterior longitudinal approach. At histological examination, the excised masses consisted of an outer layer of hyaline cartilage without significant chondrocyte atypia and an inner region of bone trabeculae formed by endochondral ossification. At follow-up, 8 and 4...
Para-articular Osteochondroma of the Knee
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2007
We report a case of para-articular chondroma located in the infrapatellar fat pad of the knee of a 42-year-old woman with a history of anterior knee pain and restricted range of motion. On clinical examination, a solid palpable mass in the infrapatellar region was detected. Radiography and computed tomography of the knee revealed the presence of 3 different "popcorn"-like gross calcifications within Hoffa's fat pad. Magnetic resonance imaging showed areas of signal intensity in Hoffa's fat pad that were consistent with calcific nodules surrounded by chondral tissue. During arthroscopy, a dense extrasynovial mass was discerned within Hoffa's fat pad. The mass was entirely removed through an open approach medial to the patellar tendon. Resection specimens consisted of 3 well-circumscribed nodules of 5 ϫ 2.5 ϫ 1.5, 2 ϫ 2 ϫ 1, and 1.5 ϫ 2 ϫ 1 cm, respectively. Grossly, these nodules were surrounded by adipose tissue and presented a thin fibrous membrane. Histologic examination showed that the nodules were composed of cartilaginous tissue surrounded by fibrous connective and adipose tissue with multifocal endochondral ossification. The precise pathogenetic mechanism of these tumors remains unknown, but cartilaginous metaplasia of articular and para-articular connective tissue seems to be the primary cause. Patients with these lesions are currently treated with the use of marginal resection or excision.
Extra-osseous osteochondroma-like soft tissue mass of the patello-femoral space
BMC musculoskeletal disorders, 2006
Extraskeletal cartilaginous tumors are uncommon. Osteochondromas usually arise from the metaphyseal region of the growing skeleton. A 53 year old man presented with a three years history of anterior knee pain and inability to flex his knee more than 90 degrees . Clinical examination and imaging studies revealed a nodular calcific mass in the anterior portion of the knee, displacing the medial portion of the patellar tendon. Following excision, histopathology confirmed the diagnosis of extra-osseous osteochondroma-like soft tissue mass, with no recurrence 24 months after surgery. An integrated clinical-pathologic diagnosis helps to clarify the nature of extraskeletal cartilaginous tumors that can arise at unusual anatomic site. Complete local surgical excision is the management of choice.
In Vivo, 2021
Osteochondroma, the most common benign bone tumor, is a projection on the external surface of the bone, which can be sessile or pedunculated. 85% of osteochondromas present as solitary lesions, while 15% occur in the context of hereditary multiple exostoses (HME), a genetic disorder that is inherited in an autosomal dominant manner. Although often asymptomatic, symptoms may eventuate from compression of adjacent vessels or nerves, fractures, osseous deformities, bursa formation, or malignant transformation. Cartilage cap thickness >2 cm in adults or >3 cm in children as well as new onset of pain or growth, or rapid growth of the lesion, especially after the closure of the growth plate, might reflect cancerous transformation. Surgical resection is indicated for symptomatic lesions, complications, cosmetic reasons or malignant transformation. Excision of the tumor with free margin is the treatment of choice. Local recurrence is less than 2% if complete resection is achieved. Osteochondroma is the most common benign bone tumor accounting for 20-50% of benign bone tumors and 9% of all bone tumors (1-3). It is defined as a cartilage-capped bony projection on the external surface of a bone (2, 4). The lesion may grow during childhood, but no osteochondroma develops or enlarges after puberty (5, 6). Two pathognomonic features that ascertain the diagnosis are the presence of cortical and medullary continuity with the parent bone and a cartilage cap (7, 8). Most lesions are solitary, but approximately 15% of the patients have multiple tumors (6). Multiple osteochondromas are developed in the context of multiple hereditary exostoses (HME), a rare genetic disorder that is inherited in an autosomal dominant manner (2, 9). In the literature, HME has also been referred to as multiple hereditary osteochondromas, hereditary deforming dyschondroplasia, diaphyseal aclasis, and multiple cartilaginous exostoses (10). The majority of patients have a positive family history, while mutations in one of the EXT genes can be detected in about 90% of the HME cases (11, 12). Traditionally, most osteochondromas are incidentally diagnosed as they are symptomless (2, 4). Complications associated with osteochondromas are common and encompass compression of adjacent structures, fractures, osseous deformities, bursa formation with or without bursitis, and malignant transformation (2, 7, 13). Malignant transformation is more frequent in HME than solitary osteochondromas (6, 14). Plain radiographs are usually sufficient to diagnose osteochondromas, whereas cross-sectional imaging such as multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are used to evaluate the cartilage cap, marrow continuity with the parent bone in complex areas, and complications (3, 4, 15). Asymptomatic lesions are treated solely with observation, while symptomatic lesions or lesions with suspicious imaging findings require surgical resection.
Osteochondroma. An Osteological Study
Background: Osteochondroma is the most common tumor of bone, accounting for approximately one third of benign lesions in the skeleton, is a broad (sessile) or narrow (pedunculated) skeletal protrusion comprised of marrow and cortical bone. Although it is benign, its biological behavior still has a malignant potential. Chondrosarcoma arising in osteochondroma has been recognized for many years. Osteochondromas might occur on any bone preformed in cartilage, they were especially seen on the long bones of the extremities, predominantly around the knee. In fact, the lower limb seemed to be at a higher risk of the tumor than the upper limb on the top two locations: distal part of the femur and proximal part of the tibia, however, the proximal humerus ranked the third place for solitary osteochondroma while the proximal fibula for multiples osteochondromas. Methods and Findings: A total of 20 skeletons and 18 cadavers of both sex, 16 males and 2 females, with different age groups were used, this study was carried out by routine dissection classes for undergraduate medical student´s in the Morphology Laboratory of the University of Pamplona during the years 2013-2016. In only one sample was found the presence of osteochondroma. The measurement of the osseous mass was of 7x3.5x1.5 cm, attached to the posterolateral aspect of the middle third of the femur. Conclusions: Osteochondroma is generally asymptomatic or discovered accidentally, but it can cause different symptoms depending on site of occurrence local swelling, bony deformities, fracture, bursa formation, arthritis and impingement on adjacent tendons, vascular or neurologic compromise, and dislocation The importance of correct treatment and follow-up of large osteochondromas to avoid complications such as further damage to neighboring neurovascular structures, and potential malignant degeneration. The present study describe a rare location from an osteochondroma in the femur diaphysis.
Diagnosis and evolution of the benign tumor osteochondroma
Experimental and Therapeutic Medicine, 2021
Osteochondroma represents a bone outgrowth covered by cartilaginous tissue and localized on the external surface of the bone. The incidence of osteochondroma is 20-35% of all pediatric benign tumors. Osteochondromas can be present in solitary or multiple forms and usually occur in the metaphysis of long bones in immature skeletons. The present study aimed to retrospectively determine the association between imaging diagnostic accuracy and histopathological examinations, which are the main methods of diagnosis for this type of tumor. A total of 66 patients presenting with radiological aspects of osteochondroma were initially selected; however, only the 56 patients who had a positive histopathological diagnosis of osteochondroma were eventually included in this study. Patient characteristics were taken into consideration and included age, sex, lesion localization, lesion imaging semiotics and histopathological aspects. Osteochondromas are generally asymptomatic lesions that are often incidentally diagnosed after trauma, which makes it difficult to determine the exact incidence of this pathology.
Extraskeletal paraarticular osteochondroma of the knee—a case report and tumor overview
The Knee, 2006
Extraskeletal paraarticular osteochondromas are rather unusual osteocartilaginous lesions that arise in the soft tissues adjacent to the joint with no bony or joint continuity. This diagnosis should be considered with the demonstration of a well-circumscribed extraskeletal mineralized mass without any direct continuity with adjacent bone or joint. However, as with other lesions, clinicoradiographic features with histological correlation clinch the diagnosis. Differentiation from other lesions, particularly synovial osteochondromatosis and chondrosarcoma is essential to avoid unnecessary aggressive surgical procedures as marginal excision is adequate for these lesions. We present here such an infrapatellar lesion and discuss criteria helpful in distinguishing these benign lesions from other morphological similar lesions.