ENHONDROM
MILAN MILANOVIĆ
340/10
19.04.2013.
ENHONDROM
Enhondrom je vrsta benignog tumora kostiju koji nastaje
od hrskavice.
Najčešće se javlja na metakarpalnim kostima šaka i
metatarzalnim kostima stopala.
Najčešći je u uzrastu od 10 do 20 godine.
Dijagnostikuje se sa jednakom učestalošću i kod
muškaraca i kod žena.
U rijetkim slučajevima može se javiti više tumora kao dio
sindroma. Sindromi su poznati kao OLLIEROVA bolest i
MAFFUCCI sindrom.
Osobe koje imaju enhondrom najčešće nemaju nikakve
vidljive simptome. Ponekad se mogu prepoznati sledeće
pojave :
Bol u kostima
Deformitet kostiju
Uvećanje afektovanog prsta
Spori rast kosti u afektovanoj zoni.
Veoma rijetko se transformiše u maligni tumor (>1 %).
Liječi se konzervativnim i hirurškim putem. Treba ispitivati
i tretirati samo one tumore koji uzrokuju povećanje
veličine, bol ili oticanje kostiju.
Dijagnoza se postavlja na osnovu kliničke slike, RTG,
CT, MR,NMD.
RTG snimci
•Detail of a lytic expansile lesion in the fifth
metacarpal bone in the right hand (same
patient as in previous image). There is
thinning of the cortex with a somewhat
scalloped appearance. A pathologic fracture
is noted, but no appreciable calcifications are
seen in the lesion.
•Radiograph of the right femur
demonstrates a calcified
intramedullary lesion in the distal
shaft.
• Geographic lytic lesion
• Central often metaphyseal in long bones
• Can be eccentric also
• Expansile remodeling with thinned cortex
• Chondroid matrix with calcifications in majority of tumors
• Approximately 20% have limited or no calcifications
• MRI
• Lobulated margin
• Marked increased intensity long TR images
• Calcified chondroid - low intensity all sequences
CT snimci
•Axial computed tomography image demonstrates a fluffy calcific matrix within the medullary canal of the distal femur. The surrounding cortex is intact.
•CT scan: enchondroma of Middle Phalanx There was no mineralization detected in this enchondroma.
•CT scan: enchondroma of Middle Phalanx There
was no mineralization detected in this
enchondroma.
MR snimci
•Axial T1-weighted magnetic resonance
imaging study shows an intramedullary
lesion with low signal intensity and lobular
morphology in the distal femur. The
endosteal aspect of the cortex is not
affected.
•Coronal T1-weighted magnetic
resonance imaging study demonstrates
predominantly decreased signal intensity
within a lesion in the distal femur (same
patient as in previous image). The lesion
has a lobular morphology. No endosteal
scalloping is noted.
•Axial T2-weighted magnetic resonance
imaging study shows regions of high signal
intensity in the lesion (same patient as in
previous image). No surrounding edema is
noted.
•Coronal T2-weighted magnetic resonance
imaging study demonstrates small
lobulated foci of increased signal intensity
separated by a background mesh of
decreased signal intensity (same patient as
in previous image). The adjacent cortex is
intact.
Literatura
MedScape. Enhondroma imaging March 6, 2013. Available at
http://emedicine.medscape.com/article/389224-overview#a21
James C. Witing M.D. Enhondroma September 7, 2012. Available at
http://www.tumorsurgery.org/patient-education/bone-tumors/bone-
tumor-types/enchondroma.aspx
Wehner Medical Center. Enhondroma August 13, 2012. Available at
http://medicalcenter.osu.edu/patientcare/healthcare_services/bone_d
isorders/benign_bone_tumors/enchondroma/Pages/index.aspx
HVALA NA PAŽNJI !!!