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 !!!