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    1.7.9 Osteochondroma PDF

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    1.7.9 Osteochondroma PDF

    Uploaded by

    Sofa Amalia
    31 views2 pages

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    1.7.9 osteochondroma.pdf

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    31 views2 pages

    1.7.9 Osteochondroma PDF

    Uploaded by

    Sofa Amalia

    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    of 2

    Osteochondroma

    Objectives
    1. Describe the pathology of osteochondroma (exostosis)
    2. Describe the location and gross appearance of typical osteochondromata
    3. Describe the radiographic appearance of osteochondromata
    4. Discuss indications for removal of osteochondromata
    5. Discuss the potential for malignant degeneration of solitary osteochondromata

    Discussion

    The most common bone tumor is an osteochondroma. Accounting for nearly half of all
    bone tumors. The origin is unclear, but they appear to result from some type of insult to
    the periphery of the growth plate, as a result of which the growth is directed more
    laterally than normally. There are two general categories of osteochondromata, sessile
    and pedunculated, depending on the size of the base. Both types are orientated away
    from the growth plate. The radiographic appearance is so characteristic of an
    osteochondroma that further imaging studies are unnecessary. The cortex of the
    underlying bone opens to join the cortex of the osteochondroma. The distal bony of the
    osteochondroma is capped by cartilage, which is felt to represent that part of the growth
    plate rendered asunder from the rest of the plate, microscopically the cartilage cap does
    resemble a growth plate. The cartilage cap is <1cm in thickness. The metaphyses of long
    bones, especially about the knee, are most often affected. A myriad of symptoms have
    been reported from osteochondromata appearing in unusual locations. Problems with
    osteochondromata about the knee are symptomatic (under the pes anserinus), vascular
    (popliteal fossa) or related to peroneal nerve pressure (posterolateral). Lesions in these
    parts of the knee probably warrant excision if they are large enough to impinge on either
    the vessels or the peroneal nerve. The process of excision is straightforward, recurrence
    is not a problem. The entire exostosis should be excised if possible, although near the
    peroneal nerve, this may not be feasible without unwise retraction of the nerve. The risk
    of malignancy for a solitary osteochondroma is very low. The entity of multiple
    hereditary exostosis is discussed under that topic. Radiation induced osteochondromata
    may very well be more inclined toward malignant degeneration than the usual solitary
    osteochondroma.

    References
    1. Vasseur MA, Fabre O. Vascular complications of osteochondromas. Journal of
    Vascular Surgery 2000;31(3):532-8.
    2. Govender S, Parbhoo AH. Osteochondroma with compression of the spinal cord.
    A report of two cases. Journal of Bone & Joint Surgery - British Volume
    1999;81(4):667-9.
    3. Mahboubi S, Dormans JP, D'Angio G. Malignant degeneration of radiation-
    induced osteochondroma. Skeletal Radiology 1997;26(3):195-8.
    4. Fraser RK, Nattrass GR, Chow CW, Cole WG. Pes anserinus syndrome due to
    solitary tibial spurs and osteochondromas. Journal of Pediatric Orthopedics
    1996;16(2):247-8.
    5. Cardelia JM, Dormans JP, Drummond DS, Davidson RS, Duhaime C, Sutton L.
    Proximal fibular osteochondroma with associated peroneal nerve palsy: a review of six
    cases. Journal of Pediatric Orthopedics 1995;15(5):574-7.
    6. Springfield DS. Bone and soft tissue tumors. In: Morrissy RT, Weinstein SL,
    editors. Pediatic Orthopaedics. Philadelphia: Lippincott-Raven; 1996. p. 423-57.
    7. Simon MA, Springfield DS. Surgery for bone and soft tissue tumors.
    Philadelphia: Lippincott-Raven; 1998.

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