It is important to know osteochondromas are considered developmental lesions rather than true neoplasms. An osteochondroma, very simply put, is a common, benign bone tumour. It typically is seen occurring in the metaphyseal area of the long bones. “Chondro” means relating to cartilage cartilage and “chondroma” means benign cartilaginous tumour. So, an osteochondroma is a cartilage-capped bony outgrowth found on the surface of the bone.
What are the causes of an osteochondroma ?
The overwhelming majority of these tumours present as single, sporadic, mostly non-hereditary lesions. Osteochondromas are most probably caused by any of the two- either a congenital defect (birth defect) or a trauma of the perichondrium (a layer of cartilage that surrounds developing bone) which results in the fragment protruding out of the bone.
There are osteochondromas which occur in the hereditary multiple osteochondromas (HMOs), a disorder that is inherited in an autosomal dominant pattern (by autosomal dominant inheritance, we mean it is enough for a single parent to have the disease for the child to get it). However, these are rarer as compared to the non-hereditary lesions.
What are the clinical features of osteochondroma ?
Osteochondroma is usually symptomless and is found accidentally on incidental examination. The majority are asymptomatic lesions and discovered incidentally, appearing mostly as a slowly-growing mass. The general age group affected by osteochondromas are mostly children or adolescents, with slight male predilection.
Malignant change in a solitary osteochondroma is exceedingly rare. However, in hereditary osteochondromas, the malignant transformation rate may be a little bit higher.
How is an osteochondroma diagnosed ?
The collaboration of radiologists, bone pathologists and orthopaedic surgeons is needed to accurately diagnose and treat osteochondromas.
Radiologically, the pathognomonic distinctive of this tumour is the cortical and marrow continuity of the lesion seen with the adjoining bone. The lesions may be single or they may be multiple, the latter being a part of the hereditary multiple exostoses syndrome. The lesion may be broad-based or sessile, or it can have a stalk and be pedunculated.
Histopathologically, at microscopic examination, an osteochondroma is an uneven bony mass surrounded by a bluish-gray cap or covering of cartilage. Normally, the cartilage cap varies in its thickness (1 to 6 mm). It resembles a normal growth plate with rows of chondrocytes. However, the cartilage in an osteochondroma is somewhat disorganized as compared to normal cartilage. The base of the lesion is seen to have a rim of cortical bone and central cancellous bone.
Sudden and aggressive growth of a previously latent lesion is a warning sign of probable malignant transformation.
How is an osteochondroma treated ?
The treatment of choice for osteochondroma is complete surgical removal. However, in cases where the skeleton is not yet mature, a partial excision can be performed.
What are the complications of osteochondroma?
These lesions may also appear with various complications such as bone deformities, fractures, compromise of nerves or blood vessels, bursa formation (formation of a small fluid-filled sac) and more rarely, malignant transformation (to a chondrosarcoma).
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Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
