This Article Full Text Full Text (PDF) CME: Take the exam for this article: Oncology Test 4: Spring 2006 (publication date May 15, 2006; expiration dat... [Supplementary Material] Letters to the Editor: Submit a response Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Reprints and Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Potter, B. K. Articles by Murphey, M. D. Search for Related Content PubMed PubMed Citation Articles by Potter, B. K. Articles by Murphey, M. D. Related Collections Oncology Social Bookmarking             What's this?

Solitary Epiphyseal Enchondromas

¹ Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, 6900 Georgia Avenue, N.W., Building 2, Clinic 5A, Washington, DC 20307. E-mail address for B.K. Potter: benjamin.potter{at}na.amedd.army.mil
² Department of Radiologic Pathology, Armed Forces Institute of Pathology, 6900 Georgia Avenue, N.W., Washington, DC 20306

Investigation performed at the Armed Forces Institute of Pathology and Walter Reed Army Medical Center, Washington, DC

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the United States Army or the Department of Defense. All authors are employees of the United States Government. This work was prepared as part of their official duties and, as such, there is no copyright to be transferred.

Methods: We performed a retrospective review of 761 patients who had been referred to our two institutions over an approximately fifty-five-year period and who received a final diagnosis of enchondroma. All lesions had been biopsied, and the pathological diagnosis had been confirmed. Lesions of the hands, feet, or axial skeleton (253 patients) as well as lesions that appeared to originate in the metaphysis or diaphysis (475 patients) were excluded. Only enchondromas of the long bones that originated in the epiphysis were analyzed. The study group included thirty-three patients (twenty male patients and thirteen female patients) with a mean age of 26.7 years, including eleven patients with open physes. We performed additional descriptive analyses with regard to patient age, gender, lesion location, clinical presentation, and treatment as well as an extensive radiographic analysis.

Results: The most common locations were the proximal part of the humerus (ten lesions; 30%) and the distal part of the femur (six lesions; 18%). The most common presenting symptom was pain (twenty-three patients). Radiographic analysis demonstrated extensive matrix mineralization in association with twenty-three lesions. Twenty-eight of the thirty-three lesions were geographically well defined; of these, twenty-one had sclerotic borders, and seven did not. Although all lesions were centered and were predominantly located within the epiphysis, twenty of the thirty-three lesions demonstrated radiographic evidence of metaphyseal extension, including four of the eleven lesions in patients with open physes. Twenty-four lesions extended into the subchondral bone. The mean size of the thirty-three enchondromas in greatest radiographic dimension was 2.7 cm (range, 1.1 to 4.9 cm). Twenty-six of the thirty-three lesions were amenable to surgical treatment with curettage with or without bone-grafting, with only one recurrence. With the limited follow-up available, no lesion underwent sarcomatous degeneration.

Conclusions: Epiphyseal enchondromas are rare lesions. Although their biologic behavior appears to mirror that of conventional metaphyseal enchondromas, their proximity to the joint space may lead to more frequent painful symptoms, a propensity for physeal involvement, and the need for earlier definitive surgical intervention.

Level of Evidence: Prognostic Level IV. See Instructions to Authors for a complete description of levels of evidence.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2005 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.