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Enchondroma vs low grade chondrosarcoma

Dr Alexandra Stanislavsky and Dr Frank Gaillard et al.

Differentiating enchondromas from low grade conventional chondrosarcomas is a frequent difficulty as the lesions are both histologically and radiographically very similar.
Features which are useful :

cortical breach
- seen in 88% of long bone chondrosarcomas
- seen in only 8% of enchondromas
scalloping involving > 2/3 of cortical thickness
- seen in 90% of chondrosarcomas
- seen in only 10% of enchondromas
permeative or moth eaten bone appearance
- seen in high grade chondrosarcomas, not in low grade tumours
soft tissue mass beyond bone
- not seen in enchondroma
increased uptake on bone scan
- seen in 82% of chondrosarcomas
- seen in only 21% of enchondromas
location
- hands and feet are uncommon locations for chondrosarcoma
- spine, pelvis, sacrum and ribs are rare locations for enchondromas