Enchondroma

Case contributed by Patrick Baird-Fraser , 30 Sep 2020
Diagnosis certain
Changed by Dai Roberts, 1 Oct 2020

Updates to Case Attributes

Presentation was changed:
Right knee/hip pain, no history of trauma.
Body was changed:

This case isDifferentiating between an example of a large chondroid lesion with appearances in keeping with an enchondroma but features whichvs low-grade chondrosarcoma can be challenging 1.  Features that should raise the suspicion of low-grade chondrosarcoma include a low grade chondrosarcoma (size >5size over 5-6cm, pain, and endosteal scalloping)Enchondroma vs low grade chondrosarcoma. A Due to the size and pain, a biopsy was therefore performed and histology confirmed an enchondroma

  • -<p>This case is an example of a large chondroid lesion with appearances in keeping with an enchondroma but features which raise the suspicion of a low grade chondrosarcoma (size &gt;5-6cm, pain and endosteal scalloping). <a href="/articles/enchondroma-vs-low-grade-chondrosarcoma-3">Enchondroma vs low grade chondrosarcoma</a>. A biopsy was therefore performed and histology confirmed enchondroma. </p>
  • +<p>Differentiating between an <a href="/articles/enchondroma-vs-low-grade-chondrosarcoma-3">enchondroma vs low-grade chondrosarcoma</a> can be challenging <sup>1</sup>.  Features that should raise suspicion of low-grade <a title="Chondrosarcoma" href="/articles/chondrosarcoma">chondrosarcoma</a> include a size over 5-6cm, pain, and endosteal scalloping.  Due to the size and pain, a biopsy was performed and histology confirmed an <a title="Enchondroma" href="/articles/enchondroma">enchondroma</a>. </p>

References changed:

  • 1. M D Murphey, D J Flemming, S R Boyea et-al. Enchondroma versus chondrosarcoma in the appendicular skeleton: differentiating features. (1998) RadioGraphics. 18 (5): 1213-37; quiz 1244-5. <a href="https://doi.org/10.1148/radiographics.18.5.9747616">doi:10.1148/radiographics.18.5.9747616</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/9747616">Pubmed</a> <span class="ref_v4"></span>

Updates to Study Attributes

Findings was changed:

13cm chondroid lesion within the medulla of the distal femoral diametaphysis. No associated soft-tissue component, although partially imaged on the lateral projection.

Updates to Study Attributes

Findings was changed:

LargeLong 13.5x2.2x1.9cm (CCxTVxAP(CCxTRxAP) heterogeneously intermediate T1 signal and heterogeneously high T2 signal lesion within the distal femoral diaphysis extending into the metaphysis. Evidence of minor endosteal scalloping affecting the posterior cortex of the femoral metaphysis.

Updates to Quizquestion Attributes

Question was added:
Would you recommend further imaging?
Answer was added:
Yes, an MRI would better further assess the nature of the lesion.

Updates to Quizquestion Attributes

Question was added:
What are your findings?
Answer was added:
Large chondroid lesion within the medulla of the distal femoral diametaphysis. No associated soft-tissue component, although partially imaged on the lateral projection.

Updates to Quizquestion Attributes

Question was added:
What are your findings?
Answer was added:
Long heterogeneously intermediate T1 signal and heterogeneously high T2 signal lesion within the distal femoral diaphysis extending into the metaphysis. Evidence of minor endosteal scalloping affecting the posterior cortex of the femoral metaphysis.

Updates to Quizquestion Attributes

Question was added:
What features should raise the suspicion of a low-grade chondrosarcoma?
Answer was added:
Size over 5-6cm, pain, and endosteal scalloping.

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