Enchondroma in the 2nd proximal phalanx

Presentation

Incidental finding. Asymptomatic for 2 years.

Patient Data

Age: 35 years
Gender: Male

Osteolytic lesion in the 2nd proximal phalanx of the right hand, characterized by a narrow zone of transition, measuring 10mm x 9mm.

Annotated image

An expansile lytic lesion with non-aggressive features, such as: narrow zone of transition, no gross bone destruction, no periosteal reaction, no soft tissue mass.

Case Discussion

Enchondromas are benign cartilaginous tumors and rarely transform into chondrosarcomas. Even though these two entities may present similar radiographic features and might be difficult to distinguish from one another, biopsies are not typically indicated because there is also an histologic similarity of benign and malignant cartilage lesions. Furthermore, surgery is not generally necessary, as most of the cases are asymptomatic. Therefore, regular radiological follow up is the best alternative to establish if it is really an enchondroma. Actually, that is exactly what the patient presented above has been going through, he has done 4 x-rays of his hand in the last two years, and no changes were noticed since the first one. 

Contributed by Dr. Guilherme Pioli Resende M.D. and Dr. Daniel Brito de Medeiros M.D.

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