Enchondroma protuberans

Case contributed by Dr. Fabian Hänel

Presentation

Moderate pain and a palpable mass at the dorsoradial aspect of the proximal phalanx of the thumb.

Patient Data

Age: 12 years
Gender: Female

Initial MRI

MRI

There is an exophytic cortical-based mass at the dorsoradial aspect of the proximal phalanx of the thumb. The lesion demonstrates a high T2 signal and intermediate T1 signal. A string-like isointense connection to physis is present. In addition, there is a small cortical defect with inflammatory changes of the adjacent soft tissue.

Preoperative

X-ray

Exophytic mass at the dorsoradial aspect of proximal phalanx D1 with a small cortical defect.

Intraoperative

Photo

Intraoperative photo. Cortical defect can be seen.

Postoperative

X-ray

Postoperative. Exophytic mass was resected. No bone grafting.

Pathologist report:

1.2 x 0.6 cm bony specimen. Microscopy shows hyaline cartilage with isomorphic chondrocytes, surrounded by regular cancellous bone tissue.

Conclusion: Ecchondroma. No sign of malignancy.

Case Discussion

This is a case is of histologically proven enchondroma protuberans.

A cartilaginous connection between enchondroma and growth plate is recognizable.

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