From the Guidelines
Chondromas are typically benign cartilaginous tumors that can be managed conservatively, with surgical intervention reserved for symptomatic cases or those that pose a risk to bone integrity, as supported by recent clinical guidelines 1.
Key Characteristics of Chondromas
- Chondromas are most commonly found in the small bones of the hands and feet but can occur in other bones.
- They are slow-growing and usually form within the bone (enchondroma) or on its surface (periosteal chondroma).
- Most chondromas are asymptomatic and discovered incidentally on X-rays taken for other reasons.
- When symptoms do occur, they may include mild pain, swelling, or pathological fractures.
Diagnosis and Treatment
- Diagnosis involves imaging studies such as X-rays, CT scans, or MRI, and sometimes a biopsy to confirm the nature of the tumor.
- Treatment is often unnecessary for asymptomatic chondromas, but surgical removal (curettage) may be recommended if the tumor causes pain, increases in size, or threatens bone integrity, as suggested by recent guidelines 1.
- After removal, the cavity is usually filled with bone graft or cement.
- The prognosis is excellent, with low recurrence rates, though patients with multiple chondromas (Ollier disease) or those with Maffucci syndrome require monitoring as they have a slightly higher risk of malignant transformation into chondrosarcoma.
Management Considerations
- Recent studies, such as the ESMO-EURACAN-GENTURIS-ERN PaedCan clinical practice guideline for diagnosis, treatment, and follow-up of bone sarcomas 1, emphasize the importance of individualized management approaches for chondromas, considering factors such as symptomatology, tumor size, and location.
- Active surveillance with close radiological monitoring may be an appropriate management strategy for asymptomatic, non-progressive chondromas, as recommended by some reference centers 1.
From the Research
Characteristics of Chondromas
- Chondromas are benign tumors characterized by the formation of mature cartilage 2
- They typically involve the short bones of the hands and feet 2
- Chondromas can be either solitary or multiple, with multiple cases often referred to as enchondromatosis 2, 3
Types of Chondromas
- Enchondroma: a type of chondroma that can be successfully treated by surgical methods 3
- Periosteal chondroma: a type of chondroma that differs in site and clinical manifestations 3
- Enchondromatosis: a condition characterized by multiple chondromas, which can increase the risk of malignant transformation 2
Treatment and Prognosis
- Treatment of single lesions typically involves curettage and bone grafting, which is usually uneventful 2
- However, cases with multiple chondromas, such as Ollier's disease or Maffucci's syndrome, require a tailored therapeutic approach 2
- The risk of malignant transformation is approximately 50% in cases with multiple enchondromatosis 2
Rare Cases of Chondromas
- Chondromas can rarely occur in the spine, with some cases originating from the intervertebral disc 4
- These cases can be difficult to identify and may be indistinguishable from herniated intervertebral discs until surgical resection 4