Enchondroma - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of Enchondroma.
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Enchondroma occurs in about 1%. It is a benign cartilage tumor seen as an incidental finding on the x-rays. The cartilage will look like calcified arcs, rings, or punctate calcification. It is located in the metaphysis of long bones such as the proximal femur, proximal tibia, proximal humerus and distal femur. 42% occurs in small tubular bones such as the hands and feet. In fact, it is the most common tumor of the hands and feet. If it occurs in the pelvis or in the scapula, it is chondrosarcoma. Enchondroma is a cartilage lesion with basophilic cytoplasm. It has benign histologic features. It appears acellular or hypocellular with a lot of matrix and some cells that does not have any atypical cells or any pleomorphism. It appears more cellular in the hands and the feet (appears malignant, but it is not malignant). Enchondroma has no symptoms. It is frequently discovered incidentally during unrelated x-ray exams. Enchondroma does not cause pain unless there is a pathologic fracture (check for another source of pain). Sometimes it becomes initially clinically evident after a pathologic fracture, especially in the hands and feet. There is a calcified, well defined lesion. You will see rings, arcs, stippled calcification, and punctate calcification. It is uniformly distributed, no cortical destruction (cortex is intact), endosteal scalloping or erosion can occur, but it is less than 50% of the cortical width and no soft tissue mass. Bone scan will have increased uptake. Bone scan will be “cold” if it is bone infarct (hot in enchondroma). Look at T2 MRI, you will see a lesion with high uptake. You find a lobular lesion and a bright signal on T2 due to the high water content of the cartilage. Biopsy is usually not done. There is difficulty in interpreting the low grade cartilage lesion from enchondroma. When pain or endosteal scalloping occurs in more than 2/3 of the cortex, think about chondrosarcoma (rule out low grade chondrosarcoma). The diagnostic distinction between a benign enchondroma and low grade chondrosarcoma is difficult. It should be based on clinical history and radiographic findings. Chondrosarcoma is usually large in size, it has a soft tissue mass, may have cortical destruction and periosteal reaction with significant endosteal scalloping. There may be lucency on the x-ray and chondrosarcoma occurs more in the pelvis and scapula, and does not occur in the hands or the feet. Enchondroma does not cause symptoms and no need for any treatment such as surgery. Do observation and follow-up x-rays (3 months, 6 months, or yearly) and no further work-up is necessary. If there is pain, check for another source of the pain (enchondroma in the proximal humerus: check for impingement, rotator cuff tear, or arthritis). Enchondroma in the hand and feet: pathological fracture could be treated surgically, especially if the lesion is big, because repeated fractures can occur. Immobilize the fracture with protective splint until union will allow the fracture to heal, then you will do curettage and bone graft. If the lesion is large and further pathologic fracture is expected, then you will do curettage and bone graft. Ollier’s disease is multiple enchondromatosis. The lesion is present from birth. It does not have a known inheritance pattern. It is an inborn error of endochondral ossification. Patient will have shortened, bowed affected limbs. It has a high incidence of malignancy (up to 25%). Maffucci syndrome has multiple enchondromatosis and hemangiomas. It has a high risk of malignant vascular tumor (angiosarcoma).

[@anmolshaheen3836]

Dr. You are just amazing... I always rely upon your lectures for clearing my anatomy exams.. U are best teacher ever

[@photosusa]

Thank you for this video

[@universeusa]

Awesome KZbin channel. Thanks!

[@srinivasaraosirasapalli5104]

nice presentation

[@tigre9271]

I have two endochomdras. One in my distal femur and one in the knee. On the same leg. My symptoms were periodic soreness and periodic buckling. The one in the knee is the one probably causing the buckling. I work in an imaging center and volunteered for a knee mri. They were found them on the mri, then I had an xray to confirm the diagnosis.

[@varma1327]

And what did you do after that ? I have the same situation in my right knee..

[@darraghmoriarty4001]

I also have 2 in my hand, did they diagnose you with olliers disease or anything or is it just the 2 benign ones you have?

[@tigre9271]

@@darraghmoriarty4001 Just 2 benign ones.

[@darraghmoriarty4001]

Did you know you had 2 before you went for the x ray? Basically I’m asking could you feel that there was something there before or did you only find out after the scan?

[@tigre9271]

@@darraghmoriarty4001 Yes, I knew I had something going on in my knee for a couple yrs prior to my Mri. It didn't bother me that much. I thought I might have had a touch of arthritis. But when my coworker said he needed a volunteer to scan a knee, I jumped at it. I chose my troubled knee. When they saw the masses, the radiologist said they looked like endochondromas, but I would need a xray to confirm it. So that's what I did. Had an xray . And it was confirmed by another radiologist at Kaiser where my Dr is at. I had my x-ray about 4-6 months after my Mri because I was busy and was not too concerned. After the xray, the dr. said it was stable since the Mri 6 months prior, so I didn't need to do anything.

[@dawnsearle6813]

Hi thank you for doing this video. My son is now 32 yrs old and has hereditary multiple Exostoses he had 50 + surgeries. There is a support group in the Uk called HME-The New Generation on Facebook. Please join and do the questionnaire and we will let you in, as it’s a closed group. We had a social event in Wokingham Uk in September and it was a huge success. People came from all over to meet others that never met anyone before with HME. It was magical. We all feel like one big hme family when we are together, we understand what people go through, some going through school childhood feeling isolated, scared and wondering how they can cope with the pain. We the trustees share experiences and are there for anyone struggling. We are not professionals but we have lived with this condition so have years experience in surgeries, schooling, bullying,aftercare,pain,isolation, dealing with schools, appointments. Please get in touch if you want to know more. Thx

[@vajirawitradman8980]

Thanks, sir

[@sowmyasrinivas9483]

Watching this after getting surgery for enchondroma. This is the 2nd time getting it surgically removed. Hope it doesn't regrow again.

[@kunalkhurana2839]

Is surgery painful ? And why this tumor has been grown back, did doctor explained you? Please reply.

[@karenlanglais1941]

@@kunalkhurana2839 They grow back because it is virtually impossible to remove all of the cells. It doesn't happen overnight, it usually years.

[@mgvin269]

omg it regrows? that's sad. Today the doctor has detected there's enchondroma in my father's thigh bone, I'm really worried about his health..Is it life threatening?

[@photosusa]

@@mgvin269 as far as I know from reading medical articles online and not being a doctor myself, enchondroma is benign. I seem to have one in my shoulder area. As long as it does not grow it should be fine. If it grows and causes pain it's better to remove it as it may lead to a bone fracture. I suggest your dad speak to an orthopedic surgeon, what I am going to do myself. My concern is to have a 100% confidence the tumor is enchondroma and not a low grade chondrosarcoma which is cancerous. The only way to know as I read is to monitor the growth of the tumor, chondrosarcoma grows fast, enchondroma does not and rarely turns into cancer.

[@acefrehley28]

Grew up with Olliers disease in my left leg... Corrected in Boston. I live a very normal life now and am as active as ever. I believe I have one of these tumors on my upper part of my tibula just under the knee. Wondering if you have any insight?

[@soulrefreshrhythm1305]

Thanks for your valuable lectures

[@nancylowry1962]

Thank you. It was very helpful and informative

[@refugiomarisela961]

Dr you are amazing I have an enchondroma but they are not sure it could be a chondrosarcoma I live in Hawaii no doctors that specialize in bone tumor . Would it be possible to have a consultation by phone with you . I am very worry and I need your help please. My name is Marisela .please let me know if you you could help me ..thank you and God bless you

[@mponemoeketsi2392]

Hi What did you do ever since. Please advice

[@alberto-4642]

Thanks doc !

[@ashiskumar2008]

Thanks sir

[@amtalali5529]

great job

[@juanpeng7642]

Dear Dr, I am 41 old woman. Just found I have a 6cm enchondroma in my femur bon. My doctor said it's enchondroma or chondrosarcoma. one side of my tumor is very close to cortex. This is the risk I was told. May I ask if I can wait for 3 months and watch the changes? If the tumor is not intact after 3 months, will the treatment be different comparing now? I am struggling about this now. Really hope to get your advice. I appreciate for your video. It already answered most of my questions in my mind.

[@mponemoeketsi2392]

May I kindly ask what did you do ever since.....

[@mosinsultana8844]

Hw r u?

[@marlenegura1161]

Thank you!!!! Very helpful!!!!😊

[@kat9319]

Why do I have pain??!!!!

[@audreystar4868]

Thank you for sharing.

[@Dr.QaisarAbbas99]

Like22 good job 👍🔔🔔🔔🔔

[@karenlanglais1941]

I would like to say that not all of the information in this video is correct. It is possible to have enchondroma's in the pelvic area without it being cancer. I really wish the information about enchondromas that is being put out there was more accurate.

[@raminarabnejad3741]

thank you sir