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OSTEOCHONDROMA

OSTEOCHONDROMA. Cartilage capped exostosis Commonest benign tumour of bone Metaphyseal developmental abnormality. INCIDENCE. 45 % of benign bony tumours 12 % of all bony tumours Become evident < 20 yrs Solitary or multiple Any enchondral ossification bone. CLINICALLY.

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OSTEOCHONDROMA

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  1. OSTEOCHONDROMA • Cartilage capped exostosis • Commonest benign tumour of bone • Metaphyseal developmental abnormality OSTEOCHONDROMA

  2. INCIDENCE • 45 % of benign bony tumours • 12 % of all bony tumours • Become evident < 20 yrs • Solitary or multiple • Any enchondral ossification bone OSTEOCHONDROMA

  3. CLINICALLY • Lump or mechanical problem • Tendon or nerve irritation • Sessile or pedunculated • 50% distal femur, proximal tibia, proximal humerus OSTEOCHONDROMA

  4. CLINICAL • Active growth during puberty • Move towards diaphysis during growth • Excise if troublesome in second decade OSTEOCHONDROMA

  5. RADIOLOGY • Flat/ sessile / pedunculated • Tumour blending into metaphysis • Pedunculated orientated proximally • Cartilage cap with calcification OSTEOCHONDROMA

  6. PATHOLOGY • Normal bone covered by normal cartilage cap • Cartilage cap resembles normal growth plate • Cartilage more disorganized OSTEOCHONDROMA

  7. PATHOLOGY • Covered by thin layer of periosteum • Binucleate chondrocytes in lacunae OSTEOCHONDROMA

  8. TREATMENT • Nil required unless symptomatic • Extra-capsular marginal excision • Recurrence < 5% OSTEOCHONDROMA

  9. PROGNOSIS • Risk of malignancy if solitary - 0.2 % • Risk of malignancy in diaphyseal aclasia : - 20 % • Sarcomatous changes usually low- grade OSTEOCHONDROMA

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