What is Enchondroma?
Enchondroma is the name given to a type of a noncancerous growth or tumor which develops in the cartilage within the bones. It is a benign condition and most of the time does not cause any symptoms and rarely does it require any treatment. Enchondromas are normally incidentally diagnosed during radiological studies which are being done for some other condition. Generally as stated Enchondroma does not require any treatment but in some cases these tumors tend to make the bones weak resulting in them being fractured easily. In such cases, a surgical removal of the Enchondroma becomes essential to prevent future fractures.
Enchondroma is commonly seen in children and young adults with an age range of 10-20 years. They usually form in the small bones of the hands but they can also develop in the long bones of the body as well. Enchondroma rarely become malignant but people with conditions like Ollier’s Disease have greater chances of Enchondromas becoming cancerous. If Enchondroma gets malignant, then that condition is termed as chondrosarcoma.
What are the Causes of Enchondroma?
The root cause as to why Enchondromas develop is still not known but some researchers suggest that it may develop when cells instead of developing into bone develop into cartilage resulting in development of an abnormal growth within the cartilage of the bone causing Enchondroma.
What are the Symptoms of Enchondroma?
As stated, Enchondromas do not cause any symptoms. Usually Enchondromas develop as a single tumor but in some cases there are multiple Enchondromas. In such cases, there may be deformity of the bone which can occur. The individual may also tend to break the bone easily or with little pressure as the bones get weak due to the presence of multiple Enchondromas, especially in the hands and feet.
If an individual experiences pain which is not resolving and all other potential sources of pain have been ruled out then a low grade chondrosarcoma may be suspected and further investigations may need to be done to rule it out.
How is Enchondroma Diagnosed?
As Enchondromas are in majority of cases asymptomatic, hence its diagnosis is very difficult and usually incidental during radiological studies being done for some other condition. When a tumor is identified, the physician will then conduct a thorough evaluation of the tumor through various tests and biopsy to rule out a cancerous growth and confirming that the tumor is nothing but an Enchondroma.
To begin with, the physician will take a detailed history of the patient inquiring about any pain in the area of the tumor and whether there is any pain experienced at rest or at night. Repeat x-rays will be done to observe the status of the tumor and if no growth is seen after repeated x-rays then Enchondroma is confirmatively diagnosed.
Sometimes an MRI or a CT scan may also be done to definitively rule out any cancerous tumor and confirm the diagnosis of Enchondroma. A biopsy of the tumor will also be done to rule out a malignant tumor and confirm the diagnosis of Enchondroma.
How is Enchondroma Treated?
As stated, majority of cases of Enchondromas do not require any treatment. Treatment for Enchondroma is only required when multiple lesions are present and are affecting bone health and making the bone weak and prone to frequent fractures. In such cases, surgical removal of Enchondroma is recommended but before that the physician will recommend close observation of the lesion with periodic x-rays to see whether the size of the tumor is increasing or not.
The surgical procedure done for removal of Enchondromas is called as curettage. In this procedure, an incision is made at the site of the tumor and the tumor is scraped off of the bone. The recurrence rate for Enchondromas is very low due to its benign nature. Once the tumor is removed the surgeon will fill in the void created by the tumor with a bone graft.
What is the Prognosis of Enchondroma?
In majority of cases, Enchondromas are totally cured with surgical removal. Enchondromas once removed do not recur as they are benign. In case if the lesion recurs then it may be a sign that the lesion may be a low grade chondrosarcoma and further treatment may be required in such cases. Otherwise, once the lesion is removed, the prognosis is very good for Enchondroma.
- “Enchondroma.” Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/enchondroma/symptoms-causes/syc-20454698
- Wint, David B., et al. “Enchondroma.” StatPearls [Internet], 2021. https://www.ncbi.nlm.nih.gov/books/NBK448201/
- Li, Yanxia, et al. “Enchondroma of the Hand and Foot: Imaging, Pathology, and Treatment.” Skeletal Radiology, Volume 50, Issue 5, 2021, pp 757-769. DOI: 10.1007/s00256-020-03597-7
- Singh, Alka, et al. “Enchondroma in Hand: A Review of 11 Cases.” Journal of Clinical Orthopaedics and Trauma, Volume 9, Issue 3, 2018, pp 254-258. DOI: 10.1016/j.jcot.2017.09.007