Yoshida Yuki, Anazawa Ukei, Watanabe Itsuo, Hotta Hiraku, Aoyama Ryoma, Suzuki Satoshi, Nagura Takeo
Department of Orthopedic Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa-shi 272-8513, Chiba, Japan.
Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku 160-8582, Tokyo, Japan.
World J Clin Cases. 2021 May 6;9(13):3063-3069. doi: 10.12998/wjcc.v9.i13.3063.
Intracortical chondroma of the metacarpal bone which could be painful is an extremely rare condition and previously only one case has been reported. Due to the similar physical features and appearance on clinical imaging, it is difficult to differentiate between intracortical chondroma and osteoid osteoma. Therefore, pathological examination is usually required to establish a definite diagnosis, which is often carried out only after tumor removal. In this study, we describe a case of intracortical chondroma which developed in the metacarpal bone and demonstrate the utility of magnetic resonance imaging (MRI).
We present a case of a 40-year-old man with intracortical chondroma of the metacarpal bone who was strongly suspected of having a tumor, and it was confirmed using contrast-enhanced MRI and successfully treated with curettage. MRI performed before tumor removal revealed signal intensity similar to that of the nidus of an osteoid osteoma. However, no abnormal intensity was observed in the bone or soft tissues surrounding the tumor. Such abnormalities on images would indicate the presence of soft-tissue inflammation, which are characteristics of osteoid osteoma. Furthermore, contrast-enhanced imaging revealed no increased enhancement of the areas surrounding the tumor. This is the first report to describe the contrast-enhanced MRI features of intracortical chondroma. This may serve as a guide for clinicians when intracortical chondroma is suspected.
The contrast-enhanced MRI was useful for the differential diagnosis of intracortical chondroma.
掌骨皮质内软骨瘤可引起疼痛,是一种极为罕见的病症,此前仅报道过一例。由于临床影像学上的物理特征和表现相似,皮质内软骨瘤与骨样骨瘤难以鉴别。因此,通常需要病理检查才能确诊,而这往往在肿瘤切除后才进行。在本研究中,我们描述了一例发生在掌骨的皮质内软骨瘤病例,并展示了磁共振成像(MRI)的作用。
我们报告一例40岁男性掌骨皮质内软骨瘤患者,该患者被高度怀疑患有肿瘤,经增强MRI确诊,并成功进行了刮除术治疗。肿瘤切除前进行的MRI显示信号强度与骨样骨瘤的瘤巢相似。然而,在肿瘤周围的骨骼或软组织中未观察到异常强化。图像上的此类异常表明存在软组织炎症,这是骨样骨瘤的特征。此外,增强成像显示肿瘤周围区域没有增强。这是第一份描述皮质内软骨瘤增强MRI特征的报告。这可能为临床医生怀疑皮质内软骨瘤时提供指导。
增强MRI对皮质内软骨瘤的鉴别诊断有用。