Costache Mihai Aurel, Iordache Sergiu, Cursaru Adrian, Popa Mihnea, Serban Bogdan, Cretu Bogdan, Marinescu Andreea, Cirstoiu Catalin
Orthopaedics and Traumatology, University Emergency Hospital, Bucharest, ROU.
Radiology and Imaging, University Emergency Hospital, Bucharest, ROU.
Cureus. 2024 Aug 19;16(8):e67210. doi: 10.7759/cureus.67210. eCollection 2024 Aug.
Chondroma is a benign tumor formation that occurs through the proliferation of cartilaginous tissue. It can be located centrally (enchondroma) or peripherally, often appears between 10-30 years of age, and is commonly discovered incidentally. This case report describes a 46-year-old woman presenting with pain in the left calf and partial functional impotence. The onset of her symptoms was affirmatively marked by a mild skiing-related trauma. Following protocol, X-ray imaging (antero-posterior and lateral views) of the calf was performed, with the only finding being a solitary bony lesion, with internal calcifications, sclerotic margin and radiolucent internal matrix. Facing the uncertainty of diagnosis from a clinical and radiographic standpoint, it was decided to admit the patient for further evaluation and start the standard protocol of imaging investigations - computed tomography, magnetic resonance imaging, and bone scintigraphy - and determine the subsequent therapeutic behavior. Differential diagnosis between enchondroma and low-grade chondrosarcoma can be difficult due to their histopathological similarity. The therapy of choice in enchondroma comprises non-surgical treatment (observation) if the lesion remains unaltered in imaging, or curettage/filling with bone substitutes/allografts, but considering the advanced age and interruption of the bone cortex in our case, we opted for curative surgical treatment.
软骨瘤是一种通过软骨组织增殖形成的良性肿瘤。它可位于中央(内生软骨瘤)或外周,常见于10至30岁之间,通常为偶然发现。本病例报告描述了一名46岁女性,表现为左小腿疼痛和部分功能障碍。其症状的发作明确以一次与滑雪相关的轻度创伤为标志。按照流程,对小腿进行了X线成像(前后位和侧位),唯一发现是一个孤立的骨病变,伴有内部钙化、硬化边缘和透光的内部基质。从临床和影像学角度面对诊断的不确定性,决定收治该患者进行进一步评估,并启动标准的影像学检查方案——计算机断层扫描、磁共振成像和骨闪烁显像——并确定后续的治疗行为。由于内生软骨瘤和低级别软骨肉瘤在组织病理学上相似,二者的鉴别诊断可能存在困难。内生软骨瘤的首选治疗方法包括,如果病变在影像学上保持不变则采取非手术治疗(观察),或刮除/用骨替代物/同种异体移植物填充,但考虑到我们病例中的患者年龄较大且骨皮质中断,我们选择了根治性手术治疗。