The human body is indeed a marvel creature. The way the body has many parts and different functions help humans to live and survive. Body parts such as limbs help people to move around and move objects. This enables humans to do many activities in their daily life. There are many diseases that can affect the bone which makes up the limbs. One of the diseases known as enchondroma can affect the bone. In this DoctorOnCall’s article, we will be learning about enchondroma and how it is treated.
Enchondroma is a type of non-cancerous bone tumours that begins in the bone cartilage. Cartilage is known as the connective tissue that develop from the bone. There are many different types of cartilage in the body. Specifically, enchondroma most often affects the cartilage that lines the inside of the bones. Enchondroma is the most common type of hand tumour. This type of tumour does affect person of any age and both men women are at chance of developing it.
The cause of enchondroma remains unknown. There are theories that have been said to be responsible for enchondroma. It can be due to the overgrowth of the cartilage that lines at the ends of the bone or persistent growth of cartilage originating from the embryonic cells that should turn to bone. There is no evidence showing exposure of radiation, chemical or any specific activity might have been the cause for this tumour compared to the many tumours arising from such exposure.
A person with enchondroma may not experience any symptoms at all. However, it is still possible for some to have symptoms such as hand pain and enlargement of the affected finger. Slow bone growth in the affected area can also be seen. In case of multiple lesions in which the tumours appear in the hands or feet, it can weaken the bone and cause bone deformity. This may also lead to bone fractures. Multiple enchondromas may be known as Ollier disease or Maffucci syndrome. Ollier disease is characterised by multiple enchondromas distributed at one side of the limbs whereas Maffucci syndrome is characterised by multiple enchondromas at both sides of the limbs. Maffucci syndrome and Ollier disease, although may seem similar, can be distinguished by the presence of purplish growth of skin of the tangled abnormal blood vessels (haemangiomas). Patients with Ollier disease or Maffucci syndrome often have severe forms of enchondroma.
Since patients with enchondroma may or may not have symptoms, enchondromas are usually found accidentally during routine x-rays that are taken for other reasons. Once enchondroma is detected, doctors might run further examination and tests to confirm the tumour. This is important to ensure that the tumour is not an aggressive or cancerous tumour. MRI or CT-scan may be needed if doctors want to get clear pictures of the tumour and its surrounding structures. In case a tumour has turned into malignancy, scans may show bone erosion, bone inflammation or mass growing outside the bone. Bone scan may be asked for some cases by using radioactive dyes. Biopsy, a procedure of attaining a small sample of tumour tissue may be necessary should there be suspicion of malignancy.
Once diagnosis is confirmed, patients can look forward to treatments. Treatments often depend on the stage of the tumours and symptoms. When there are no symptoms, treatment typically is not needed and only observation is needed to monitor for changes. This includes periodic x-rays or other tests. Most cases of tumour without symptoms need no removal of the tumour. In tumours with symptoms, treatments often revolve around surgery. Surgery may be curettage, a procedure commonly used to treat enchondromas by scraping the tumour out of the bone and bone graft after the curettage. Bone graft is done by filling in the cavity with bone graft to stabilise the bone. Bone graft typically is taken from a donor from another area of the body but also may be from another substance. Chemotherapy or radiation is rare to be used in treating enchondroma.
It is rare for enchondroma to come back (recurrent) after completing treatment. However, recurrence may be high when it involves long bones. Ollier disease and Maffucci syndrome may be causing higher recurrence rates and chance of becoming malignant tumours. It is important to get treatment when it is recommended as delayed surgery may be causing an extended period of immobilisation. This also may be causing higher cost for patients as there is the need for additional fracture surgery on top of the primary enchondroma surgery.
It can be concluded that enchondroma are non-cancerous bone tumours that are often found accidentally as they commonly have symptoms. Either patients do or do not have symptoms, once they are diagnosed with enchondroma, they need to follow doctor’s advice and attend appointments. It is important to treat enchondroma as fast as possible to prevent further problems in future that can cause problems in performing daily life routines.
