Osteochondroma. An Osteological Study
Background: Osteochondroma is the most common tumor of bone, accounting for approximately one third of benign lesions in the skeleton is a broad (sessile) or narrow (pedunculated) skeletal protrusion comprised of marrow and cortical bone. Although it is benign, its biological behavior still has a malignant potential. Chondrosarcoma arising in osteochondroma has been recognized for many years. Osteochondromas might occur on any bone preformed in cartilage, they were especially seen on the long bones of the extremities, predominantly around the knee. In fact, the lower limb seemed to be at a higher risk of the tumor than the upper limb on the top two locations: distal part of the femur and proximal part of the tibia, however, the proximal humerus ranked the third place for solitary osteochondroma while the proximal fibula for multiples osteochondromas.
Methods and Findings: A total of 20 skeletons and 18 cadavers of both sex, 16 males and 2 females, with different age groups were used, this study was carried out by routine dissection classes for undergraduate medical student´s in the Morphology Laboratory of the University of Pamplona during the years 2013-2016. In only one sample was found the presence of osteochondroma. The measurement of the osseous mass was of 7 x 3.5 x 1.5 cm, attached to the posterolateral aspect of the middle third of the femur.
Conclusions: Osteochondroma is generally asymptomatic or discovered accidentally, but it can cause different symptoms depending on site of occurrence local swelling, bony deformities, fracture, bursa formation, arthritis and impingement on adjacent tendons, vascular or neurologic compromise, and dislocation The importance of correct treatment and follow-up of large osteochondromas to avoid complications such as further damage to neighboring neurovascular structures, and potential malignant degeneration. The present study describe a rare location from an osteochondroma in the femur diaphysis.
2- Kitsoulis P, et al. Osteochondromas: review of the clinical, radiological and pathological features. In Vivo. 2008;(5):633–46. Available from: http://iv.iiarjournals.org/content/22/5/633.long
3- Wang D, DeRubertis BG. Popliteal artery occlusion secondary to exostosis of the femur. Perspect Vasc Surg Endovasc Ther. 2012;24(4):217–20. Available from http://journals.sagepub.com/doi/
4- Vanhoenacker FM, et al. Hereditary multiple exostoses: from genetics to clinical syndrome and complications. Eur J Radiol. 2001;40(3):208–17. Available from: http://www.ejradiology.com/ar
5- Heron N. Femoral exostosis causing vastus medialis pain in an active young lady: a case report. BMC Res Notes. 2015 Apr 2;8:119. Available from: https://bmcresnotes.biomedcentral.com/arti
6- Hameetman L, et al. The role of EXT1 in nonhereditary osteochondroma: Identification of homozygous deletions. J Natl Cancer Inst. 2007; 99: 396-406. Available from: https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djk067
7- Solomon L. Hereditary multiple exostosis. Am J Hum Genet. 1964 Sep; 16(3): 351–63. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1932480/pdf/ajhg00549-0101.pdf
8- Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH. Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 2000;20 (5): 1407-34. Available from: http://pubs.rsna.org/doi/full/10.1148/radiographics.20.5.g00se171407
9- Dorfman HD, Czerniak B. Osteochondroma. Bone tumors. St. Louis: Mosby; 1998. p. 331–46.
10- Resnick D, Kyriakos M, Greenway GD. Osteochondroma. In: Resnick D, editor. Diagnosis of bone and joint disorders. 3rd ed. Philadelphia: Saunders; 1995. p. 3725–46.
11- De Souza AMG, Bispo Júnior RZ. Osteochondroma: ignore or investigate? Revista Brasileira de Ortopedia. 2014; 49(6):555-564. doi:10.1016/j.rboe.2013.10.002. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487501/
12- Chrisman OD, Goldenberg RR. Untreated solitary osteochondroma. Report of two cases. J Bone Joint Surg Am. 1968; 50: 508-12. Available from: https://insights.ovid.com/pubmed?pmid=5644
13- Van Oost J, Feyen J, Opheide J. Compartment syndrome associated with an osteocartilaginous exostosis. Acta Orthop Belg.1996; 62: 233-5. Available from: http://www.actaorthopaedica.be/
14- Cardelia JM, et al. Proximal fibular osteochondroma with associated peroneal nerve palsy: a review of six cases. J Pediatr Orthop. 1995; 15: 574-577. Available from: https://www.ncbi.nlm.nih.gov/pubmed/7593564
15- Vallance R, Hamblen DL, Kelly IG. Vascular complications of osteochondroma. Clin Radiol. 1985; 36: 639-42. Available from: https://www.ncbi.nlm.nih.gov/pubmed/4064551
16- Bovée JVMG, Hogendoorn PCW. Multiple Osteochondromas. In: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. Fletcher CDM, Unni KK and Mertens F (eds.). Lyon, France: IARC; 2002. p. 360-2.
17- Quirini GE, Meyer JR, Herman M, Russell EJ. Osteochondroma of the thoracic spine: an unusual cause of spinal cord compression. Am J Neuradiol. 1996; 17: 961-4. Available from: http://www.ajnr.org/content/17/5/961.long
18- Saglik Y, Altay M, Unai VS, Basari K, Yildiz Y. Manifestations and management of osteochondromas: a retrospective analysis of 382 patients. Acta Orthop Belg. 2006; 72: 748-55. Available from: https://pdfs.semanticscholar.org/3957/bffa7103ed328722cab4c8dea05658df265 .pdf?_ga=2.24847738.1343818818.1509068484-1426685699.1509068484
19- Lee K, Davies A, Cassar-Pullicino V. Imaging the Complications of Osteocondromas. Clinical Radiology. 2002; 57: 18-28. Available from: http://www.clinicalradiologyonline.net/article/S000
20- Stieber JR, Dormans JP. Manifestations of hereditary multiple exostoses. J Am Acad Orthop Surg. 2005; 13(2):110-120. Available from: https://insights.ovid.com/pubmed?pmid=15850368
21- Pandya NK, et al. Spinal cord compression in a patient with multiple hereditary exostoses caused by breast adenocarcinoma metastatic to osteochondromas of the spine: case report. Spine. 2006; 31: 920-4. Available from: https://insights.ovid.com/pubmed?pmid=17108823
22- Koga M, et al. Osteochondroma in the mandibular condyle that caused facial asymmetry: a case report. Cranio. 2006; 24: 67-70. Available from: http://www.tandfonline.com/doi/abs/10.1179/cr
23- Koehl GL, Tilson HB. Osteochondromas associated with facial asymmetry and masticatory dysfunction: report of two cases. J Oral Surg. 1977; 35: 934-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/269942
24- Huang HR, Lin TY, Wong KS. Costal exostosis presenting with hemothorax: report of one case. Eur J Pediatr. 2006; 165: 342-3. Available from: https://link.springer.com/article/10.1007%2Fs0
25- Castells L, et al. Case report: haemothorax in hereditary multiple exostosis. Br J Radiol.1993; 66: 269-70. Available from: http://www.birpublications.org/doi/pdf/10.1259/0007-1285-66-783-269
26- Scott EM, White FJ, Jennings PE. Popliteal vein thrombosis associated with femoral osteochondroma and popliteal artery pseudoaneurysm. Postgrad Med J. 1995;71:441-2. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2397980/pdf/postmedj00031-0059.pdf
27- Lizama VA, Zerbini MA, Gagliardi RA, Howell L. Popliteal vein thrombosis and popliteal artery pseudoaneurysm complicating osteochondroma of the femur. AJR Am J Roentgenol. 1987;148:783-4. Available from: http://www.ajronline.org/doi/pdfplus/10.2214/ajr.148.4.783
28- Khaira HS, Parnell A, Crowson MC. Femoral exostosis presenting with deep vein and arterial thrombosis. Br J Surg. 1995;82:911. Available from: http://onlinelibrary.wiley.com/doi/10.1002/
29- Vasseur MA, Fabre O. Vascular complications of osteochondromas. J Vasc Surg. 2000 Mar;31(3):532-8. Available from: http://www.jvascsurg.org/article/S0741-5214(00)90315-X/fulltext
30- Tenenbaum S, Arzi H, Shabshin N, Liberman B, Caspi I. Selective computed tomography-guided perisciatic injection as a diagnostic tool in multiple hereditary exostoses. Orthopedics. 2012;35(9):e1446–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22955418
31- Ayerza M, Abalo E, Aponte-Tinao L, Muscolo D. Endoscopic resection of symptomatic osteochondroma of the distal femur. Clin Orthop Relat Res. 2007;459:150–3. Available from: https://pdfs.semanticscholar.org/6375/cb2b028d1cb2dd5be7c9523dab95a99a35f0.pdf
32- Fitzgerald CWR, Rowan FE, O'Neill SC, Mulhall KJ. A mountain among molehills: removing an impinging large femoral neck osteochondroma in a man with hereditary multiple exostoses. BMJ Case Reports. 2014;09:2014. Available from: http://casereports.bmj.com/content/2014/bcr-2013-202317.abstract
33- Mesfin A, Goddard M, Tuakli-Wosornu Y, Khanuja H. Total hip and knee arthroplasty in patients with hereditary multiple exostoses. Orthopedics. 2012;35(12):e1807–10. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23218641
34- Glick R, Khaldi L, Ptaszynski K, Steiner GC. Dysplasia epiphysealis hemimelica (Trevor disease): a rare developmental disorder of bone mimicking osteochondroma of long bones. Hum Pathol. 2007; 38:1265-72. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0046-8177(07)00063-9
35- Bovée JVMG, Hameetman L, Kroon HM, Aigner T, Hogendoorn PCW. EXT-related pathways are not involved in pathogenesis of Dysplasia Epiphysealis Hemimelica and Metachondromatosis. J Pathol. 2006; 209:411-9. Available from: http://onlinelibrary.wiley.com/
36- Silverman FN. Dysplasia epiphysealis hemimelica. Semin Roentgenol. 1989; 24:246-58. Available from: http://www.sciencedirect.com/science/article/pii/0037198X89900229
37- Ippolito E, Tudisco C. Dysplasia epiphysealis hemimelica. Clinical, histological and histochemical features. Ital J Orthop Traumatol. 1983: 9:101-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/6411654
38- Kuo RS, Bellemore MC, Monsell FP, Frawley K, Kozlowski K. Dysplasia epiphysealis hemimelica: clinical features and management. J Pediatr Orthop. 1998; 18:543-8. Available from: https://insights.ovid.com/pubmed?pmid=9661870
39- Bassett GS, Cowell HR. Metachondromatosis. Report of four cases. J Bone Joint Surg Am. 1985; 67:811-14. Available from: https://insights.ovid.com/pubmed?pmid=3873457
40- Herman TE, et al. Metachondromatosis: report of a family with facial features mildly resembling trichorhinophalangeal syndrome. Pediatr Radiol. 1997; 27:436-41. Available from: https://link.springer.com/article/10.1007/s002470050164
41- Kennedy LA. Metachondromatosis. Radiology. 1983; 148:117-18. Available from: http://pubs.rsna.org/doi/pdf/10.1148/radiology.148.1.6602353
42- Bovée JV. Multiple osteochondromas. Orphanet J Rare Dis. 2008 Feb 13;3:3. doi: 10.1186/1750-1172-3-3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276198/
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright policies & self-archiving
We are a RoMEO green journal.
Author's Pre-print: author can archive pre-print (ie pre-refereeing)
Author's Post-print: author can archive post-print (ie final draft post-refereeing)
Publisher's Version/PDF: author can archive publisher's version/PDF
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access and Benefits of Publishing Open Access).
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.
Articles are published Under License of Creative Commons Attribution 4.0 License ©