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Tumors of Cartilage

A 25 year old nanny with a right hip mass

Case Identification
Case ID Number: 
20120112NA
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

The patient is a healthy 25-year-old woman. She had a bump discovered near her right hip several years ago, that she thought was cellulite. It was not painful then. Recently the bump seems bigger, and it is now symptomatic.

Radiological findings:: 
There is a pedunculated surface lesion on the posterior aspect of the right proximal femur, which measures about 50 x 40 mm in size. It projects into the muscular tissues posterior and lateral to the lesser trochanter. Portions of the lesion are densely ossified. There are some ring and arc patterns of calcification. The lesion has a cap of tissue with high signal intensity on T2 weighted images consistent with cartilage. The maximum thickness of the cap is less than 2 cm.
Laboratory results:: 
none requested
Differential Diagnosis: 
Osteochondroma versus chondrosarcoma, secondary
Further Work Up Needed:: 
Due to the appearance and history of this lesion, combined with the thickness of the cartilage cap, excisional biopsy appears to be a reasonable approach.
Special Features of this Case:: 
When a lesion that has features consistent with osteochondroma has been growing or increasing in symptoms in an adult, secondary chondrosarcoma must be considered. However, the patient's history of a bump in the area several years ago helps establish that the lesion has probably been present for some time. Large deep osteochondromas around the proximal femur may be asymptomatic until some sort of bursitis or degenerative change begins causing inflammation or pain. Patients typically will present with these in their mid-20s or even in their 30s or 40s. The symptoms are not from growth of the lesion, but rather from the tissues that are in contact with the lesion becoming symptomatic due to advancing age.

Bizarre Osteochondromatous Proliferación Parosteal

Bizarre parosteal proliferación osteochondromatous (BPOP) es una lesión rara que ocurre más comúnmente en las manos y los pies.
Este tumor se presenta en adultos en sus 20's y 30's
Hay una historia de una masa ligeramente dolorosa En las radiografías simples, una masa ósea con márgenes bien definidos se considera que debe aplicarse a la superficie del hueso
La extirpación completa con el margen óptimo es el tratamiento de elección.

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Bizarre Parosteal Osteochondromatous Proliferation

Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare lesion that occurs most commonly in the hands and feet.
This tumor occurs in adults in their 20's and 30's
There is a history of a mildly painful massOn plain radiographs, a bony mass with well defined margins is seen to be applied to the surface of the bone
Complete excision with the best possible margin is the treatment of choice.

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Borrar Condrosarcoma de la Célula

Borrar de la célula de cáncer es un tumor destructivo bajo grado de malignidad que se presenta en los adultos. condrosarcoma de células claras es poco común y representa alrededor del 2% de todos los condrosarcomas.
La mayoría de pacientes con diagnóstico de condrosarcoma de células claras estaban en tercera y cuarta décadas de la vida. localización más frecuente es en la epífisis. Los sitios más frecuentes de afectación son el fémur proximal, húmero proximal, fémur distal y la tibia proximal.
Los síntomas más comunes son dolor e inflamación, que generalmente son de larga duración. Puede haber limitación del rango de movimiento de la articulación afectada. En las radiografías, estos tumores están bien circunscritos lesiones mixtas escleróticas Lucent y con un aspecto activo.
El tratamiento y pronóstico: resección en bloque con un amplio margen de un hueso normal y el tejido blando es el procedimiento de elección.

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