Bone
Chondrogenic tumors
Enchondroma of hands and feet


Topic Completed: 1 August 2013

Minor changes: 31 October 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Enchondroma [title] of hands and feet

Nat Pernick, M.D.
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Cite this page: Pernick N. Enchondroma of hands and feet. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonechondromaenchondroma.html. Accessed May 26th, 2020.
Definition / general
  • Usually asymptomatic or pain due to pathologic fracture
  • Age 20 - 49 years, no gender preference
  • May be due to displaced growth plate
  • Sites: small bones of hands and feet (rare in thumb or ribs)
  • 70% solitary; 30% multiple
  • Multiple enchondromas: may produce severe deformities; associated with chondrosarcomatous transformation
  • Maffuci syndrome: multiple enchondromas and soft tissue hemangiomas; also ovarian carcinoma, brain gliomas
  • Ollier disease: nonhereditary disease of multiple enchondromas of long bones and flat bones (up to 50% of skeleton) with associated skeletal deformities, histologic features of low grade chondrosarcoma should be ignored if radiographically benign; most lesions regress when skeleton matures; often ovarian sex cord tumors
Radiology description
  • Thinning but preservation of cortex, O ring sign, no penetration into soft tissue, pathologic fractures common
Radiology images

AFIP images

Enchondroma of finger


 Contributed by Dr. Mark R. Wick

Finger Xray

Treatment
  • Excision, may recur if incompletely excised
  • Often no treatment recommended
Case reports
Gross description
  • Well circumscribed, pale blue, solid, resembles cartilage but without myxoid change
Microscopic (histologic) description
  • Lobules of hyaline cartilage encased by bone and covered by perichondrium (fibrous tissue)
  • Resembles low grade chondrosarcoma due to hypercellularity, binucleation, myxoid change but radiographically is benign
  • Calcification, endochondral ossification
  • Necrosis common in benign lesions due to avascular cartilage
  • Tongues of bone extend into cartilage (vs. sharp interface at growth plate)
  • More atypia present with Ollier disease and Maffuci syndrome
Microscopic (histologic) images

Contributed by Dr. Mark R. Wick

Various images

Differential diagnosis
  • Epiphyseal dysplasia: in babies, affects multiple joints
  • Low grade chondrosarcoma: breaks through or erodes cortex, marked myxoid change, large tumors occupy marrow space and entrap bony trabeculae
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