Bone & joints

Other chondrogenic tumors

Enchondroma



Last author update: 1 August 2013
Last staff update: 6 January 2023

Copyright: 2003-2023, PathologyOutlines.com, Inc.

PubMed Search: Enchondroma of hands and feet

Nat Pernick, M.D.
Page views in 2022: 15,965
Page views in 2023 to date: 2,345
Cite this page: Pernick N. Enchondroma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bonechondromaenchondroma.html. Accessed February 8th, 2023.
Definition / general
  • Usually asymptomatic or pain due to pathologic fracture
  • May be due to displaced growth plate
  • 70% solitary; 30% multiple
  • Multiple enchondromas: may produce severe deformities; associated with chondrosarcomatous transformation
Terminology
  • Enchondroma protuberans: rare, exaggeratedly eccentric enchondroma resembling osteochondroma radiologically (Hum Pathol 1982;13:734)
  • 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
Epidemiology
  • Age 20 - 49 years, M = F
Sites
  • Small bones of hands and feet (rare in thumb or ribs)
Radiology description
  • Thinning but preservation of cortex, O ring sign, no penetration into soft tissue, pathologic fractures common
  • Long bones: well circumscribed tumor of metaphysis or diaphysis with flecks of calcification; doesn’t invade the cortex
Radiology images

Contributed by Mark R. Wick, M.D. and AFIP

Finger Xray

Enchondroma of finger

Tibia Xray

Multifocal in Ollier disease, CT scan


Distal femur Xray

Femur Xray

Enchondroma of distal femur

Enchondromatosis
(Ollier disease)

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
Gross images

Contributed by Mark R. Wick, M.D. and AFIP

Multifocal in Ollier disease

Enchondroma expands the rib

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 (versus sharp interface at growth plate)
  • More atypia present with Ollier disease and Maffuci syndrome
  • Long bones: hypocellular, few binucleated cells, may be multifocal but does not infiltrate marrow; no myxoid change
Microscopic (histologic) images

Contributed by Mark R. Wick, M.D. and AFIP

Various images

Islands of cartilage

Sparsely cellular cartilage

Cellular areas with moderate nuclear pleomorphism

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
Back to top
Image 01 Image 02