How to treat multiple enchondromas in children?

Chondroma is a tumor disease that is very common in adolescents. This tumor is generally benign and is most likely to appear in the pelvis, limbs, ribs and other parts of the body, especially in the cartilage, so it is called chondroma. If a child has this disease, although the probability of malignancy is very small, parents should still pay attention to it. The current scientific treatment methods are as follows.

Treatment of multiple enchondromas in children:

Surgical resection is the only effective treatment. In the past, considering that the tumor will stop growing as the epiphyseal plate closes and the malignancy rate is extremely low (0.5% to 1% for single lesions and about 2% for multiple lesions), it is generally believed that surgical resection is only indicated when local pain occurs, joint movement is hindered, or blood vessels, nerves, and organs are compressed.

It is generally advocated that once a single osteochondroma is diagnosed, it should be surgically removed at a scheduled time. Due to the large number of multiple osteochondroma lesions, it is difficult to remove them in one operation. However, it is difficult for patients to accept several or even dozens of surgeries to remove the tumor, so only those osteochondromas that cause symptoms or interfere with joint movement and are accompanied by limb deformities can be selectively removed. Corrective surgery for limb deformity can be performed in one stage with tumor resection or in stages, depending on its complexity. If the tumor compresses nerves, blood vessels or affects joint movement, or if fracture occurs due to pedicle trauma, surgical resection is an indication. Of course, surgery is not contraindicated if there are no obvious symptoms.

The focus of the operation is to remove as much as possible from the base without stripping off the local periosteum. The cartilage cap and periosteum should be removed together to prevent tumor recurrence while taking care to prevent damage to the epiphyseal plate.

examine

X-ray examination showed that the tumor was located on the cortical surface of one side of the long bone metaphysis, and its appearance was a cauliflower-shaped, pendulous bone block, with its tip facing the opposite direction of the adjacent joint. Its base is continuous with the bone cortex directly or through a thin pedicle. Although the cartilage cap on the surface of the tumor does not show up on X-rays, it often has calcification and ossification. Larger tumors located in the forearm or lower leg may compress adjacent bones, causing compression bone defects or deformities. Multiple cases are often accompanied by skeletal deformities.

diagnosis

The diagnosis can be made based on the above manifestations and laboratory auxiliary examination characteristics.

Differential Diagnosis

Based on the clinical characteristics, pathological changes and X-ray examination features, it can be differentiated from other bone tumors.