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ENHONDROM

MILAN MILANOVI 340/10 19.04.2013.

ENHONDROM
Enhondrom je vrsta benignog tumora kostiju koji nastaje

od hrskavice. Najee se javlja na metakarpalnim kostima aka i metatarzalnim kostima stopala. Najei je u uzrastu od 10 do 20 godine. Dijagnostikuje se sa jednakom uestalou i kod mukaraca i kod ena. U rijetkim sluajevima moe se javiti vie tumora kao dio sindroma. Sindromi su poznati kao OLLIEROVA bolest i MAFFUCCI sindrom.

Osobe koje imaju enhondrom najee nemaju nikakve

vidljive simptome. Ponekad se mogu prepoznati sledee pojave : Bol u kostima Deformitet kostiju Uveanje afektovanog prsta Spori rast kosti u afektovanoj zoni. Veoma rijetko se transformie u maligni tumor (>1 %). Lijei se konzervativnim i hirurkim putem. Treba ispitivati i tretirati samo one tumore koji uzrokuju poveanje veliine, bol ili oticanje kostiju. Dijagnoza se postavlja na osnovu klinike slike, RTG, CT, MR,NMD.

RTG snimci

Radiograph of the right femur demonstrates a calcified intramedullary lesion in the distal shaft.

Detail of a lytic expansile lesion in the fifth metacarpal bone in the right hand (same patient as in previous image). There is thinning of the cortex with a somewhat scalloped appearance. A pathologic fracture is noted, but no appreciable calcifications are seen in the lesion.

Geographic lytic lesion Central often metaphyseal in long bones Can be eccentric also Expansile remodeling with thinned cortex Chondroid matrix with calcifications in majority of tumors Approximately 20% have limited or no calcifications MRI Lobulated margin Marked increased intensity long TR images Calcified chondroid - low intensity all sequences

CT snimci

Axial computed tomography image demonstrates a fluffy calcific matrix within the medullary canal of the distal femur. The surrounding cortex is intact.

CT scan: enchondroma of Middle Phalanx There was no mineralization detected in this enchondroma.

CT scan: enchondroma of Middle Phalanx There was no mineralization detected in this enchondroma.

MR snimci

Axial T1-weighted magnetic resonance imaging study shows an intramedullary lesion with low signal intensity and lobular morphology in the distal femur. The endosteal aspect of the cortex is not affected.

Coronal T1-weighted magnetic resonance imaging study demonstrates predominantly decreased signal intensity within a lesion in the distal femur (same patient as in previous image). The lesion has a lobular morphology. No endosteal scalloping is noted.

Axial T2-weighted magnetic resonance imaging study shows regions of high signal intensity in the lesion (same patient as in previous image). No surrounding edema is noted.

Coronal T2-weighted magnetic resonance imaging study demonstrates small lobulated foci of increased signal intensity separated by a background mesh of decreased signal intensity (same patient as in previous image). The adjacent cortex is intact.

Literatura
MedScape. Enhondroma imaging March 6, 2013. Available at

http://emedicine.medscape.com/article/389224-overview#a21 James C. Witing M.D. Enhondroma September 7, 2012. Available at http://www.tumorsurgery.org/patient-education/bone-tumors/bonetumor-types/enchondroma.aspx Wehner Medical Center. Enhondroma August 13, 2012. Available at http://medicalcenter.osu.edu/patientcare/healthcare_services/bone_d isorders/benign_bone_tumors/enchondroma/Pages/index.aspx

HVALA NA PANJI !!!