KidsMD Health Topics

Chondromas

  • Overview

    Chondromas are benign (not cancerous) tumors made of cartilage that are found mostly in the small bones of the hand and feet.

    • They can also occur in the humerus (upper arm), femur (thigh bone) and ribs.
    • These tumors rarely produce symptoms, but can cause the affected bone to easily fracture.
    • They don't spread and usually stop growing when your child's bones reach full growth potential.

    They are classified as one of two types depending on where on the bone they are located:

    • Echondromas: This kind of chondroma is found in the marrow cavity of the bone
    • Periosteal Chondromas: This kind of chondroma forms at the surface of the bone

    Support for your family

    We understand that you may have a lot of questions when your child is diagnosed with a chondroma. Is it cancer? Will it spread? What do we do next? We've tried to provide some answers to those questions in the following pages, and our experts can explain your child's condition fully. If you have further questions during your hospital stay, Boston Children's Hospital can put you in touch with other families who have experienced this condition.

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    Boston Children's Hospital
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    Boston MA 02115

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  • In-Depth

    Can chondromas become malignant?

    Some may continue to grow and transform into a malignant condition called chondrosarcoma in adulthood. Your child's doctor will pay close attention to any tumor that grows past skeletal maturity, especially those that produce new

    The bones most at risk for malignant transformation are those most central in location.

    For instance, tumors found in the pelvis or shoulder girdle have a higher tendency to transform than those found in the bones of the hands and feet, which almost never become malignant.

    What causes chondromas and who is affected by them?

    We don't know the exact cause of chondromas.

    • Chondromas account for 25 percent of all benign bone tumors.
    • Echondromas - the most common type bone tumors found in the hand
      • Boys and girls are equally affected.
      • They can occur at any age but usually echondromas are not discovered until people are in their 30s or 40s.
    • Periosteal chondromas - extremely rare
    • They usually appear earlier, which may be because they produce symptoms, leading to earlier detection.

    What are the symptoms of chondromas?

    Echondroma

    • usually no symptoms
    • pain
    • fracture
    • tendinitis (usually in the upper arm)
    • painless swelling of a digit

    Periosteal chondromas

    • dull, achy pain
    • swelling
    • a mass that can be felt
    • sometimes no symptoms
  • Tests

    How are chondromas diagnosed?

    In addition to a taking a complete medical history and performing a full physical examination, your child's doctor may use some combination of the following tests to diagnose either type of chondroma:

    • X-rays - A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
    • Magnetic Resonance Imaging (MRI) -This test is particularly useful in identifying tumors in areas that are difficult to image on a plain x-ray.
    • Computerized Tomography scan (also called CT or CAT scan) - A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs.
    • Bone scan - A nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints, to detect bone diseases and tumors and to determine the cause of bone pain or inflammation.
    • Complete blood count (CBC) - A measurement of size, number and maturity of different blood cells in a blood sample.
  • What's the treatment for chondromas?

    Treatment for children with chondromas without symptoms may involve observation alone. Your child's doctor will watch for any signs of bone destruction or malignant transformation. Doctors will probably want to remove your child's chondromas that are causing symptoms, such as pain or fracture.

    Removing the chondroma

    The operation of choice, performed by an orthopaedic surgeon, usually involves curettage.

    Curettage describes a procedure in which a tumor is surgically scraped out of the bone, leaving a cavity that is then packed with either donor bone tissue (allograft), bone chips taken from another bone (autograft), or other materials depending on the preference of the surgeon.

    While the operation is performed, the surgeon will take a biopsy, a tissue sample of the tumor, so it can be examined under a microscope.

    If the tumor is causing destruction or if doctors believe it will degenerate to a malignant condition known as chondrosarcoma, the tumor and surrounding healthy tissue may be surgically removed.

    What is the long-term outlook for a patient with a chondroma?

    The long-term outlook for a patient with echondroma or periosteal chondroma varies from patient to patient depending on:

    • the extent of the disease
    • the size and location of the tumor
    • the presence of absence of malignant degeneration
    • the age and overall health of your child
    • your child's tolerance for specific medication, procedures or therapies

    Generally, echondroma and periosteal chondroma that are not causing any symptoms will resolve on their own as they stop growing at skeletal maturity. Due to the possibility of a transformation into a malignant condition, however, continual follow-up care is essential if your child is diagnosed with a chondroma.

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