Orthopedic Surgery

Endochondroma

Endochondromas are benign tumors made up of cartilage that form in the central area of the bone where bone marrow is stored. Cartilage is the tough, elastic, fibrous connective tissue that coats the bones where the joints are located. When a person suffers many endochondromas, they are diagnosed with a syndrome called Ollier’s disease. Most endochondromas form in the hands and feet.

There are two types of chondromas:

Chondromas affect males and females equally between the age of 10 and 30.

Cause of endochondroma

The cause of single endochondromas is unknown, but research has shown that Ollier’s disease has a genetic component. Multiple endochondromas are caused by a gene error that results in abnormal endochondral bone formation.

Symptoms of endochondroma

Endochondromas are usually painless and are usually found accidently for a non-related injury. Endochondroma of the hands and feet is suspected when fingers become enlarged, or fractures or deformities occur.

If pain is a symptom — whether generalized pain or when bones are at rest — this can indicate a malignant tumor. Your child’s doctor should perform tests to determine if the tumor is the benign endochondroma or chondrosarcoma (a cancerous growth).

Diagnosing endochondromas

At The Children’s Hospital of Philadelphia, clinical experts use a variety of diagnostic tests to diagnose endochondroma, including:

Treatment of endochondroma

Most endochondromas require no treatment.

However, if the endochondroma gets larger or if it becomes painful, then a biopsy of the affected bone may be necessary to rule out a cancerous growth. A biopsy is a surgical procedure where a sample of the growth is removed and tested for malignant and benign cells.

If surgery is necessary, intralesional curettage is generally the chosen treatment. Curettage involves scraping out the bone to completely remove the tumor and filling the space with material such as methyl methacrylate cement or diluted phenol. Bone grafting with removal is common.

Though surgery for endochondroma is highly effective, we understand that any surgery can be a stressful experience for children and families. At CHOP, we offer a wealth of resources about how to prepare your child for surgery and what to expect during surgery.

Additionally, we employ numerous best practices before, during and after surgery to decrease the risk of infection and increase positive outcomes. Safety in surgery is a top priority at Children’s Hospital.

Follow-up care

Because endochondromas have the potential to become malignant chondrosarcomas, it is important for your child to see a physician regularly, especially if any symptoms recur.

During follow-up visits, X-rays and other diagnostic testing may be done to monitor your child’s health.

Follow-up care and ongoing support and services are available at our Main Campus and throughout our CHOP Care Network. Our team is committed to partnering with parents and referring physicians to provide the most current, comprehensive and specialized care possible for your child.

Long-term outcomes

Most often endochondromas are found accidentally, during an examination for another condition. It is rare they change and become malignant. Overall, 1 percent of endochondromas become malignant.

In 30 percent of patients with Ollier’s disease, endochondromas will become malignant and form cancerous growths called chondrosarcomas.

Prognosis for a single benign endochondroma is excellent. Research is ongoing to identify or isolate chemical markers that could differentiate between benign and malignant tumors.

Resources

Contact us

To make an appointment with the Division of Orthopedic Surgery at The Children's Hospital of Philadelphia, call 215-590-1527 or contact us online.

Reviewed by: Jason L. Katz, PA-C, MHS, ATC-R, and John P. Dormans, MD, FACS
Date: January 2013

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CHOP's Division of Orthopedic Surgery works closely with the Cancer Center to diagnose and treat children with benign and malignant tumors. Learn more about the Cancer Center at CHOP