What is periosteal chondroma?
Periosteal chondroma is a rare, benign tumor on the surface of the bone. It is made up of cartilage, a tough, flexible connective tissue found in many areas in the body.
Periosteal chondroma forms in the periosteum — a fibrous membrane made up of blood vessels and connective tissue that covers the bone.
Fifty percent of periosteal chondromas occur in the long bone of the arm. Boys are twice as likely to be affected as girls.
The exact cause of periosteal chondroma is unknown. Research is underway to determine if there is a genetic or environmental relationship to this benign tumor.
Signs and symptoms
Periosteal chondroma is usually asymptomatic, meaning it doesn’t cause symptoms. However, some children may experience:
- Dull, achy pain or tenderness near the tumor
- Swelling or a mass that can been seen or felt
- A broken bone
Generally, periosteal chondroma doesn’t spread to other parts of the body, but it can continue to grow as your child grows.
Testing and diagnosis
At Children’s Hospital of Philadelphia (CHOP), our clinical experts use a variety of diagnostic tests to diagnose periosteal chondroma in your child, including:
- X-rays, which produce images of bones.
- Magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs, soft tissues, muscles, ligaments and other structures within the body. Your child is exposed to no radiation during an MRI.
- Computed tomography (CT) scan, which uses a combination of X-rays and computer technology to examine bones and produce cross-sectional images ("slices") of the body.
- EOS imaging, an imaging technology that creates 3-dimensional models from two flat images. Unlike a CT scan, EOS images are taken while the child is in an upright or standing position, enabling improved diagnosis due to weight-bearing positioning.
- Needle biopsy, which is a procedure where a doctor places a small needle through the skin and into the lesion to withdraw a small sample of the abnormal tissue. The tissue is analyzed to confirm any findings.
There are many treatment options available for bone and soft tissue tumors, and some children will need a combination of these therapies. At CHOP, experts at the Bone and Soft Tissue Tumor Program take a team approach to treatment. Orthopaedic, cancer and other specialists collaborate to provide your child with individualized care and the best possible outcomes.
Our program is led by Kristy L. Weber, MD, and Alexandre Arkader, MD, nationally renowned surgeons who specialize in treating bone and soft tissues tumors, limb-sparing surgery and reconstructive surgery.
If your child’s periosteal chondroma is not causing any symptoms, clinicians generally recommend a “watch-and-see” approach that includes ongoing monitoring to ensure the tumor does not grow.
For children experiencing symptoms from the periosteal chondroma surgery may be recommended.
Surgical treatment may include:
- Intralesional curettage, which involves scraping out the bone to completely remove the tumor
- Intraoperative adjuvants — such as cryotherapy (liquid nitrogen), phenol (a chemical) or cauterization (burning the tumor bed) — which are used to remove microscopic tumor cells
- Bone grafting, a surgical procedure to replace missing bone with artificial graft material or cadaver bone
Depending on the size and location of periosteal chondroma removed, your child may be able to return home that day or may spend one night in the Hospital.
Though surgery for tumors 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. For more details about safety protocols at Children's Hospital of Philadelphia, see safety in surgery.
Follow-up care for periosteal chondroma will depend on what treatment your child received.
If the tumor was surgically removed, your child will see the orthopaedic surgeon about one to two weeks after surgery, then again at three and six months post-surgery.
If your child was not experiencing symptoms and doctors recommended watchful waiting, ongoing monitoring will be needed. During follow-up visits, X-rays and other diagnostic testing of the tumor site are recommended to closely monitor your child’s health.
Follow-up care and ongoing support and services for your child and family 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.
The long-term outlook for children with periosteal chondroma is excellent. These tumors rarely recur after complete removal.
Reviewed by Alexandre Arkader, MD, Kristy L. Weber, MD, FACS