Osteochondroma: MR imaging of tumor-related complications

Abstract

Osteochondromas can be complicated by mechanical irritation, compression or injury of adjacent structures, fracture, malignant transformation, and postoperative recurrence. Magnetic resonance imaging represents the most valuable imaging modality in symptomatic cases, because it can demonstrate typical features of associated soft tissue pathology, which can be differentiated from malignant transformation. Reactive bursae formation presents as an overlying fluid collection with peripheral contrast enhancement. Dislocation, deformation, and signal alterations of adjacent soft tissue structures can be observed in different impingement syndromes caused by osteochondromas. Magnetic resonance imaging provides excellent demonstration of arterial and venous compromise and represents the method of choice in cases with compression of spinal cord, nerve roots, or peripheral nerves, depicting changes in size, position, and signal intensity of the affected neural structures. Malignant transformation as the most worrisome complication occurs in approximately 1% of solitary and 5-25% of multiple osteochondromas. Magnetic resonance imaging is the most accurate method in measuring cartilage cap thickness, which represents an important criterion for differentiation of osteochondromas and exostotic (low-grade) chondrosarcomas. Cartilage cap thickness exceeding 2 cm in adults and 3 cm in children should raise the suspicion for malignant transformation. Finally, MR imaging can detect postoperative recurrence by depiction of a recurrent mass presenting typical morphological features of a cartilage-forming lesion.

Osteochondroma of the OsCalcaneum- A Case Report

“…The tumours of the hand and feet bones, which include those of the calcaneum, constitute only of 10% the osteochondromas [6]. Cartilage cap thicknesses of greater than 1 to 2 cm in adults and of 2 to 3 cm in growing children suggest a malignant transformation [7]. In the study of Kinoshita et al, among 83 cases of bone and soft tissue tumours of the foot, osteochondroma was the most commonly reported benign tumour.…”

Giant Cervical Spine Osteochondroma in an Adolescent Female

“…However, our case was a bit different in both its gender occurrence as well as its location in the lower cervical spine. The noted complications of cervical osteochondromas include, compressions of vertebral artery, subclavian artery and the common carotid artery [1, 4,5] as well as other neurological complications. In our case, there was no neurological deficit.…”

A calcaneal osteochondroma with recurrence in a skeletally mature patient: a case report

“…However, it can be very difficult to correctly measure the thickness of a totally nonmineralized cartilage cap because it cannot be easily differentiated from surrounding muscle or bursa. Cartilage cap thickness greater than 1 to 2 cm in adults and 2 to 3 cm in growing children suggests malignant transformation [1,2,20]. …”