Recently, more and more benign neoplasms in the body have begun to appear in people. This is due to heredity, ecology or poor nutrition - it is not known exactly. Often there is an enchondroma of the femur, which causes deformation of the limb and requires surgical intervention. This neoplasm consists of cartilage tissue that is located inside the tubular bones. The disease proceeds without any signs, however, large tumors can provoke a change in the limb segment. Sometimes a fracture can occur, which very rarely develops into a malignant neoplasm.
Description
An enchondroma is a benign tumor that consists of mature cartilage located in the anatomical zone where it should not be normal. Typically, the neoplasm is located in the bones, but there are cases of its presence in the lungs, mammary glands and brain. So, femoral enchondroma accounts for about ten percent of all bone diseases. The disease manifests itself due to a violation of the process of bone formation in the prenatal period and in the first few years of life. A tumor is a mature cartilage that has lost its structure, its cells are disordered, they are different in size and shape. It is covered with a perichondrium, inside of which foci of ossification are observed. In this case, tissue deformation occurs, which is characterized by the formation of cysts from the intercellular substance, which is diluted.
Gradually, the tumor grows, multiple neoplasms are formed, accompanied by Muffuchi syndrome. Therefore, such tumors are considered by doctors to be potentially malignant and require immediate removal. Thus, the enchondroma is a swollen single focus, in the center of which is an irregularly shaped enlightenment.
Etiology and epidemiology
In 50%, the disease is observed in people who are not forty years old. The disease produces between the ages of eleven and sixteen years. Gender and nationality do not affect the development of the disease. An ailment is detected randomly, mainly with pathological fractures. The tumor is located in the tubular bones, in their medullary canal. In half of the cases, the enchondroma of the femur is found in large bones. To delete or not to delete it? This question should not arise, since in any case surgical intervention is required. Of all neoplasms of a benign nature that affect the human skeleton, about ten percent account for the enchondroma. This disease affects young able-bodied people. Medicine cannot accurately answer the question of what causes contribute to the development of the disease.
Causes
Currently, medicine does not know the causes of the disease. It has been established only that this anomaly does not occur when exposed to radiation or toxins, and is not associated with professional activities of a person. Doctors suggest that the causes of femoral enchondroma are associated with rickets, injuries, and inflammation in bone tissue. Basically, the pathology begins to manifest itself in childhood, therefore it is often found before the age of forty. In this case, treatment should be immediate, since over time, the risk of a tumor growing into a malignant neoplasm increases.
Symptoms
Signs of the disease are poorly expressed. Tumors of a small size do not show any symptoms, with random examinations revealed femoral enchondroma: MRI, CT and radiography. Moreover, these examinations are in no way associated with this disease. If the tumor is huge, deformation of the limb appears. The neoplasm is palpated as a dense formation, while pain can occur if the tumor compresses adjacent nerves and blood vessels. Large enchondroma, which are located near the joints, cause arthralgia, synovitis or restriction of movement. Since the cartilage is not dense enough, the tumor cannot withstand heavy loads, so the bone strength at the site of the lesion is very reduced. A small injury can provoke a fracture in this place, which is accompanied by severe pain, limited movement. Often, a femoral enchondroma, the treatment of which can only be surgical, exhibits the following symptoms:
- pain at night, the increase of which may indicate the transition of the neoplasm into a malignant form;
- the appearance of edema and swelling at the site of the lesion;
- frequent fractures of the femur;
- chronic pain syndrome, which is mild.
In this case, the enchondroma can be single (damage to only one bone) and multiple (damage to several bones that are located nearby). The symptoms of these two types of tumors are no different.
Olie and enchondroma disease
Olya’s disease is a congenital disease in which long tubular bones, in particular metaphyses, are affected on the lower extremities. Pathological changes are clearly visible in the femur, they are characterized by impaired ontogenesis, resulting in a lag in growth and deformation of the human limbs. In this case, the femoral enchondroma may be accompanied by hemangioma, fibroma, exostosis, and so on. The treatment of such pathologies during the growth period of the child is currently difficult, since relapses always appear when abnormal areas are removed.
Diagnostics
If signs of the disease appear, you need to contact an oncologist for an examination. The patient is prescribed a set of diagnostic procedures that are aimed at eliminating malignant neoplasms. First, the oncologist examines the symptoms, paying particular attention to the nature of the pain. The femoral enchondroma has clear boundaries and an oval elongated shape , CT and radiography show the presence of endostal sclerosis in the affected area, and using these techniques, the integrity of the cortical layer of the bone, as well as the structure of the neoplasm, is assessed.
In long tubular bones, enlightenment in the form of a cloud is observed, there may be dark areas in it, which indicates a focus of calcification. In short bones, tumors have a uniform appearance; they occupy a bone diameter. If there is a suspicion of a malignant tumor, a biopsy is performed. In this case, the material is taken from several zones, since at the initial stage the malignant enchondroma of the femur can alternate with areas of degeneration. MRI is performed to examine the soft tissues that surround the pathology. The final diagnosis is made after all studies. On radiographic images, the neoplasm has the appearance of spots of a small size and a light shade, which are located in the form of an arch or ring. Their size is usually about five centimeters.
Differential diagnosis
Such a neoplasm must be differentiated with a giant bone cell tumor, cyst, or chondrosarcoma. It is especially difficult to diagnose with a small malignancy of chondrosarcoma and enchondroma, since these two diseases have similar forms of visualization. Most of the similar diseases are excluded by MRI. It is difficult to enchondroma of the femur, the treatment of which is only surgical, differentiates with an intraosseous ganglion, metastasis of granulomatosis, sarcoidosis and tuberculosis of bones. Examination of the material taken during the biopsy allows distinguishing the enchondroma from other tumors. Using MRI, doctors distinguish this disease from bone marrow infarction. Many doctors claim that the most difficult is the diagnosis of cartilage tumors, especially its forms: benign or malignant.
Treatment
Many people wonder how to cure the femoral enchondroma. The answer is simple - because of the risk of a tumor degenerating into a malignant neoplasm, doctors recommend removing it after a diagnosis is made. Tumors that grow are excised, if the pathology is large, transplants are used. If the femoral enchondroma is aggressive, should the operation be done? Doctors answer in the affirmative, because if this is not done, it will grow beyond the boundaries of the bones. In this case, the tumor is cured, and a special filler is placed in the cavity that forms after the surgical intervention.
Usually the enchondroma does not recur. But in childhood this is possible, so operations are usually not performed. Segmental or ablastic bone resection is also used as a surgical treatment. In the absence of manifestations of the disease, the patient is recommended to be regularly monitored by an oncologist to monitor the growth of the tumor. In the presence of pathological fractures, they are first treated, and then an operation is prescribed, the femoral enchondroma also scraped out.
When a late stage of the disease is observed, the tumor is removed along with the bone. The patient is fully restored in the postoperative period. He can be prescribed massage, physiotherapeutic treatment, exercise therapy so that his physical activity returns to normal. It is worth paying attention to nutrition, it must be balanced and proper, it is recommended to lead an active lifestyle.
Forecast
The prognosis for this disease may be favorable. But there is a risk of transformation of the tumor into malignant. This is especially true for large pathologies that are located near the vascular or nerve bundles, and this is also possible when the tumor grows on soft tissue, relapses after surgery.
Prevention
At present, the exact causes of the development of the pathology are unknown, therefore, no special preventive measures exist. It is recommended to lead a healthy lifestyle, eat right, engage in physical education. All this reduces the risk of a tumor. If women are in position, they should closely monitor their health. It is not recommended to use alcohol, drugs and nicotine. If you suspect a pathology, you should consult with an oncologist. Timely treatment can save a patient's life.
Summary
Thus, the causes of the appearance of a cartilage tumor in young people are currently unknown. If it is found on the femur, then doctors carry out surgical intervention, since such a pathology can develop into a malignant neoplasm. Usually, the prognosis of this disease is favorable, patients after rehabilitation are fully restored. Enchondroma has recently begun to be observed more often than in the last ten years, but doctors say that this is not due to the effect on the body of radiation and exposure to various toxins.