What is chondroma? This is a benign tumor that consists of mature cartilage structures and is located in the cortical layer of the bone. The tumor accounts for only 0.66% of all skeletal neoplasms, found in patients of different age groups.
The causes, symptoms, diagnosis and treatment of chondroma, in the ICD - 10 which is listed under the code D16, you will learn after reading the article.
Causes of Chondroma
At the moment, doctors can not find the exact cause of the occurrence of chondroma. But it was possible to identify several factors that directly affect the development of this tumor:
- Age (most often it is the interval between 10-30 years, the peak falls on 11-16 years).
- Inflammatory processes in the body.
- Damage to the spine by viruses.
- Bad ecology.
- Long-term exposure to external factors, such as gasoline, radiation, gases, etc.
- The harmful activity of the person himself on the body (smoking, alcoholism, lack of sleep, lack of physical activity, unbalanced nutrition).
- Various injuries and fractures.
- Violation of the processes of ossification (diagnosed in the growth zone).
Symptoms
Symptoms of periosteal chondroma in a child and adult correspond to symptoms of enchondroma. The difference in the increase in a large neoplasm is a visually and tactile tangible pronounced tumor in the region of the affected limb segment. Typical localization is the diaphysis and metadiaphysis of long tubular bones. Differential diagnosis is carried out with defective metaphysical fibrosis and primary chronic osteomyelitis.
Key features
The main symptoms are:
- headache;
- dizziness;
- joint pain
- impaired coordination of movements;
- difficulty breathing through the nose;
- the appearance of a tumor;
- blurred vision;
- pain in the affected area;
- pathological fractures;
- painful thickening;
- injection swelling.
The disease usually proceeds easily and without pronounced symptoms. But many doctors believe that the appearance of such formations is potentially dangerous, because even when still in the form of a benign tumor, a neoplasm can at any time turn into a malignant one.
Chondroma often affects the bones (chest, collarbone, finger bone, etc.), but can also develop in soft tissues and cartilage (for example, in the larynx). In adults, most often there are formations consisting of a chondromic tube in the bones of the hands, less often on the sternum, thigh and knee. Damaged bone parts tend to deform. If the chondroma is located on long tubular bones, especially in the knee joint, then there is a high risk of a sudden pathological fracture.
As a treatment for peristatic chondromas, edge resection is used. With a large tumor size, resection is supplemented with bone defect plasty.
Types of Chondroma
Clinicians apply a classification based on the location of the tumor. There are 2 types of chondrome:
- Enchondroma. The formation of this kind of tumor occurs in those areas where cartilage tissue is normally absent. This happens more in the parotid gland, ovaries, brain, lungs and others. A neoplasm in the small bones of the limbs or tubular bones is still able to localize.
- Echondroma. In this case, the neoplasm is formed from a full-fledged cartilage of small size. Most often, joint cavities, vertebrae, ears, cartilage of ribs and more are affected.
Classification
Classification by the nature of the course:
- Benign. What is benign chondroma? Such a neoplasm increases at a slow pace and does not cause patient anxiety. It should be noted that it is able to increase throughout his life, while not degenerating into malignant forms.
- Malignant. What is malignant chondroma? This type of tumor is formed more in the proximal femur, as well as the humerus. Chondroma of the rib, sternum and pelvis is most susceptible to malignant degeneration.
During the examination, the doctor will determine the nature of the neoplasm. After they learned what a chondroma is, it is advised to study its types in more detail.
Rib cage
The defeat of the chest more often touches the ribs, and the neoplasm is formed on the verge of cartilage and bone lobe of the bone. The main indicator is a cosmetic flaw, especially detected in subjects of a subtle physique. With an increase in chondroma volumes, the ribs tend to grow into the periosteum from the inner edge of the rib and even pleura, which is accompanied by quite severe pain.
Collarbone
Clavicle chondroma accounts for only 15% of tumors of the bone framework of the chest, but it is very dangerous with the prospect of an increase in the direction of internal organs and compression of large vessels, nerves, lungs, or hearts. Symptoms may include shortness of breath, palpitations, symptoms of a blood flow pathology in the head.
Skull
Chondroma of the bone and cartilage base of the nose can provoke a violation of nasal breathing, soreness, deformity, and a throat lesion - voice difficulties and asphyxiation. Manifestations of chondromas growing in the bones of the skull depend on the nerve or the separation of the brain that undergoes compression.
Among the features are likely:
- Pain in the head and a feeling of weakness.
- Motor disorders.
- Change of coordination of movements.
- Visual pathologies with compression of the optic nerves or their intersection.
An ear
A cartilaginous swelling of the ear with an increase in the auricle brings mainly a cosmetic defect, and localizing in the middle or inner ear, can cause hearing pathology and pain. After elimination of the disease, relapses often occur.
Other locations
In addition to small bones, joints of the hands and feet, damage to large bone joints, in particular the knee joint, is acceptable. A tumor of this localization often appears in athletes whose knee is experiencing significant overload and frequent injuries that initiate the reproduction of cartilage cells. Chondroma of the knee joint is accompanied by pain and limitation of physical activity of the limb. Synovitis is likely, in which the pain becomes stronger, a swelling of the entire joint occurs.
Diseases of the internal organs are considered to be the result of intrauterine growth pathologies if the islands of cartilaginous embryonic matter remain where an adult should not have it. Thus, lung chondroma is a kind of malformation, is asymptomatic and is often detected by chance. In addition to the lung, such tumors can occur in the ovaries, salivary glands, including the brain.
Chondroma Diagnosis
The orthopedist-traumatologist is involved in the identification of a cartilaginous neoplasm at the initial stages. Based on the patient's complaints, external examination and palpation, an x-ray examination is prescribed. On the lumen in the patient's card foggy white spots are clearly visible, which cannot be anatomical features of the structure or a simple malfunction of the device.
After the doctor makes a presumptive diagnosis (chondroma in the district clinic cannot be 100% complete, the final examination and the final option are determined only by the oncologist), the patient is asked to take a general and special blood test for antibodies that show the presence or absence of a tumor process. If antibody markers are positive, a referral for a full medical examination to the oncology center is issued.
Upon arrival at the oncology center, the doctor first gives out a referral for general tests to determine the condition of the body at the time of admission. Next, a second study of the affected area and a biopsy of the cartilage tissue are performed. This is necessary in order to confirm the benign course of the disease. As soon as the result of a biopsy confirms the presence of chondroma, a complex treatment is prescribed with the use of resection (mechanical removal of the tumor) and maintenance drug therapy.
In the postoperative period, the oncologist makes the last screening study to finally confirm the positive outcome of the surgical intervention. To do this, an X-ray is taken, a blood test is taken, a scan on a thermal imager is a special device that shows the affected areas in the form of bright yellow light, since blood is actively flowing to them.
Chondroma Treatment
Chondroma is a benign neoplasm that grows from mature cartilage tissue in various parts of the human body. It is not dangerous, but must be removed immediately, since there is a risk of blocking the main vessels with further degeneration of the chondroma into a malignant cancer segment. Chondroma treatment should be dealt with as quickly as possible. Even though this neoplasm is benign, it tends to rapidly proliferate, metastasize, attach and overlap the great vessels. The longer the patient does not consult a specialist oncologist, the more processes appear in the chondroma, which creates an almost guaranteed recurrent course.
Chondroma treatment is carried out in urban clinical centers for cancer patients. There are all the necessary drugs and medical equipment for diagnosis, removal of the tumor. Children whose immunity is more prone to changes caused by various malfunctions are more likely to suffer from benign and malignant tumor processes.
At the present stage of development of medicine, such methods of tumor removal are used:
- Radical therapy. Surgical removal of cartilage, bone, followed by prosthetics. It is advisable to apply this technique in the case of a mild systemic lesion when the hands, joints, larynx, sternum, phalanx of the fingers are involved. Cranial chondromas require periodic replacement of the prosthesis, since the shape of the head can change (especially in children) and there is a risk of complications due to the use of an artificial object: non-survival, improper overgrowing. The period of complete recovery after resection is 7 to 10 days.
- Radiation therapy. It is used only in cases where mechanical removal of chondroma is not possible. This applies to rare cases of damage to blood vessels, cranial nerves - cerebral neurochondroma. In addition, RT has many side effects and contraindications, which also forces the medical staff of the hospital to choose more gentle methods of influencing the problem.
- Chemical therapy. A rarely used technique. It is prescribed after removal of the tumor in order to completely eliminate pathological agents from the cartilage tissue - metastasis. It can also be prescribed for the purpose of complex recovery, if the disease progressed rapidly and affected the work of vital organs and systems of the body. In addition, CT allows you to get rid of the remnants of the neoplasm, which cannot be removed operably.
- Radio wave cleaning. The use of radio waves to break down tumor processes is a common technique that is applied immediately after tumor resection. Cleaning allows you to remove microbranches of chondroma, which can again grow, leading to a relapse of the disease and their degeneration into a malignant oncological process.
- Supportive drug therapy. To restore the mobility of bone-cartilage tissue, chondroprotectors are prescribed. These drugs allow you to restore metabolic processes within the affected area, to resume the natural growth of cartilage. In addition, depending on the symptoms, analgesics, antispasmodic ointments, calcium, potassium and iron preparations can be used. They help speed up the rehabilitation process, relieve swelling and normalize the general condition of the patient. In addition, any radical process is associated with the loss of blood and many useful substances.