Benign Neoplasms of Musculoskeletal Tissues

dr. Farry

OSTEOMA

Osteoma

• Rare benign tumor that may appear on the surface of the skull or tibia

• X-ray well-demarcated area of radio-opaque

• No treatment is required unless the lesion presses on soft tissue

OSTEOCHONDROMA(OSTEOCARTILAGINOUS EXOSTOSIS)

Osteochondroma(Osteocartilaginous Exostosis)

• Abnormal growth direction and remodeling of bone and cartilage in the metaphyseal long bones of young children

• Most common– Distal femur– Proximal tibia– Proximal humerus

Osteochondroma(Osteocartilaginous Exostosis)

• Consists of normal bone capped with normal cartilage with its own epiphyseal plate

• Growth of the tumor persists until the growth of nearby epiphyseal plate ceases

• Types– Pedunculated (stalked) type

• Long with narrow base

– Sessile type• Short with broad base

Osteochondroma(Osteocartilaginous Exostosis)

• Symptoms– Painless lump– May interfere nearby

soft tissue/joint function

• Indication of excision– Cosmetic purpose– Interfering normal

function of the limb

OSTEOID OSTEOMA

Osteoid Osteoma

• A benign bone tumor that arises from osteoblasts

• Consists of small, round, uncalcified nidus which is surrounded by reactive bone

• Does not grow in size and tend to be <1cm

Osteoid Osteoma

• Incidence– Children/young adults– Boys > girls– Most common in femur

and tibia

• Symptoms– Dull pain that increases at

night

• X-ray– Radiolucent nidus

surrounded with radioopaque reactive bone

Osteoid Osteoma

• Treatment– Surgical excision of the

nidus and narrow margin of surrounding bone

– Percutaneous overdrilling, cauterization, laser coagulation, or crytherapy of the nidus

ENCHONDROMA

Enchondroma• A cartilage cyst within a bone

marrow which develops from local abnormal growth of chondrocyte from epiphyseal plate

• Most common in tubular bones of the hands and feet (metacarpal/metatarsal, phalanx)

• 2% will become chondrosarcoma

• Multiple enchondroma Ollier disease (enchondromatosis)

Enchondroma

• As the lesion grows bone is slowly absorbed from inner cortex and periosteal reactive bone deposited on the outer cortex the lesion expanded with thin cortex may become pathological fracture

• Symptoms– Painless lump– Pathological fracture pain

• X-ray– Lytic lesion with thin cortex

Enchondroma

• Treatment– Curretage with packing

of cancellous bone grafts at the residual cavity

NONOSSIFYING FIBROMA

Nonossifying Fibroma• A fibrous bone lesion that is usually

asymptomatic and discovered as an incidental finding on x-ray

• The most common benign bone tumor in children and adolescents

• Most common in long bones of lower limb

• Consists of collagen rich connective tissue, fibroblasts, histiocytes and osteoclasts which originates from epiphyseal plate

• Still not clear whether it is a true neoplasm or a developmental disorder of growing bone

Nonossifying Fibroma

• X-ray– Well marginated

radiolucent lesion, with a distinct multilocular appearance

• Self-limiting disease no treatment needed

Thank You