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(Osteocartilaginous Exostosis)

Definition

An osteochondroma is the most common type of benign bone tumor. It arises from cartilage tissue in children and adolescents between the ages of 10 and 20. It usually appears on the bones of the arms and legs, and, less often, on the pelvic bones and shoulder blades. An osteochondroma ordinarily stops growing when a person reaches full height.
Most tissue in the body can grow beyond normal limits and form a mass, also known as a tumor. Tumors come in two forms: benign and malignant. The malignancies which are referred to as cancer, rarely stop growing. The benign tumors reach a certain size and then stop.
Cartilage
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Causes

The cause of osteochondroma remains unknown. A hereditary form of the disease may be related to one or more gene mutations.

Risk Factors

The following factors may increase your chance of developing osteochondroma. If you have any of these risk factors, tell your doctor:
  • Multiple hereditary exostoses—In this rare inherited condition, numerous osteochondromas develop throughout the skeletal system often leading to bone deformities and an increased risk of cancer.
  • Radiation treatment or exposure as a child
  • Salter-Harris fractures

Symptoms

Symptoms may include:
  • A hard, bony lump that may be:
    • Painless and not tender, but the tissue around it may become irritated and painful
    • Enlarging in size
  • A long bone that breaks with less than the usual amount of force
  • Pressure on nearby structures, including nerves

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will very likely be referred to an orthopedic surgeon for further diagnosis and treatment.
Images may be taken of your bodily structures. This can be done with:

Treatment

Treatment options include the following:

Leave It Alone

If the lump is not uncomfortable or likely to cause a fracture or other problem, and there is no evidence that it is malignant, it can be left alone. Your doctor may want to retest periodically.

Surgical Excision

If the lump is large, uncomfortable, in a dangerous location, or suspected of being cancerous, surgical removal is the treatment of choice. This involves a general or regional anesthetic and a few days in the hospital. If the bone is weakened by the surgery, the surgeon may need to rebuild it, and the recovery time may be extended to weeks or months.
Since remnants of the tumor may remain after surgery, your doctor may want to retest you every few years to make sure it doesn’t start to grow again.

Prevention

There are no preventive measures for osteochondroma.

RESOURCES

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

Johns Hopkins University http://www.hopkinsmedicine.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Childhood Cancer Canada http://www.childhoodcancer.ca

References

Murphey M, Choi J, Kransdorf M, et al. Imaging of Osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics . 2000 Sept-Oct;20(5):1407-34. Available at: http://radiographics.rsna.org/content/20/5/1407.long . Accessed June 24, 2013.

Osteochondroma. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00079 . Updated May 2012. Accessed June 24, 2013.

Osteochondroma. BoneTumor.org website. Available at: http://www.bonetumor.org/tumors-cartilage/osteochondroma . Accessed June 24, 2013.

Patient guide to osteochondroma. Johns Hopkins Medicine website. Available at: http://www.hopkinsortho.org/osteochondroma.html . Accessed June 24, 2013.

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