Extraskeletal Chondroma
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Extraskeletal chondroma is a cutaneous condition, a rare benign tumor of mature
cartilage Cartilage is a resilient and smooth type of connective tissue. Semi-transparent and non-porous, it is usually covered by a tough and fibrous membrane called perichondrium. In tetrapods, it covers and protects the ends of long bones at the joints ...
.


Signs and symptoms

An extraskeletal chondroma often manifests clinically as a nodular
soft tissue Soft tissue connective tissue, connects and surrounds or supports internal organs and bones, and includes muscle, tendons, ligaments, Adipose tissue, fat, fibrous tissue, Lymphatic vessel, lymph and blood vessels, fasciae, and synovial membranes. ...
mass that steadily enlarges without discomfort and may exist for varying lengths of time before diagnosis. The fingers and toes are the most often affected areas. The tumor is oval in shape and clearly defined; it rarely has a diameter more than 3 cm.


Causes

Rather of coming from mature osseous or cartilaginous tissue, it is believed that this tumor originates from the fibrous stroma of
soft tissues Soft tissue connects and surrounds or supports internal organs and bones, and includes muscle, tendons, ligaments, fat, fibrous tissue, lymph and blood vessels, fasciae, and synovial membranes. Soft tissue is tissue in the body that is not ...
. Micro trauma that occurs repeatedly could be the trigger.


Diagnosis

A positive diagnosis can only be made through a histological analysis. An extraskeletal osteochondroma may show up on traditional
radiography Radiography is an imaging technology, imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical ("diagnostic" radiog ...
as a well-circumscribed, lobulated mass with intense core mineralization. The extraskeletal position of the mass can be verified by CT, which can also reveal foci of
ossification Ossification (also called osteogenesis or bone mineralization) in bone remodeling is the process of laying down new bone material by cells named osteoblasts. It is synonymous with bone tissue formation. There are two processes resulting in t ...
or
calcification Calcification is the accumulation of calcium salts in a body tissue. It normally occurs in the formation of bone, but calcium can be deposited abnormally in soft tissue,Miller, J. D. Cardiovascular calcification: Orbicular origins. ''Nature M ...
that help narrow the diagnosis to extraskeletal chondroma. The most effective radiologic method is
magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...
(MRI), which is able to characterize the tumor's extent, contour, shape, and intensity as well as its relationship to any calcifications or surrounding structures. According to histopathology, the tumor has a lot of lobular structures and certain sections that resemble mucus-containing
hyaline cartilage Hyaline cartilage is the glass-like (hyaline) and translucent cartilage found on many joint surfaces. It is also most commonly found in the ribs, nose, larynx, and trachea. Hyaline cartilage is pearl-gray in color, with a firm consistency and has ...
. Eosinophilic cells with a spindle or circular form are sparsely distributed throughout the tumor matrix. Tumor cells enlarge and take on a rounded appearance, resembling hyaline
cartilage Cartilage is a resilient and smooth type of connective tissue. Semi-transparent and non-porous, it is usually covered by a tough and fibrous membrane called perichondrium. In tetrapods, it covers and protects the ends of long bones at the joints ...
. Incomplete lacuna-like voids can occasionally occur in the surrounding matrix. In few circumstances, multinuclear cells and nuclear
atypia Atypia (from Greek language, Greek, ''a'' + ''typos'', without type; a condition of being irregular or nonstandard) is a histopathology, histopathologic term for a structural abnormality in a Cell (biology), cell, i.e. it is used to describe atypi ...
are present in benign chondroma as well.


Treatment

The only effective treatment is surgery, however recurrence is frequent.


See also

*
List of cutaneous conditions Many skin conditions affect the human integumentary system—the organ system covering the entire surface of the Human body, body and composed of Human skin, skin, hair, Nail (anatomy), nails, and related muscle and glands. The major function o ...


References


Further reading

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External links


Pathology Outlines
{{Osseous and chondromatous tumors Dermal and subcutaneous growths Osseous and chondromatous neoplasia