Tenosynovial chondroma of the hand: A case report with a brief review of the literature

Tumors of hyaline cartilage occurring in the soft tissues of the hands and feet arise by metaplasia from the synovium of tendon sheaths and have a benign clinical evolution. Although recurrences may develop, they show no tendency to metastasize. The majority of these tumors prove to be diagnostic difficulties because of the alarming histologic atypia they display. We report a case of tenosynovial chondroma of the hand and briefly review the salient features of these lesions.     

Periosteal chondroma of the ischium; an unusual location

Periosteal chondroma is a rare benign tumor of hyaline cartilage. Periosteal chondroma arising in the ischium is an extremely rare event. By presenting this case report, we aim to remind that differential diagnosis of these lesions should be carefully performed especially for unusual locations. A 51-year-old man visited the orthopedics clinic with the complaints of left pelvic mass and pain lasting about one year. Computed tomography showed a solid mass with abundant specks of calcification that was 4x5 cm in diameter and associated with the ischium of the left pelvic bone. There was no evidence of penetration into the medullary cavity and cortical sclerosis. No radiological aggressive appearance was observed. The lesion was removed with the covering periosteum. Microscopically, there were lobules of hyaline cartilage composed of chondrocytes with foci of endochondral ossification and calcification. The case was reported as 'periosteal chondroma'. In conclusion, this case report presents a case of periosteal chondroma, a rare tumor, which occurred in an unusual location and age range. The differential diagnosis of periosteal chondroma from malignant lesions is necessary for avoiding aggressive and inappropriate treatment.     

Extremely rare case of primary cardiac chondroma in a patient presenting with acute pulmonary edema

Primary tumors of the heart are rare entities, substantially less frequent than cardiac metastases. Primary chondroma is an exceptionally rare cardiac tumor. We describe the case of a patient presenting with acute pulmonary edema with the incidental echocardiographic finding of a large left atrial tumor that was histopathologically diagnosed as primary cardiac chondroma.     

Immunohistochemical study on collagenous proteins and biophysical analysis of crystals in extraskeletal chondroma

The immunohistological distribution of collagen types I, II, III, and VI in five cases of extraskeletal chondroma was examined and compared with that in six cases of enchondroma. In addition, the composition of crystals deposited in three wses of extraskebtal chondroma were biophysically analyzed with special attention to the relationship between the collagen types of the matrix and the crystal deposition. In extraskeletal chondroma, immunoreactivity of type II collagen in the extracellular matrix and type VI collagen in the pericellufar area, which were strongly and diffusely recognized in the normal hyaline cartilage and enchondroma, was diminished. Instead, additional types of collagen, types I and III, were demonstrated in the matrix. Electron roentgenographic microanalysis and infrared light spectroscopic analysis revealed that calcium pyrophosphate dihydrate (CPPD) was included in the crystals of extraskeletal chondroma. CPPD crystals were observed in/ around collagen types I and III. The possible relationship between the difference of collagen composition in the matrix and the CPPD crystal deposition is discussed.     

Rearrangement of band q13 on both chromosomes 12 in a periosteal chondroma

Cytogenetic analysis of a recurrent periosteal chondroma revealed nonreciprocal translocations of both chromosomal segments 12q13→qter, from one chromosome 12 to 7q32 and from the homologous chromosome 12 to 16q22. The remaining parts of the two chromosomes 12 formed a dicentric chromosome. This is the second reported chondroma with a 12q13-15 rearrangement, and changes of this chromosome region consequently seem to be nonrandom occurrences in chondromas. © 1993 Wiley-Liss, Inc.     

Posterior interosseous nerve neuropathy. Clinical and electromyographical aspects.

A clinical-EMGraphic examination was carried out in 37 patients with posterior interosseous nerve neuropathy: 5 cases had a traumatic origin, 4 iatrogenic, and 28 non-traumatic. One of the non-traumatic cases had a lipoma, and another had chondroma. In the other cases, nerve entrapment at the level of the arcade of Frohse could be presumed. Acute or chronic onset of the deficit was probably due to repeated pronation-supination hand movements. A motor deficit in finger extension together with a radial deviation of the wrist, was typical. Surprisingly about 50% of the non-traumatic cases showed some sensory disturbance at the forearm, wrist or hand. EMG examination was useful to establish the entity and topography of the deficit. Follow-up was carried out in 27 cases (3 traumatic, 2 iatrogenic and 22 non-traumatic). Even if spontaneous recovery is possible, though infrequent, in non-traumatic cases with marked deficit surgery gave the most satisfactory results, especially when onset had been acute and operation was performed within nine months of onset.     

Soft tissue osteochondroma: case report and immunohistochemistry for parathyroid hormone-related protein

Surface lesions of bone usually present little diagnostic dilemma because the majority are conventional osteochondromas. Other surface bone lesions include periosteal chondroma, periosteal chondrosarcoma, and parosteal osteosarcoma. Mineralized soft tissue lesions such as myositis ossificans, synovial chondroma, and synovial sarcoma may present in a similar fashion when they occur in a juxtaarticular position. The soft tissue osteochondroma or paraarticular osteochondroma may simulate some of these more aggressive tumors, and its recognition is important to avoid overtreatment. A case of an 11-year-old male with a soft tissue osteochondroma is reported to illustrate the characteristic radiographic and histological features of this rare entity. No prior reports have examined soft tissue osteochondroma for expression of parathyroid hormone related protein, an established cartilage tumor proliferative mitogen.     

Chondroblastoma-like chondroma of soft tissue: report of the first case in the base of skull

Chondroblastoma-like chondroma (CLC) of soft tissue is a rare benign neoplasm that usually involves the soft tissues of the hand. This report describes the first case of CLC of soft tissue arising in the base of the skull. A 33-year-old man was seen with a slow growing mass in the right parotid region of his face. The noncontrast computed tomographic scans showed an 8.5-cm mass with calcifications involving the right masticator space and extending through the bone into the middle cranial fossa. The radiologic differential diagnosis included osteosarcoma, leiomyosarcoma, chondrosarcoma, and giant cell tumor. During surgery, the large lateral skull base tumor appeared to involve the middle and infratemporal fossae and eroded the surrounding bone. Although the tumor was removed piecemeal, total excision was performed. On microscopic examination, the tumor displayed lobules of mature hyaline cartilage with numerous chondroblasts, coarse calcifications including chicken wire calcifications, and scattered osteoclasts. No atypia, mitoses, necrosis, or osteoid formation was seen. The tumor was diagnosed as chondroma with chondroblastoma features of the soft tissue. His postoperative clinical course was uneventful; however, after 7 months, he had a local recurrence identified on follow-up magnetic resonance imaging. He underwent repeat surgical excision of the tumor, which showed similar histology as the previous excision. This large skull based tumor eroding the bone, which clinically and radiologically mimicked a malignant process, was an unusual presentation of a benign cartilaginous neoplasm. Pathologists should be aware that CLC may occur in the base of the skull and this lesion should be differentiated from the other benign or malignant tumors arising in this area. These lesions have a potential for local recurrence; hence, a close follow-up is recommended.     

Correlation between clinicopathological features and karyotype in 100 cartilaginous and chordoid tumours. A report from the Chromosomes and Morphology (CHAMP) Collaborative Study Group.

The evaluation of chondroid lesions requires full integration of clinical, radiographic, and pathological data; tumour typing is often a challenge for the diagnostic pathologist. Although a variety of chromosomal abnormalities have been documented in chondroid lesions, the potential usefulness of cytogenetic analysis remains unclear. This study has critically reviewed and analysed 117 karyotyped samples from 100 patients with cartilaginous and chordoid tumours. Cases were selected based on successful chromosomal analysis and adequacy of clinical, radiographic, and pathological information. To ensure objective evaluation, the cytogenetic results were correlated in a double-blind setting with consensus diagnoses independently determined on each case, after complete review of the histological, radiographic, and clinical findings. Karyotypic aberrations were identified in 41/92 cartilaginous tumours (5/11 osteochondromas, 2/3 chondromyxoid fibromas, 0/4 chondroblastomas, 11/29 chondromas, 0/3 chondroid tumours of undetermined malignant potential, 22/40 chondrosarcomas and 1/2 miscellaneous cartilaginous lesions) and 5/8 chordomas. Complex karyotypic changes were a feature of malignant tumours (chondrosarcoma and chordoma) and of chondrosarcoma among cartilaginous tumours, where they correlated with high tumour grade. Among primary well-differentiated cartilaginous lesions of bone, the finding of an abnormal karyotype was consistently associated with a grade 1 chondrosarcoma diagnosis. Among karyotypically abnormal cartilaginous tumours, loss of distal 8q was associated with osteochondroma, +5 with synovial chondroma/chondromatosis and parosteal or soft tissue chondroma, alterations of chromosome arm 6q with chondromyxoid fibroma, +7 with bone chondrosarcoma, and 17p1 alterations with grade 3 chondrosarcoma. Alterations involving 12q13 characterized synovial chondroma/chondromatosis in the chondroma group and myxoid chondrosarcoma of bone in the chondrosarcoma group. In conclusion, cytogenetic abnormalities in chondroid lesions are common and are not randomly distributed. They are associated with malignancy/tumour grade as well as with specific diagnoses in many cases, and can therefore be of potential value for tumour typing.     

Extraskeletal chondroma of the fallopian tube

Extraskeletal chondroma can occur in the hands, feet, head and neck. This tumor usually presents as a small solitary nodule. The histogenesis of the tumor is controversial, but some have suggested a metaplastic origin. Chondroma of the fallopian tube is very rare. There is only one report in English literature. The origin of this tumor can be subcoelomic mesenchyme of the tubal serosa or mesenchyme of the myosalpinx. We describe a case of chondroma arising from the serosal surface of the fallopian tube with a review of literature. A 30-yr-old woman visited hospital due to left adnexal mass. On operating finding, 2 x 3 cm sized nodular mass was noted on the left tubal serosal area. The excised mass showed multilobulated appearance covered with thin fibrous membrane. The cut surface was solid, grayish yellow, and myxoid with a focal gelatinous area. The microscopic finding showed islands and elongated lobules of mature benign cartilage without cytologic atypia.     

原发性骶骨肿瘤的手术治疗

目的：探讨原发性骶骨肿瘤手术治疗的方法及临床疗效。方法：手术治疗原发性骶骨肿瘤15例,其中脊索瘤7例、骨巨细胞瘤4例、神经纤维瘤2例、软骨肉瘤1例、恶性畸胎瘤1例。术后放疗5例。结果：随访6个月～4a,11例恢复良好,无永久性排尿排便障碍;1例因手术切口感染,于术后半年死于全身衰竭;2例脊索瘤患者分别于术后1年和2年复发;1例软骨肉瘤术后2年半复发。结论：骶骨肿瘤应采取以手术为主的综合治疗,正确的手术方法能够减少术后并发症和肿瘤的复发。     

Extraskeletal chondroma with lipoblast-like cells

An extraskeletal chondroma occurring over the dorsum of the wrist of a 61-year-old woman is reported. The lobulated tumor is cellular and shows mild-to-moderate nuclear pleomorphism of the chondroid cells. A unique feature is that some tumor cells are univacuolated and multivacuolated owing to accumulation of lipid, mimicking the appearances of lipoblasts.     

18‐Year‐Old Woman with a Dural Mass

We report a case of a dural‐based chondroma in the right frontal extra‐axial region. Chondromas are benign cartilaginous tumors which are uncommon intracranially. Their diagnosis should be predicated on the exclusion of a chondrosarcoma and clinical studies should be performed to rule out any underlying tumor predisposition syndromes.     

New formation of elastic fiber material in aortic defects covered with muscle flaps

The examination of the coverage of vascular defects with intercostal muscles showed during an observation period of 7 weeks the development of cartilage tissue with thick elastic fiber nettings running between the chondroma.     

Cartilage-forming tumours of bone and soft tissue and their differential diagnosis

The prevalence of primary malignant bone tumours is estimated to be 1:100,000 within the general population: 17–24% of these are malignant cartilaginous tumours (chondrosarcomas). The incidence of benign bone tumours is largely unknown, due to lack of registration as well as frequent failure to present clinically. Benign cartilaginous tumours of bone include chondroma, osteochondroma, chondroblastoma and chondromyxoid fibroma, whereas among the malignant cartilaginous bone tumours conventional, juxtacortical, mesenchymal, dedifferentiated, and clear cell chondrosarcomas are recognized. The histological distinction between the different entities is based on cell type/differentiation, matrix formation and architecture, combined with radiodiagnostic and clinical data. Extraskeletal cartilaginous lesions are extremely uncommon and include soft tissue chondroma, mesenchymal and extraskeletal myxoid chondrosarcoma. The formation of cartilaginous matrix can be found in many other non-cartilaginous tumours (such as periosteal osteosarcoma and chondroblastic osteosarcoma) and tumour-like lesions (such as fibrous dysplasia, Nora's lesion, primary synovial chondromatosis, dysplasia epiphysealis hemimelica and callus formation) These conditions may lead to an erroneous diagnosis of a primary osseous cartilaginous tumour.     

Benign cartilage tumors

Benign cartilage lesions can be divided into those that differentiate towards fetal type cartilage (chondroblastoma and chondromyxoid fibroma) and those that differentiate towards mature hyaline type cartilage (osteochondroma, chondroma). Nora lesion is a reactive periostitis that mimics osteochondroma and is discussed with this group of lesions. This article reviews their clinical, radiological and pathological features along with the main differential diagnoses. It also briefly reviews multiple osteochondromas, multiple enchondromas and Maffucci syndrome.     

Chondromas (enchondroma, periosteal chondroma, enchondromatosis)

Chondromas combine a group of benign cartilaginous tissue tumors with common histological manifestations. The tumors (enchondroma, periosteal chondroma, and enchondromatosis) differ in sites and clinical manifestations. Chondromas are generally hypocellular, avascular tumors with an abundance of hyaline cartilage matrix and chondrocytes located diffusely, in clones or lobules. Small bone chondromas, Ollier's disease, and Mafucci's syndrome are characterized by the tumor tissue containing a large number of cells and by greater cytological atypia. Enchondroma is successfully treated by surgical methods.     

Spontaneous neoplasms of pigs--a study of 31 cases.

Thirty-one porcine neoplasms were examined at the Animal Disease Diagnostic Laboratory of Purdue University, from January 1st 1966 to december 31st 1976. The series comprised 8 lymphosarcomas, a granulocytic sarcoma, 7 melanomas, 2 haemangiosarcomas, 3 haemangiomas, 3 papillomas, 2 embryonal nephromas, a glioblastoma, an ameloblastoma, a lipoma, a chondroma, and a leiomyoma.     

Chondroma of the bladder

 This case report describes a chondroma of the bladder in a 63-year-old woman with clinical complaints of pain in the left fossa iliaca. The lesion was a tumour with a lobulated growth pattern composed of chondrocytes embedded in a chondroid matrix. Neither mitotic figures nor increased cellularity were present. Nuclei were inconspicuous. Immunohistochemical examination showed reactivity for S100 and vimentin. Received: 22 April 1997 / Accepted: 25 August 1997