In the following, a definition, causes, diagnosis and possible course for enchondroma will be named. In addition to possibilities of therapy and forms of prophylaxis, other useful information about this benign form of bone tumor will be pointed out.
What is an enchondroma?
Enchondroma is an initially mostly harmless form of tumor disease in the cartilaginous mass of human bone. Enchondroma always occurs in a benign form. Therapy is not absolutely necessary, but close observation of the benign cell degeneration should be ensured in most cases. This form of cell proliferation occurs most frequently between the ages of 20 and 40. Often one comes across the mostly painless enchondromas by chance during X-rays. They are usually located in the thin long bones. However, if enchondromas are found in a body in various places, one speaks of certain syndromes, whereby with this diagnosis, a malignant development of the tumor disease is to be expected significantly more often.
Causes
Causes of enchondromas have not been definitively determined, and ultimately some scientists assume that in the case of cartilage tumors, it is likely to be the embryonic remnants of the growth plate.
Symptoms, complaints, and signs
Enchondroma is usually associated with very few complaints and symptoms. For this reason, the disease is also diagnosed and treated relatively late. Those affected suffer primarily from swelling. These occur mainly on the fingers or hands, but are not associated with pain. Pain is very rare with enchondromas. The tumor is usually discovered only by chance. Further complaints do not occur due to the enchondroma. However, the tumor itself can spread in the body if the disease progresses unfavorably, and metastasis can occur. In this case, tumors form in various parts of the body, usually leading to the death of the affected person. An enchondroma can also lead to a thickening of the bone in the further course. In this case, the swelling increases and pain may occur. Due to the pain, many patients also suffer from restricted mobility and thus considerable limitations in everyday life, which leads to a significantly reduced quality of life. As a rule, an enchondroma can be removed relatively well and without complications if diagnosed early. However, it is not possible to make a general prediction about the life expectancy of the affected person.
Diagnosis and progression
In enchondroma, as mentioned above, the patient rarely suffers from pain. Most often, the benign, that is, the benign tumor is diagnosed on X-ray for other reasons, that is, by chance. As a diagnostic method, first of all, imaging techniques are used. In addition to X-rays, computer tomography, MRI, and less frequently scintigraphy are used. Only in doubtful cases a biopsy is performed. In a biopsy, a tissue sample is taken from the affected cartilage mass with a needle-like instrument. The tissue sample is then examined in the laboratory to rule out the possibility that it is a malignant cartilage tumor. Then, if a life-threatening chondrosarcoma is eventually diagnosed, other treatment steps are taken. Enchondromas are most frequently found in the fingers, i.e. about two thirds of them. More precisely, they are the long tubular bones of the fingers. More rarely, benign tumors occur in the foot area, the toes. The calcifications on the cartilage mass can also be diagnosed on the pelvic scapula, on the femur, i.e. the thigh bone, on the humerus, i.e. the upper arm bone. If enchondromas are more likely to occur close to the trunk, they should be thoroughly removed. It was observed that the location of cartilage tumors has some influence on whether benign enchondromas can develop into malignant chondrosarcomas. Enchondromas grow rather slowly and remain unnoticed by the body. Nevertheless, it must be ruled out that the cell degeneration is not a malignant tumor after all. If it is a syndrome concerning the enchondroma, that is, if there is an excessive accumulation of the phenomenon, the attending physician should also be much more vigilant against malignant tumor development.To name two syndromes in which there is a multiple occurrence of enchondromas, Ollier syndrome and Mafucci syndrome should be mentioned. In both, degeneration to chondrosarcoma may become likely.
Complications
In most cases, enchondroma does not result in complications. The symptom requires treatment in only a few cases, and in this case it does not represent a health complication for the patient. Only in some cases the patient is affected by pain, which he often does not know immediately to assign to an enchondroma. If pain does occur, it is usually not very severe. Sometimes there may be a thickening of the bone, so there may also be a restriction of movement. This reduces the patient’s quality of life. The growth can also cause more severe pain, in which case the enchondroma must be treated. The treatment itself is performed as a surgical procedure, aiming at the complete removal of the tumor. In most cases, the patient must have follow-up examinations after the operation to prevent the tumor from forming again. Life expectancy is not reduced by an enchondroma if the cancer does not spread to other regions of the body. After the treatment, the movement restrictions also disappear completely, so there are no further complications.
When should you go to the doctor?
An enchondroma is usually a benign growth on the bone, so there is no need for immediate medical and drug treatment. Most often, enchondromas develop on the finger or toe bones, although the formation of an enchondroma elsewhere is not excluded. Since an enchondroma belongs to the group of tumors, it should always be examined by an appropriate physician. Only such treatment can determine whether it is a benign or malignant tumor. If it turns out to be a benign tumor, there is no need for subsequent treatment by a physician. As long as there are no changes in size, discoloration or pain, there is no need to see a doctor. However, if a change does occur, the visit to the doctor should not be put on the back burner. The first signs of a change should be assessed by a doctor as soon as possible.
Treatment and therapy
In many cases, an enchondroma is entirely harmless and can often be left without treatment. Nevertheless, observation of the bone area is often advised because the risk of chondrosarcoma may remain latent. The therapy is therefore done after an imaging diagnosis and in case of doubt with the addition of a tissue sample from the bone mainly with observing behavior of the treating physician. However, if the enchondroma proliferates into a malignant chondrosarcoma, a cartilage cancer, bone mass is surgically removed and replaced with tumor endoprostheses. These are usually artificial joints that provide a high degree of comfort. However, malignant cartilage cancer is very rare in the phalanges.
Outlook and prognosis
The prognosis of enchondroma depends on the course of the disease as well as other previous diseases. There are patients who, despite the cartilaginous tumor, experience no impairment in everyday life and are symptom-free. In these cases, no treatment is necessary and the patient can continue to live with the enchondroma until his or her demise. A shortening of life is not to be expected. If a malignant tumor is diagnosed, surgery is often performed with removal of the mutated cartilage. Depending on the size of the enchondroma, follow-up treatments or therapies may be necessary to improve range of motion. There is a possibility of a cure. However, permanent damage can also occur that is not treatable. In severe cases, artificial joints or bones are implanted in the patient to ensure improvement in mobility. In addition, the enchondroma may have developed due to an underlying disease. These syndromes are called enchodromatoses and must be diagnosed as well as treated. The patient is then given an assessment of the prospects for recovery. If the affected person suffers from other bone or joint diseases, his prognosis worsens. In the case of a chronic disease, a cure cannot be assumed.In all possible forms of enchondroma, regular checkups are necessary to assess changes and respond promptly.
Prevention
Since the causes are almost unknown, only general things can be advised as prophylactic measures. A healthy lifestyle, as well as the renunciation of carcinogenic poisons such as those from tobacco consumption and the like are advisable. A varied cuisine, enough outdoor exercise and paying attention to mental balance always have a positive effect on good vitality.
Aftercare
In most cases of enchondroma, the options for aftercare prove to be relatively difficult. The focus is also on direct and medical treatment of the affected person by a medical professional in order to completely treat and remove the tumor. Early diagnosis and early treatment are also very important to prevent the further spread of the tumor in the body. Even after successful treatment of the enchondroma, regular examinations should be done to detect and treat further tumors early. In most cases, the enchondroma can be treated and completely removed by surgery. This does not result in any other particular complications. However, after the operation the patient should always rest and take care of his body. The patient should refrain from exertion or other stressful activities in order not to slow down the healing process. Patients suffering from enchondroma are often dependent on the support of friends and family. Intensive conversations can be very helpful, especially in cases of psychological discomfort. In most cases, the enchondroma can be removed relatively well, so that there is also no reduced life expectancy of the patient.
What you can do yourself
People affected by benign cartilage proliferation rarely complain of symptoms or discomfort. Also, the benign nature of enchondromas argues against the need for a therapeutic approach. Nevertheless, even after surgical removal of the cartilage tissue, those affected should consult their physician regularly in order to be able to recognize a possible neoplasm at an early stage. A degeneration of the harmless tumor into a malignant bone tumor can also be detected or ruled out in good time by regular screening. Patients should undergo regular X-ray examinations once a year to clarify the findings. In the case of more pronounced swellings that lead to pain and greater restrictions in everyday life, surgical removal of the tumor tissue is indicated. Patients who have decided against surgery should adjust their lifestyle accordingly and refrain from taking unnecessary risks by placing greater stress on the bone area in question. This is because enchondromas contribute to a weakening of bone strength and increase the risk of fractures in the affected areas. Therefore, high-risk sports as well as higher, overly one-sided physical stress in leisure time and at work should be avoided. The same applies in particular after an operation, which calls for the affected area to be immobilized as far as possible for a few weeks. The healing process of the irritated nerve pathways proceeds all the faster, the longer and more consistently the operated region is spared.
