An osteochondroma is a benign form of tumor on the bone. Similar types of tumors include so-called ecchondromas, which develop into an osteochondroma as a result of ossification processes. The tumor arises from an area of the bone located near a joint (medical term metaphysis).
What is an osteochondroma?
Osteochondroma is also known synonymously as cartilaginous exostosis. In principle, it is a benign tumor of the bones. Osteochondromas occur in the majority of cases near the joints. They emerge from the bone in a stalk-like manner. The so-called long tubular bones are particularly frequently affected by osteochondromas. Basically, the tumors often resemble mushrooms in their shape. Female patients are less likely to develop osteochondromas than males. Osteochondromas are among the most common types of tumors of the bones. In numerous cases they develop already in infantile patients. After the growth processes of the bones are completed after puberty, osteochondromas usually stop growing. Osteochondromas are generally characterized by the fact that they cause symptoms in only a few cases. Impairments caused by the tumor usually only result when other areas in the vicinity of the osteochondroma are squeezed. These are, for example, blood vessels or nerve tracts. In the majority of cases, osteochondromas also do not show any pressure pain. Therapeutic interventions are only necessary if complaints occur. In this case, the osteochondroma is usually removed completely. In general, osteochondromas are characterized by a relatively positive prognosis, with degeneration occurring extremely rarely.
Causes
The exact causes for the development of osteochondromas are not known. In the majority of cases, the tumors of bone develop in the region of the external femur. The proximal humerus bone is also often affected by an osteochondroma. The growth of the osteochondroma takes the form of a stalk or fungus. In some cases, an osteochondroma leads to malformations in the surrounding bone area due to space-occupying lesions.
Symptoms, complaints, and signs
Osteochondromas manifest themselves in various signs and symptoms. In most cases, tumors of the bones stop growing before the end of the second decade of life. In this case, the affected area often appears swollen, although individuals do not experience pain. Actual discomfort from the osteochondroma often only occurs when nearby nerve fibers, muscles, or blood vessels are crushed or displaced by the tumor. In this case, the diseased patients feel pain in the neighboring muscles, for example. In numerous cases, however, osteochondromas do not show any symptoms. Some affected individuals are too short for their age. It is also possible that arms or legs have a different length.
Diagnosis and course of the disease
The diagnosis of osteochondroma is based on the typical symptoms of the tumors. In the case of characteristic changes in the bones, an appropriate physician should be consulted for the signs. In the first step, this doctor discusses the present complaints as well as their onset and potential factors of origin within the framework of a medical history. A family history may provide significant indications of the presence of the disease if there are similar cases in the family. The physician then examines the individual signs of the disease using various procedures. As a rule, it is particularly important to perform an X-ray examination. This is because such imaging procedures usually make the osteochondroma relatively visible. If there is still doubt, a CT scan is also used. An MRI scan can determine how thick the cartilaginous cap is. In this way, the risk of degeneration of the tumor can be assessed. The attending physician also performs a thorough differential diagnosis to rule out diseases with similar signs. First and foremost, he examines whether the affected patient suffers from a so-called familial osteochondromatosis.
Complications
Even benign bone tumors such as osteochondroma can result in complications.Thus, affected individuals often suffer from the fear that the benign tumor will degenerate into a malignant cancer with life-threatening consequences. As a result, patients often exhibit listlessness, mood swings or depression. Another consequence of osteochondroma is the displacement of neighboring blood vessels and tissue. Depending on the location of the benign tumor, this leads to feelings of constriction. There is also a risk of loss of function of certain organs. If the osteochondroma exerts pressure on adjacent nerves, vessels or muscles, this process results in an undersupply of the organs, which in turn triggers functional disorders. In some cases, an osteochondroma has a restrictive effect on the patient’s movements. Thus, joint activities become limited or even completely impossible. As a result, the affected person can only move around to a limited extent or requires a walking aid. Some patients suffer from psychological problems due to a benign bone tumor. Because movement is restricted, this not infrequently leads to an increase in weight, which in turn puts strain on the bones. Likewise, greater stresses occur on the healthy skeletal system. The result is overexertion or problems with nerves and muscles. If an osteochondroma is treated surgically, further complications are possible. These are mostly damage to adjacent structures, bleeding, bruising, wound healing problems or infections.
When should you see a doctor?
Excessive bone growth always requires medical attention. Anyone who notices bone pain or poor posture may be suffering from osteochondroma, which must be medically diagnosed and treated. If other signs are noticed, such as fever or unusual cardiovascular complaints, hormonal changes or disorders of the immune system, the family doctor should be consulted. Affected individuals can also consult the orthopedist or a specialist in internal medicine. People who have already suffered from cancer are particularly at risk. Risk factors such as working in a contaminated area or contact with cancer-causing substances must also be clarified. Older people over the age of 40 should have regular cancer screening. It is also indicated to see a doctor at the first suspicion. If osteochondroma is detected early, treatment is promising. In contrast, an untreated bone tumor can spread and, in the worst case, be fatal. Treatment involves surgeons, physiotherapists, orthopedists and general practitioners. Depending on the symptom picture, other specialists may be consulted, for example, the oncologist or phlebologist.
Treatment and therapy
Therapeutic measures mainly depend on the symptoms as well as the size of the osteochondroma. This is because treatment of benign bone tumors is not necessary in all cases. However, if the affected patients suffer from unpleasant symptoms, the osteochondroma is usually removed. The resection is performed as part of a surgical procedure. Such removal is indicated especially if the individuals suffer from pain, malformations of nearby bone areas develop, or joint function is impaired by the osteochondroma. Osteochondroma should be removed as soon as possible especially if malignant degeneration is suspected. In particular, resection is usually advised for osteochondromas in the area of the spine, upper arm and thigh, and pelvic bone. This is because potential degeneration of the osteochondroma may be associated with significant complications. In principle, however, the prognosis for osteochondroma is comparatively good. In most cases, the osteochondroma does not grow further after the end of bone growth in puberty. If the osteochondroma maintains its size, malignant degeneration is very rare.
Outlook and prognosis
The prognosis of osteochondroma is generally favorable. It is a benign tumor that causes various symptoms but does not result in a shortening of average life expectancy. However, a prerequisite for a good outlook is medical treatment. In addition, good aftercare should be provided in the further course. The tumors that have developed are normally completely removed in a surgical procedure.If the operation proceeds without further complications, the patient can usually be discharged from treatment after the wound has healed. In order to be able to diagnose future changes and abnormalities at an early stage, regular check-ups should take place throughout the patient’s life. In many patients, an increased risk of developing a mental illness can be documented due to the emotional stress of the disease. This should be taken into account when making the overall prognosis. Relapse may occur even after complete recovery. Re-development of osteochondroma is possible at any time. However, the prognosis remains favorable in these cases if cooperation with a physician is sought early. Without treatment, growths are to be expected and, as a result, impaired range of motion. The tumors that develop increase in size. There is also an increased likelihood of additional changes in the tissue.
Prevention
There are no measures for the prevention of osteochondromas whose effectiveness has been demonstrated in relevant medical research studies. Instead, the focus is on regular medical checkups of tumors on the bones and eventual removal of the osteochondroma.
Follow-up
In the case of an osteochondroma, aftercare measures are usually significantly limited. In some cases, they are not even available to affected individuals; this is the case when the tumor was detected very late and the prospects for cure are very slim. Ideally, therefore, those affected should consult a doctor at the first signs and symptoms of the disease, so that complications or other complaints do not arise in the further course of the disease. The earlier a doctor is consulted, the better the further course of the disease often is. In most cases, the tumor can be removed by surgery. Affected persons should rest and take care of their body after the operation. They should refrain from exertion or stressful and physical activities in order not to put unnecessary strain on the body. Likewise, even after successful removal of the tumor, regular checks and examinations by a doctor are very important in order to detect and remove further tumors at an early stage. The further course of osteochondroma is strongly dependent on the time of diagnosis, so that a general course cannot be predicted. However, under certain circumstances, this disease also reduces the life expectancy of the affected person.
What you can do yourself
When an osteochondroma is diagnosed, it initially comes as a great shock to patients. A tumor disease brings anxiety and changes in life, which should be worked through therapeutically. Treatment also includes a change in diet. To compensate for the weight loss that accompanies therapy, a lot of vegetables, cheese, yogurt, cottage cheese and fish should be eaten. Meat and sausage should be avoided, as the high content of arachidonic acid can weaken the immune system and promote inflammation. If there is a loss of appetite, high-calorie liquid food from the pharmacy is a good option. Moderate sport is recommended, although the localization of the osteochondroma is decisive here. If the arms or legs are affected, only certain types of sport may be practiced. Otherwise, pain and other complaints may occur. Patients should consult the relevant specialists regarding diet and sports in order to receive the best treatment. After surgery, the usual aftercare measures apply. Patients should initially take it easy and make sure that the surgical wound heals without complications. If any discomfort occurs, the physician must be informed.