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Soft-tissue chondroma is an infrequent, benign, cartilaginous tumour that is uncommon in the head and neck region. Single-location chondromas rarely evolve into malignant neoplasms. Chondromas are composed of hyaline cartilage with focal calcification. There have been a few reports published of cases of soft-tissue chondroma of the neck and parapharyngeal space. Here is described a new location of this tumour in the masticatory space.
Periosteal chondroma is a rare benign tumor of hyaline cartilage. It develops adjacent to the cortex of the bone and is rimmed by an intact periosteal membrane. Periosteal chondromas are most common in the metaphyses of long bones followed by the small tubular bones of the hands and feet. Periosteal chondroma arising in the rib is an extremely rare event. We could only find 10 reported cases in the English literature. We present a case of periosteal chondroma in the rib discovered incidentally on chest x-ray of an 11-year-old girl.
A case of chondroma which occurred in the midline of the dorsum of the tongue in a 40-year-old Japanese male is reported together with a review of the literature. Histological investigation revealed that this lingual chondroma had the characteristics of hyaline cartilage. We regard the metaplastic transformation theory as the best explanation of histogenesis of lingual chondroma at the lateral margin, while cartilaginous rests are the origin of lingual chondroma on the dorsum of the tongue.
Chondroma of the laryngeal cartilage is an uncommon benign cartilaginous neoplasm. The commonest location is the posterior lamina of the cricoid cartilage, followed by the thyroid cartilage. The occurrence of chondroma in the epiglottis is extremely rare. Depending on the size and location of epiglottic chondroma the clinical manifestations are variable and include a lump in the neck, difficulty in swallowing fluids and dyspnea. In this study, an additional rare case of chondroma arising in the epiglottis is reported. The mass was located over the tip of the epiglottis and caused no significant clinical manifestations except for a foreign body sensation in the throat. Endoscopic excision with an adequate free margin was achieved via suspension laryngoscopy under general anesthesia with intubation. The patient was disease-free during a 1-year follow-up period. We present this case to highlight the occurrence of this rare benign lesion in the epiglottis, and stress that it should not be neglected in the differential diagnosis of an epiglottic mass. Conservative surgical excision is the initial treatment of choice and long-term follow-up is necessary.
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 cases of extraskeletal 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 pericellular 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.
BACKGROUND: Soft tissue chondroma, though rare, is well known to histopathologists and radiologists. Cytologic features of soft tissue chondroma mimic those of its malignant counterpart to a considerable extent. To our knowledge, this is the first case in which the aspiration cytology of soft tissue chondroma is described as an aid to definitive diagnosis. CASE: A 54-year-old male presented with a 6 x 5-cm swelling on his right forearm that had existed for 20 years. Its extraskeletal location was confirmed. Aspiration cytology showed myxofibrillary material and pleomorphic cells. CONCLUSION: The clinical, radiologic and cytologic triad is important for the correct cytologic diagnosis of soft tissue chondroma despite worrisome cell atypia.
Lingual chondromas are very rare tumors. It can be assumed that chondromas of the tongue develop from heterotopic embryonal cartilage. Chondromas are usually seen on the lateral borders of the tongue. Because chondrosarcomas can appear in this location, wide excision of the lesions should be performed. The CO2 laser facilitates the excision, providing a dry surgical field. Two cases of lingual chondroma are presented and their probable cause discussed.
DNA flow cytometric analysis was performed for prediction of malignancy potential, and hence of outcome, in 17 patients aged 29-76 (mean 52) years with cartilaginous tumour of the chest wall. Histologically there were nine chondromas and eight chondrosarcomas. The chondrosarcomas (3 grade I, 4 grade II, 1 grade III) were significantly larger than the chondromas (13.6 +/- 7.8 vs 4.2 +/- 2.0 cm, p < 0.001). DNA flow cytometry was performed on paraffin-embedded blocks of resected tumour. In eight of the 17 tumours (6 chondromas, 1 grade I and 1 grade II chondrosarcoma) measurement of DNA content failed because of low cellularity and severe calcification. Aneuploid DNA content was detected only in three chondrosarcomas (2 grade II, 1 grade III). The synthetic phase fraction was less than 15% in all the studied chondromas, but exceeded 25% in four of six chondrosarcomas. This case series though small, may indicate a trend towards association between higher histologic grading and greater incidence of aneuploidy with higher synthetic phase fraction. Tumour size, histologic grade, DNA ploidy and adequacy of surgical resection are the main influences on prognosis.
Over a 9-mo period, three adult ball pythons (Python regius) (one male, two females) were evaluated for severe dyspnea. Partial obstructions of the tracheal lumen were identified radiographically and/or visualized with a 3.0-mm rigid laparoscope inserted into the tracheal lumen in all three snakes. Administration of systemic antibiotics and nebulization resulted in partial improvement of the dyspnea. In two snakes, the tracheal lesions were removed with a rigid laparoscope and a flexible biopsy instrument inserted into the tracheal lumen. The other snake died and was necropsied. Histologically, the lesions from two snakes were determined to be benign chondromas. The chondromas were composed of a variably disorganized chondroid matrix populated by quiescent, normal-appearing chondrocytes within lacunae, although the chondrocytes were increased in density compared with normal hyaline cartilage and contained rare mitotic figures. The tracheal masses in one snake grew by expansion, not invasion, and were focally continuous with a mineralized cartilage tracheal ring, suggesting a benign nature. This is the second report of tracheal chondroma in ball pythons. Tracheal chondromas are exceedingly rare in humans and domesticated animals, suggesting a possible predisposition of ball pythons for this neoplasm.
OBJECTIVE: We report a case of cricoid chondroma, underlining the difficulty in establishing a precise differential diagnosis between chondroma and low-grade chondrosarcoma of the larynx. MATERIAL AND METHODS: A 48-year-old woman developed inspiratory dyspnea. The final diagnosis was cricoid chondroma. We reviewed our case and data in the literature on these cartilaginous tumors. RESULTS: The patient was treated with conservative surgery. At 18 months follow-up, no recurrence has been detected. DISCUSSION: These tumors are rarely found in an ENT location and have similar histological features. According to many authors, the clinical course alone enables a distinction between chondroma and low-grade chondrosarcoma. Surgical treatment is indicated and provides good phonatory function in the vast majority of the cases.
Juxtacortical chondroma is the less common of the two varieties of chondroma which may develop in the hand. Two cases are reported, and the authors review the clinical, radiological, pathological and therapeutic data concerning this tumour which was first individualized by Lichtenstein and Hall in 1952. Clinicians should be well informed on the characteristics of juxtacortical chondroma, since its differential diagnosis with a malignant lesion may be extremely difficult, even at histology, and since conservative surgery with complete excision of the chondroma usually results in permanent cure.
The discovery of an image of central bone calcification raises the differential diagnosis of bone infarction and chondroma. The matrix of chondroma is characteristic of cartilage. It produces typical cartilaginous calcifications: rings, arcs, coarse, irregular grains, moth-eaten appearance. These calcifications are predominantly observed in the centre of the image. They are situated in a bone defect, often multilocular, sometimes accompanied by multiple scratch marks of the cortical endosteum. In contrast, infarction is characterized by the presence of a serpiginous calcified border at the interface between live bone and dead bone. In the centre, the bony trabeculae are still visible on CT sections, in contrast with chondroma. On MRI, chondromas present a heterogeneous lobular appearance on T2-weighted sequences (checkerboard appearance) due to alternating zones of high signal intensity cartilaginous matrix and low signal intensity calcified or ossified fibrous septa. On MRI, bone infarction is characterized by a continuous peripheral line with a marked low signal intensity.
Seventy-one hamarto-chondromas were operated on at the Centre Chirurgical Marie-Lannelongue from January the 1st 1958 to September the 1st 1975. Pulmonary hamarto-chondroma is always a slowly evolving benign tumour, usually found in patients between 40 and 60, and twice as frequent in males as in females. There are two different kinds. 1) Intraparenchymal hamarto-chondromas, which have a noteworthy clinical latency and in 2 cases out of 3 are situated anteriorly and peripherally. The usual treatment consists of simple enucleation. 2) Endobronchial hamarto-chondromas, on the other hand, have a striking symptomatology of bronchial obstruction. If operated on after some delay, they will cause the destruction of distal parenchyma. Treatment depends on their topography. Segmental resection is often the sole recourse.
More than 200 cases of chondroma of the larynx, a rare benign tumor, have been reported in the literature. The majority of these tumors arise from the cricoid cartilage on the anterior surface of the posterior lamina. Treatment consists of total excision. If the removal requires resection of a portion of the cricoid ring, leaving the larynx unstable and prone to collapse, then total laryngectomy is usually performed. A new method of reconstruction was used in two additional cases of chondroma of the larynx after removal of half of the cricoid ring, without the need for total laryngectomy, Large chondromas originated from the anterior surface of the posterior cricoid lamina in both of these cases. Treatment consisted of total removal of the tumor, after which only the anterior and lateral cricoid lamina remained. Follow-up at 2 1/2 and 1 1/2 years, respectively, has not shown any evidence of tumor recurrence, airway compromise, or laryngeal collapse. This new reconstructive procedure may obviate the need for total laryngectomy when the integrity of the cricoid ring must be violated for benign tumor.
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.
A case of intracortical chondroma in the left femur in a 22-year-old man is presented. Proof was obtained by open biopsy. The issue of periosteal vs intracortical chondroma was discussed in depth, with emphasis on the radiographic appearances. The differential diagnosis of this benign intracortical lesion was also included. The histopathologic characteristics of this intracortical chondroma were described and a possible explanation for the unusual location of the cartilage lesion within the cortex was considered.
We describe herein the case of a 45-year-old man who developed a periosteal chondroma in a rib at the site of a thoracotomy that had been performed 24 years previously. To our knowledge, this is only the third case of a periosteal chondroma in a rib to be documented in the world literature. Some authors have suggested that trauma, including that of surgery, may induce chondroma formation and this association could have been an important contributing factor in the induction of the tumor in this patient.
Chondromas are tumours that develop in relation to the periosteum and, although they are common around the knee, most reports deal with soft tissue chondromas in para-articular locations or intracortical tumours in extra-articular regions. We report a rare case of an intra-articular chondroma in a 16-year-old boy of Asian origin developing in the region of the medial femoral condyle of the femur and extending into the femoral sulcus and the patellofemoral joint.