OBJECTIVE: Our aim was to evaluate the cartilage cap of osteochondromas using T2 maps and to compare these values to those of normal patellar cartilage, from age and gender matched controls. MATERIALS AND METHODS: This study was approved by the Institutional Review Board and request for informed consent was waived. Eleven children (ages 5-17 years) with osteochondromas underwent MR imaging, which included T2-weighted fat suppressed and T2 relaxation time mapping (echo time = 9-99/repetition time = 1500 msec) sequences. Lesion origins were femur (n = 5), tibia (n = 3), fibula (n = 2), and scapula (n = 1). Signal intensity of the cartilage cap, thickness, mean T2 relaxation times, and T2 spatial variation (mean T2 relaxation times as a function of distance) were evaluated. Findings were compared to those of patellar cartilage from a group of age and gender matched subjects. RESULTS: The cartilage caps showed a fluid-like high T2 signal, with mean thickness of 4.8 mm. The mean value of mean T2 relaxation times of the osteochondromas was 264.0 +/- 80.4 msec (range, 151.0-366.0 msec). Mean T2 relaxation times were significantly longer than the values from patellar cartilage (39.0 msec) (p < 0.0001). These findings were observed with T2 spatial variation plots across the entire distance of the cartilage cap, with the most pronounced difference in the middle section of the cartilage. CONCLUSION: Longer T2 relaxation times of the cartilage caps of osteochondromas should be considered as normal, and likely to reflect an increased water content, different microstructure and component.
Adolescent ; Bone Neoplasms/*pathology ; Cartilage, Articular/*pathology ; Child ; Child, Preschool ; Female ; Femur ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Osteochondroma/*pathology ; Patella/*pathology ; Retrospective Studies ; Tibia

Adult ; Bone Neoplasms ; pathology ; surgery ; Femur ; pathology ; surgery ; Humans ; Male ; Osteochondroma ; pathology ; surgery ; Young Adult

Acute Disease ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Osteochondroma ; diagnosis ; pathology ; therapy ; Spinal Neoplasms ; diagnosis ; pathology ; therapy

Various types of tumor can occur in the subungual space, including glomus tumors, subungual exostosis, hemangioma, epidermal cysts, and malignant tumors. While fibromatosis can occur at various sites throughout the body, it is very rarely seen in the toe. Here, we are the first to report a case of superficial fibromatosis mimicking a glomus tumor in the subungual space of the second toe. The presentation of this condition shows the possibility of encountering uncommon superficial fibromatosis in the distal phalanx of the toe, and suggests that superficial fibromatosis should be included in the differential diagnosis of a glomus tumor in the toe.
Adult ; *Fibroma ; *Glomus Tumor ; Humans ; Male ; *Osteochondroma ; *Toes/pathology/surgery

Adult ; Bone Neoplasms ; pathology ; surgery ; Femur Neck ; pathology ; Humans ; Male ; Osteochondroma ; pathology ; surgery

Bone Neoplasms ; diagnostic imaging ; pathology ; secondary ; surgery ; Chondrosarcoma ; diagnostic imaging ; pathology ; secondary ; surgery ; Fingers ; Humans ; Male ; Middle Aged ; Osteochondroma ; pathology ; Radiography

Adolescent ; Calcaneus ; diagnostic imaging ; Humans ; Male ; Osteochondroma ; diagnostic imaging ; pathology ; physiopathology ; Tomography, X-Ray Computed

Bone Neoplasms ; diagnostic imaging ; pathology ; Child ; Humans ; Male ; Osteochondroma ; diagnostic imaging ; pathology ; Scapula ; Tomography, X-Ray Computed

Adolescent ; Humans ; Male ; Osteochondroma ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo investigate the clinicopathologic, radiological and immunohistochemical characteristics of osteochondroma with malignant transformation.

METHODSThe clinical data, radiological imagings and hematoxylineosin stained histologic sections were reviewed in 463 cases of osteochondroma diagnosed in Shanghai 6th Hospital from 1991 to 2008, including 11 cases with malignant transformation. Immunohistochemical two-step staining was used to detect CK, vimentin, S-100 protein, p53 and c-myc expression in seven cases of osteochondroma with malignant transformation and 10 cases without malignant transformation. The relevant literature was reviewed.

RESULTSAmong the 11 cases with malignant transformation, five were single osteochondroma (5/408, 1.2%), and six were multiple osteochondromas (6/55, 10.9%). The male to female ratio was 10:1. These 11 cases were derived from femur (4 cases), tibia (3 cases), ilium (3 cases), shoulder bone (1 case) and pubis (1 case). There was one case that showed malignant transformation in both the femur and ilium. The mean ages for the malignant and non-malignant cases were 39.8 years and 20.4 years respectively. All the malignant cases showed large sized lesions with prominent calcification in the thick cartilage caps. The malignant component was low grade, peripheral chondrosarcoma (grade I-II). In some areas the tumor cells infiltrated the peripheral soft tissue and bone marrow. Of the seven cases with malignant transformation that had immunohistochemical staining, all were positive for vimentin and S-100 protein; p53 protein was positive in 2 of 7 cases.

CONCLUSIONSMalignant transformation of osteochondroma was usually encountered in multiple lesions. Most patients were more than 30 years old with a long clinical history and with a male predominance. These tumors showed thick cartilage caps with prominent calcification. The lobulated nature of the tumors was evident and they infiltrated the surrounding soft tissue. The sarcomatoid component was peripheral type, well differentiated chondrosarcoma. p53 mutation may explain part of the molecular mechanism in the malignant transformation.

Adult ; Aged ; Bone Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Cell Transformation, Neoplastic ; pathology ; Chondrosarcoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Exostoses, Multiple Hereditary ; diagnostic imaging ; metabolism ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Osteochondroma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Radiography ; S100 Proteins ; metabolism ; Tumor Suppressor Protein p53 ; metabolism ; Vimentin ; metabolism ; Young Adult