Anhondroma of the femur: causes, diagnosis, treatment methods
Recently, benign neoplasms in the body have started to appear more often among people. This is due to inheritance, ecology or poor nutrition - it is not known exactly. Often there is an endochondroma of the femur, which causes deformity of the limb and requires surgical intervention. This neoplasm consists of their cartilaginous tissue, which is located inside the tubular bones. The disease progresses without any signs, but large tumors can provoke a change in the limb segment. Sometimes there may be a fracture, which very rarely develops into a malignant tumor.
An endodroma is a benign tumor that consists of mature cartilage located in the anatomical zone where it should not be normal. Usually, the neoplasm is located in the bones, but there are cases of its presence in the lungs, mammary glands and brain. Thus, the femoral bone enchondrome accounts for about ten percent of all bone disease. The disease is manifested due to disruption of the process of bone formation during the intrauterine period and in the first few years of life. The tumor is a mature cartilage that has lost its structure, its cells are arranged disorderly, they are different in size and shape. It is covered with a perichondrium, inside which foci of ossification are observed. At the same time, tissue deformation occurs, which is characterized by the formation of cysts from the intercellular substance, which is diluted.
Gradually the tumor grows, multiple neoplasms are formed, accompanied by Muffucci syndrome. Therefore, such tumors by doctors are considered potentially malignant and require immediate removal. Thus, the enchondrome is a bloated single focus, in the center of which is an enlightenment having an irregular shape.
Etiology and epidemiology
In 50% of the disease is observed in people who are not forty years old. The disease produces at the age of eleven to sixteen years. Sex and nationality do not affect the development of the disease. Disease is detected randomly, mainly in pathological fractures. There is a tumor in the tubular bones, in their medullary canal. Half of the cases in the large bones reveal the endochondrum of the femur. Do you want to delete it or not? This issue should not arise, because in any case, surgery is required. Of all the neoplasms of a benign nature that affect the human skeleton, the enchondrome accounts for about ten percent. This disease affects young able-bodied people. Medicine can not accurately answer the question of what causes contribute to the development of the disease.
Currently, medicine knows the causes of the disease. It is established only that this anomaly does not arise when exposed to radiation or toxins, and is not related to the professional activity of a person. Doctors suggest that the cause of the endochondral femur is associated with rickets, injuries and inflammation in the bone tissues. In general, the pathology begins to manifest itself in childhood, so it is often found at the age of up to forty. In this case, the treatment should be immediate, as with time the risk of tumor growth into a malignant tumor increases.
Symptoms of the disease are poorly expressed. Tumors of a small size do not show any symptoms; in case of accidental examinations, the femoral bone enchondrome is detected: MRI, CT and X-ray. And these examinations are not connected with this disease in any way. If the tumor is huge, there is a deformity of the limb. Neoplasm is palpated as a dense formation, and pain can occur if the tumor is squeezed by the nearby nerves and vessels. Large endochondroses that have a location near the joints cause arthralgia, synovitis or restriction of movement. Since cartilage is not tight enough, the tumor does not withstand heavy loads, so the strength of the bone in the lesion is very low. A small injury can provoke in this place a fracture, which is accompanied by severe pain, limited movements. Often, the femoral bone enchondrome, whose treatment can only be surgical, exhibits such symptoms:
- pain at night, the strengthening of which can speak of the transition of the tumor into a malignant form;
- appearance of swelling and swelling in the lesion;
- frequent fractures of the femur;
- chronic pain syndrome, which is weakly expressed.
In this case, the enchondromas can be single( only one bone is affected) and multiple( multiple bones that are adjacent to each other).The symptomatology of these two types of tumors is no different.
Disease of the Olie and the Enchondroma
The disease of the Ollier is a congenital ailment, in which long tubular bones, in particular the metaphysis, are affected on the lower limbs. Pathological changes are clearly traced in the femur, they are characterized by a violation of ontogenesis, resulting in a lag in growth and deformation of the limbs of a person. In this case of the femoral bone aneurysm can be accompanied by hemangioma, fibroma, exostosis and so on. The treatment of such pathologies during the child's growth period is currently difficult, since relapses always appear when removing abnormal areas.
If you have signs of a disease, you need to contact an oncologist for a survey. The patient is prescribed a set of diagnostic procedures that are aimed at excluding malignant tumors. First, the oncologist examines the data on the symptoms, paying special attention to the nature of pain. Clear boundaries and an oval, elongated form have of the femur endochroma, CT and X-ray show the presence of endosteal sclerosis in the lesion zone, and also assess the integrity of the cortical bone layer and the structure of the neoplasm using these techniques.
In the long tubular bones there is a clearing in the form of a cloud, it can have dark areas, which indicates a calcification focus. In short bones, tumors have a uniform appearance, they occupy the diameter of the bone. If there is a suspicion of a malignant tumor, a biopsy is performed. In this case, the material is taken from several zones, since at the initial stage the malignant endochondrum of the femur can alternate with the sites of degeneration. MRI is performed to study soft tissues that surround the pathology. The final diagnosis is made after all the studies. On radiographic images, the formation has the form of spots of small size and light shade, which are located in the form of an arch or ring. Their size is usually about five centimeters.
Differential diagnosis of
Such a neoplasm must be differentiated with a bone giant cell tumor, cyst or chondrosarcoma. Especially difficult is diagnosed with a small malignancy of chondrosarcoma and an endochroma, as these two diseases have similar forms of visualization. Most similar diseases are excluded by MRI.It is difficult to a femoral bone enchondrome, whose treatment is only surgical, differentiates with ganglion intraosseous, metastasis of granulomatosis, sarcoidosis and tuberculosis of bones. Investigation of the material taken with biopsy allows one to distinguish the endochroma from other tumors. With the help of MRI, doctors distinguish this disease from a bone marrow infarction. Many doctors argue that the most difficult is the diagnosis of cartilaginous tumors, especially its forms: benign or malignant.
Many are wondering about how to cure an endochondrum of the femur. The answer is simple - because of the risk of a tumor degenerating into a malignant tumor, doctors recommend that it be removed after the diagnosis is made. Tumors that grow, excise, if the pathology of large sizes, apply grafts. If the femoral bone endocrine is aggressive, is there an operation? Doctors answer in the affirmative, because if you do not, it will grow beyond the boundaries of the bones. In this case, the tumor is scraped, and a special aggregate is placed in the cavity that is formed after surgery.
Normally, the endodroma does not recur. But in childhood this is possible, so operations usually do not take place. Segmental or ablastic bone resection is also used as a surgical treatment. In the absence of manifestations of the disease, the patient is recommended to be observed regularly with an oncologist in order to monitor the growth of the tumor. In the case of pathological fractures, first they are treated, and after that an operation is prescribed, the femoral bone enchondrome is also scraped.
When the late stage of the disease is observed, the tumor is removed along with the bone. The patient is fully restored in the postoperative period. He can be given a massage, physiotherapy treatment, exercise therapy in order for his motor activity to return to normal. It is worth paying attention to nutrition, it should be balanced and correct, it is recommended to lead an active lifestyle.
The prognosis for this disease can be favorable. But there is a risk of transformation of the tumor into a malignant one. This is especially true for large pathologies that are located near vascular or neural bundles, and it is also possible when the tumor grows into soft tissues, relapses after surgery.
At present exact causes of pathology are unknown, therefore, there are no special preventive measures. It is recommended to lead a healthy lifestyle, eat right, exercise physical culture. All this reduces the risk of a tumor. If women are in a position, they should monitor their health closely. It is not recommended to drink alcohol, drugs and nicotine. If you suspect a pathology, you need to consult an oncologist. Timely treatment can save the patient life.
Thus, the causes of the appearance of a cartilaginous tumor in young people are unknown to date. If it is found on the femur, then surgery is performed by physicians, since such a pathology can develop into a malignant neoplasm. Usually the prognosis of this disease is favorable, patients after rehabilitation are fully restored. Enhondroma has recently been observed more often than in the last ten years, but doctors say that this is not related to the effect on the body of radiation and the effects of various toxins.