|Title : Case 685|
Age / Sex : 47 / M
Chief complaint : Palpable hand mass
About 1.1 x 1.7 x 1.0cm sized exophytic mass in the right 3rd metacarpal bone.
- with intramedullary location and cortical expansion
- with lobulated shape and circumscribed margin
- with peripheral and septal enhancement
Osteochondroma, Periosteal chondroma
Enchondroma protuberans (EP)
- rare form of enchondroma which demonstrates exophytic growth outside the margins of the bony cortex
- common site: hand (usually in the phalanges or metacarpal bones) > ribs > long bones of the arm
- Radiographs of EP typically show a well-defined geographic, osteolytic intramedullary lesion that may have poorly defined matriceal calcification combined with a cortical defect and well-defined round soft-tissue expansion. Although EP can usually be diagnosed using only radiographs, some cases could not be positively diagnosed using radiography alone because it did not reveal the protruded mass or the cortical defect. The MR images clearly delineated the connection between the intramedullary lesion and the exophytic protrusion through the cortical defect as well as the tumors themselves, which resulted in the diagnosis of EP.
- Osteochondroma: presence of a cartilage cap with underlying trabecular bone
- Periosteal chondroma: periosteal location and lack of communication of the lesion with the medullary canal
Tip. Enchondroma typically appears as an intramedullary lucent lesion without mineralization at hand. However, if bone mass of the hand appears to be an exophytic mass with the characteristics of a chondroid tumor, consider enchondroma protuberans.
HS Kang, JM Ahn, Y Kang. Oncologic imaging: Bone tumors. Springer. 2017
A Kord, B Kravis, S Rsotami. Enchondroma protuberans of the hand: A case report. Radiology case report. 2020 15(7):943-946
An YY, Kim JY, Ahn MI. Enchondroma Protuberans of the hand. Am J Roentgenol. 2008 190(1):40-4.
|Total applicants||33||Correct answers||10|
|윤유성||순천향대 부천병원, 전문의|
|장민영||국민건강보험공단 일산병원, 전문의|
|Total applicants||33||Semi-Correct answers||9|
|박선영||한림대학교 성심병원, 전문의|