Prevalence of Enchondromas of the Proximal Femur in Adults as an Incidental Finding on MRI of the Pelvis

Abstract

Objective To determine the prevalence of enchondroma in adults as an incidental finding in the proximal femur on magnetic resonance imaging (MRI).

Materials and Methods A retrospective review of the MRI scans of the pelvis in a series of adult patients was conducted. All presented with nononcological musculoskeletal complaints. The site, size, and appearances of the enchondromas were identified according to criteria from previous studies.

Results A total of 1,209 proximal femora in 610 patients were reviewed and a total of 9 enchondromas were identified. These ranged from 0.6 to 2.5 cm in length (mean 1.3 cm). None showed aggressive features suggestive of malignancy. Three cases (33%) underwent follow-up MRI scans which showed no change in size or morphology.

Conclusion The prevalence on MRI of incidental enchondromas arising in the proximal femur is 0.7%. This is three to four times less common than seen in the proximal humerus and around the knee.

Keywords

enchondroma - proximal femur - MRI

Disclosure

No financial disclosure.

Publikationsverlauf

Artikel online veröffentlicht:
06. Oktober 2021

• References

• 1 Suster D, Hung YP, Nielsen GP. Differential diagnosis of cartilaginous lesions of bone. Arch Pathol Lab Med 2020; 144 (01) 71-82
• 2 Kransdorf MJ, Peterson JJ, Bancroft LW. MR imaging of the knee: incidental osseous lesions. Magn Reson Imaging Clin N Am 2007; 15 (01) 13-24
• 3 Douis H, Saifuddin A. The imaging of cartilaginous bone tumours. I. Benign lesions. Skeletal Radiol 2012; 41 (10) 1195-1212
• 4 Walden MJ, Murphey MD, Vidal JA. Incidental enchondromas of the knee. AJR Am J Roentgenol 2008; 190 (06) 1611-1615
• 5 Grainger R, Stuckey S, O'Sullivan R, Davis SR, Ebeling PR, Wluka AE. What is the clinical and ethical importance of incidental abnormalities found by knee MRI?. Arthritis Res Ther 2008; 10 (01) R18
• 6 Stomp W, Reijnierse M, Kloppenburg M. et al; NEO study group. Prevalence of cartilaginous tumours as an incidental finding on MRI of the knee. Eur Radiol 2015; 25 (12) 3480-3487
• 7 Hong ED, Carrino JA, Weber KL, Fayad LM. Prevalence of shoulder enchondromas on routine MR imaging. Clin Imaging 2011; 35 (05) 378-384
• 8 Crim J, Schmidt R, Layfield L, Hanrahan C, Manaster BJ. Can imaging criteria distinguish enchondroma from grade 1 chondrosarcoma?. Eur J Radiol 2015; 84 (11) 2222-2230
• 9 Sampath Kumar V, Tyrrell PNM, Singh J, Gregory J, Cribb GL, Cool P. Surveillance of intramedullary cartilage tumours in long bones. Bone Joint J 2016; 98-B (11) 1542-1547
• 10 Deckers C, Schreuder BHW, Hannink G, de Rooy JW, van der Geest IC. Radiologic follow-up of untreated enchondroma and atypical cartilaginous tumors in the long bones. J Surg Oncol 2016; 114 (08) 987-991
• 11 Davies AM, Patel A, James SL, Azzopardi C, Botchu R. An imaging protocol for the management of central cartilage tumours of the proximal fibula. Clin Radiol 2020; 75 (09) 714.e1-714.e6
• 12 Bovée JVMG, Bloem JL, Flanagan AM. et al. Central atypical cartilaginous tumour/chondrosarcoma, grade 1. In: WHO Classification of Tumours. Soft Tissue and Bone Tumours. 5th ed.. Lyon: WHO Classification of Tumours Editorial Board International Agency for Research on Cancer; 2020: 370-372
• 13 Skeletal Lesions Interobserver Correlation among Expert Diagnosticians (SLICED) Study Group. Reliability of histopathologic and radiologic grading of cartilaginous neoplasms in long bones. J Bone Joint Surg Am 2007; 89 (10) 2113-2123
• 14 Eefting D, Schrage YM, Geirnaerdt MJ. et al; EuroBoNeT consortium. Assessment of interobserver variability and histologic parameters to improve reliability in classification and grading of central cartilaginous tumors. Am J Surg Pathol 2009; 33 (01) 50-57
• 15 Afonso PD, Isaac A, Villagrán JM. Chondroid tumors as incidental findings and differential diagnosis between enchondromas and low-grade chondrosarcomas. Semin Musculoskelet Radiol 2019; 23 (01) 3-18
• 16 van de Sande MAJ, van der Wal RJP, Navas Cañete A. et al. Radiologic differentiation of enchondromas, atypical cartilaginous tumors, and high-grade chondrosarcomas-Improving tumor-specific treatment: a paradigm in transit?. Cancer 2019; 125 (19) 3288-3291
• 17 van Praag Veroniek VM, Rueten-Budde AJ, Ho V, Dijkstra PDS, Fiocco M, van de Sande MAJ. Study group Bone and Soft tissue tumours (WeBot). Incidence, outcomes and prognostic factors during 25 years of treatment of chondrosarcomas. Surg Oncol 2018; 27 (03) 402-408
• 18 Patel A, Davies AM, Botchu R, James S. A pragmatic approach to the imaging and follow-up of solitary central cartilage tumours of the proximal humerus and knee. Clin Radiol 2019; 74 (07) 517-526
• 19 Parlier-Cuau C, Bousson V, Ogilvie CM, Lackman RD, Laredo JD. When should we biopsy a solitary central cartilaginous tumor of long bones? Literature review and management proposal. Eur J Radiol 2011; 77 (01) 6-12
• 20 Davies AM, Patel A, James SL, Botchu R. A retrospective validation of an imaging protocol for the management of solitary central cartilage tumours of the proximal humerus and around the knee. Clin Radiol 2019; 74 (12) 962-971
• 21 Jurik AG, Hansen BH, Weber K. Solitary enchondromas-diagnosis and surveillance: Danish guidelines. Radiologe 2020; 60 (Suppl. 01) 26-32
• 22 Murphey MD, Flemming DJ, Boyea SR, Bojescul JA, Sweet DE, Temple HT. Enchondroma versus chondrosarcoma in the appendicular skeleton: differentiating features. Radiographics 1998; 18 (05) 1213-1237 , quiz 1244–1245