Juxtacortical chondroma

Case contributed by Dr Vinay V Belaval

Presentation

Pain and swelling of right thumb for one month

Patient Data

Age: 30 years
Gender: Female
MRI

Axial and coronal MRI images of right thumb demonstrate well-defined T2w slightly hyperintense, PD fat-sat hyperintense and T1w isointense juxtacortical lesion along the medial (ulnar) surface of the shaft of proximal phalanx of thumb with surrounding inflammatory edema. There is saucerisation (remodelling due to pressure effect) of the underlying cortex; however, there is intact T2w hypointense cortex. Mild marrow edema is noted in the proximal phalanx. 

CT

Corresponding CT sections in bone window demonstrate lytic nature of proximal phalangeal juxtacortical lesion with faint peripheral calcifications and thinning of the underlying medial cortex. No intralesional calcifications noted.

Case Discussion

MRI of right thumb showed well-defined PDW hyperintense juxtacortical lesion along the medial surface of proximal phalanx with thinned-out and intact underlying cortex. CT sections of the lesion showed faint peripheral wall calcifications. Mild surrounding inflammatory soft tissue edema was seen. These features were suggestive of juxtacortical chondroma. 

The patient underwent surgical excision of the lesion. Histopathology showed a benign lesion comprised of lobules of mature chondroid areas surrounded by sparse spindle cells and mature bony trabeculae. Histopathological features were consistent with juxtacortical (periosteal) chondroma,

Juxtacortical chondromas are benign cartilaginous tumors arising within the periosteum. It is commonly seen in young patients.

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Case information

rID: 63471
Published: 9th Oct 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Belcity Scan and Diagnostic Centre

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