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Pathology – Benign Bone Tumors
I. Osteochondroma
I. Osteochondroma
- Definition: Benign bone-forming tumour.
- Location: Solitary exophytic nodule arising from the metaphysis of long bones near the epiphyseal growth plate.
- Population: Common in children.
- Histology:
- Outer fibrous perichondrium.
- Cartilage cap.
- Underlying bony stalk.
- Key takeaway: Think "bone spur" growing outwards from the growth plate of a long bone in a child.
- Definition: Benign cartilage-forming tumour.
- Location: Two main types:
- Enchondromas: Medulla of bones (hands and feet are common).
- Periosteal chondromas: Surface of bone (proximal humerus is characteristic).
- Presentation: Often discovered incidentally (no symptoms).
- Histology: Chondrocytes within an abundant cartilaginous matrix.
- Key takeaway: Cartilage-based tumour, location distinguishes the subtypes.
- Definition: Benign bone-forming tumour.
- Location: Long bones of children/young adults (proximal femur is common).
- Presentation: Characteristic nocturnal pain.
- Radiographic Appearance: Small lucent nidus (<1cm) on plain radiographs.< />pan>
- Histology: Well-circumscribed, hypervascular area of bony trabeculae surrounded by reactive bone.
- Key takeaway: Small, painful lesion easily visualized on X-ray; pain is a key clinical feature.
- Definition: Benign, but locally aggressive neoplasm.
- Location: Ends of long bones.
- Population: Young adults (20-45 years).
- Presentation: Pain and swelling at the tumour site.
- Histology: Sheets of neoplastic ovoid mononuclear cells with interspersed large osteoclast-like giant cells.
- Prognosis: ~25% local recurrence rate after excision. Distant metastasis is rare.
- Key takeaway: Although benign, its local aggressiveness and potential for recurrence are significant.
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