Skip to main content
Erschienen in: Skeletal Radiology 7/2023

17.01.2023 | Scientific Article

Concurrent intraosseous cartilaginous lesions in patients with multiple osteochondromas identified on total-body MR imaging

verfasst von: Henk-Jan Van der Woude, Arnard L. Van der Zwan, Mark Flipsen, Chantal Welsink, S. John Ham

Erschienen in: Skeletal Radiology | Ausgabe 7/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To assess the prevalence of intraosseous cartilaginous lesions in patients with multiple osteochondromas based on total-body (TB) MRI examinations, used for screening purposes.

Subjects and methods

Between 2013 and 2020, TB-MRI examinations were performed in 366 patients with proven multiple osteochondromas syndrome, to rule out malignant progression. For this study, presence, or absence of intraosseous central or eccentrical chondroid lesions, defined as lobulated lesions with low signal intensity on T1-weighted images, replacing bone marrow and high signal intensity equal to fluid on T2-weighted images in the bone marrow of the meta-diaphysis of (one of) the long bones, were recorded in the long bones as part of a TB-MRI protocol.

Results

In 62 patients out of the 366 MO patients (17%), one or more intraosseous chondroid lesions (either enchondroma or atypical cartilaginous tumor) were detected. The age of the patients at time of diagnosis ranged from 17 to 61 years (mean, 36). Size of the lesions varied from 4 to 69 mm (mean, 16.3 mm). The most common location was the proximal femur (n = 29), followed by the distal femur and proximal humerus (n = 18 and n = 10, respectively). In nine of the patients with an intraosseous chondroid lesion, a second and/or third TB-MRI were available during the period of evaluation (mean interval, 2.7 years between the exams). In none of these patients increase of these intraosseous lesions was noticed.

Conclusion

Intraosseous chondroid lesions (enchondroma and ACT) appear to occur more frequently in MO patients than in the general population. TB-MRI allows to detect these, besides the identification of OC with suspicious features.
Literatur
2.
Zurück zum Zitat Hameetman L, Bovée JVMG, Taminiau AHM, Kroon HM, Hogendoorn PCW. Multiple osteochondromas: clinicopathological and genetic spectrum and suggestions for clinical management. Hereditary Cancer Clin Pract. 2004;2:161–73.CrossRef Hameetman L, Bovée JVMG, Taminiau AHM, Kroon HM, Hogendoorn PCW. Multiple osteochondromas: clinicopathological and genetic spectrum and suggestions for clinical management. Hereditary Cancer Clin Pract. 2004;2:161–73.CrossRef
3.
Zurück zum Zitat Wuyts W, Schmale GA, Chansky HA, Raskind WH. Hereditary multiple osteochondromas. In: GeneReviews Adam MP, Everman DB, Mirzaa GM, et al, editors. Seattle (WA) University of Washington Seattle; 1993–2023. Wuyts W, Schmale GA, Chansky HA, Raskind WH. Hereditary multiple osteochondromas. In: GeneReviews Adam MP, Everman DB, Mirzaa GM, et al, editors. Seattle (WA) University of Washington Seattle; 1993–2023.
4.
Zurück zum Zitat Ham SJ. Multiple hereditary exostoses: Orthop Trauma. 2013;27:118–25.CrossRef Ham SJ. Multiple hereditary exostoses: Orthop Trauma. 2013;27:118–25.CrossRef
5.
Zurück zum Zitat Czajka C, DiCaprio M. What is the proportion of patients with multiple hereditary exostoses who undergo malignant degeneration? Clin Orthop Relat Res. 2015;473:2355–61.CrossRefPubMedPubMedCentral Czajka C, DiCaprio M. What is the proportion of patients with multiple hereditary exostoses who undergo malignant degeneration? Clin Orthop Relat Res. 2015;473:2355–61.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Jurik AG, Holmberg P, Mortensen M. Whole-body MRI in assessing malignant transformation in multiple hereditary exostoses and enchondromatosis: audit results and literature review. Skeletal Radiol. 2020;49:115–24.CrossRefPubMed Jurik AG, Holmberg P, Mortensen M. Whole-body MRI in assessing malignant transformation in multiple hereditary exostoses and enchondromatosis: audit results and literature review. Skeletal Radiol. 2020;49:115–24.CrossRefPubMed
7.
Zurück zum Zitat Bernard SA, Murphy MD, Flemming DJ, Kransdorf MJ. Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology. 2010;255:857–65.CrossRef Bernard SA, Murphy MD, Flemming DJ, Kransdorf MJ. Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology. 2010;255:857–65.CrossRef
8.
Zurück zum Zitat Staal HM, Dremmen M, Robben S, Witlox A, van Rijn L. The use of whole-body MR imaging in children with HMO, an extended case study in two patients. Pediatr Ther. 2016;6:1.CrossRef Staal HM, Dremmen M, Robben S, Witlox A, van Rijn L. The use of whole-body MR imaging in children with HMO, an extended case study in two patients. Pediatr Ther. 2016;6:1.CrossRef
9.
Zurück zum Zitat Baur-Melnyk A, Buhmann S, Becker C, Schoenberg S. Whole-body MRI versus whole-body MDCT for staging of multiple myeloma. AJR. 2008;190:1097–104.CrossRefPubMed Baur-Melnyk A, Buhmann S, Becker C, Schoenberg S. Whole-body MRI versus whole-body MDCT for staging of multiple myeloma. AJR. 2008;190:1097–104.CrossRefPubMed
10.
Zurück zum Zitat Voit AM, Arnold AP, Douis H, et al. Whole-body magnetic resonance imaging in chronic recurrent multifocal osteomyelitis: clinical long-term assessment may underestimate activity. J Rheumatol. 2015;42:1455–62.CrossRefPubMed Voit AM, Arnold AP, Douis H, et al. Whole-body magnetic resonance imaging in chronic recurrent multifocal osteomyelitis: clinical long-term assessment may underestimate activity. J Rheumatol. 2015;42:1455–62.CrossRefPubMed
11.
Zurück zum Zitat Ahlawat S, Fayad LM, Khan M, et al. Current whole-body MRI applications in the neurofibromatosis: NF1, NF2, and schwannomatosis. Neurology. 2016;87:31–9.CrossRef Ahlawat S, Fayad LM, Khan M, et al. Current whole-body MRI applications in the neurofibromatosis: NF1, NF2, and schwannomatosis. Neurology. 2016;87:31–9.CrossRef
12.
Zurück zum Zitat Goud A, Wuyts W, Bessems J, Bramer J, Van der Woude HJ, Ham J. Intraosseous atypical chondroid tumor or chondrosarcoma grade 1 in patients with multiple osteochondromas. J Bone Joint Surg. 2015;97:24–31.CrossRefPubMed Goud A, Wuyts W, Bessems J, Bramer J, Van der Woude HJ, Ham J. Intraosseous atypical chondroid tumor or chondrosarcoma grade 1 in patients with multiple osteochondromas. J Bone Joint Surg. 2015;97:24–31.CrossRefPubMed
13.
Zurück zum Zitat Stomp W, Reijnierse M, Kloppenburg M, et al. Prevalence of cartilaginous tumours as an incidental finding on MRI of the knee. Eur Radiol. 2015;25:3480–7.CrossRefPubMedPubMedCentral Stomp W, Reijnierse M, Kloppenburg M, et al. Prevalence of cartilaginous tumours as an incidental finding on MRI of the knee. Eur Radiol. 2015;25:3480–7.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Walden M, Murphey M. Vidal J Incidental enchondromas of the knee. Am J Roentgenol. 2008;190:1611–5.CrossRef Walden M, Murphey M. Vidal J Incidental enchondromas of the knee. Am J Roentgenol. 2008;190:1611–5.CrossRef
15.
Zurück zum Zitat Hong ED, Carrino JA, Weber KL, Fayad LM. Prevalence of shoulder enchondromas on routine MR imaging. Clin Imaging. 2011;35:378–84.CrossRefPubMed Hong ED, Carrino JA, Weber KL, Fayad LM. Prevalence of shoulder enchondromas on routine MR imaging. Clin Imaging. 2011;35:378–84.CrossRefPubMed
16.
Zurück zum Zitat Davies AM, Patel A, Azzopardi C, James SL, Botchu R. Prevalence of enchondromas of the proximal femur in adults as an incidental finding on MRI of the pelvis. Indian J Radiol Imaging. 2021;31:582–5.CrossRefPubMedPubMedCentral Davies AM, Patel A, Azzopardi C, James SL, Botchu R. Prevalence of enchondromas of the proximal femur in adults as an incidental finding on MRI of the pelvis. Indian J Radiol Imaging. 2021;31:582–5.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Afonso PD, Isaac A, Villagran JM. Chondroid tumors as incidental findings and differential diagnosis between enchondromas and low-grade chondrosarcomas. Semin Musculoskelet Radiol. 2019;23:1–18. Afonso PD, Isaac A, Villagran JM. Chondroid tumors as incidental findings and differential diagnosis between enchondromas and low-grade chondrosarcomas. Semin Musculoskelet Radiol. 2019;23:1–18.
18.
Zurück zum Zitat WHO Classification of Tumours Editorial Board, International Agency for Research on Cancer. Soft tisssue and bone tumours WHO classification of tumours. 2020; 5th ed. volume 3. WHO Classification of Tumours Editorial Board, International Agency for Research on Cancer. Soft tisssue and bone tumours WHO classification of tumours. 2020; 5th ed. volume 3.
19.
Zurück zum Zitat Deckers C, Schreuder BH, 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(8):987–91.CrossRefPubMedPubMedCentral Deckers C, Schreuder BH, 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(8):987–91.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Sampath Kumar V, Tyrrell P, Singh J, Gregory J, Cribb G, Cool P. Surveillance of intramedullary cartilage tumours in long bones. Bone Joint J. 2016;98(11):1542–7.CrossRefPubMed Sampath Kumar V, Tyrrell P, Singh J, Gregory J, Cribb G, Cool P. Surveillance of intramedullary cartilage tumours in long bones. Bone Joint J. 2016;98(11):1542–7.CrossRefPubMed
21.
Zurück zum Zitat Ahmed S, Jubouri S, Mulligan M. Incidental long bone cartilage lesions: is any further imaging work-up needed? Skeletal Radiol. 2021;50:1189–96.CrossRefPubMed Ahmed S, Jubouri S, Mulligan M. Incidental long bone cartilage lesions: is any further imaging work-up needed? Skeletal Radiol. 2021;50:1189–96.CrossRefPubMed
22.
Zurück zum Zitat Samuel AM, Munger AM, Lee FY, Friedlaender GE, Ibe I, Lindskog DM. Bone scans have little utility in the evaluation of well-differentiated cartilaginous lesions of the humerus. Orthopedics. 2020;43:498–502.CrossRef Samuel AM, Munger AM, Lee FY, Friedlaender GE, Ibe I, Lindskog DM. Bone scans have little utility in the evaluation of well-differentiated cartilaginous lesions of the humerus. Orthopedics. 2020;43:498–502.CrossRef
23.
Zurück zum Zitat Chilvers R, Gallagher JA, Jeffery N, et al. An unusual example of hereditary multiple exostoses: a report and review of the literature. BMC Musculoskeletal Disord. 2021;22:96. Chilvers R, Gallagher JA, Jeffery N, et al. An unusual example of hereditary multiple exostoses: a report and review of the literature. BMC Musculoskeletal Disord. 2021;22:96. 
24.
25.
Zurück zum Zitat Vining NC, Done S, Glass IA, et al. EXT-2 positive multiple hereditary osteochondromas with some features suggestive of metachondromatosis. Skeletal Radiol. 2012;41:507–10.CrossRef Vining NC, Done S, Glass IA, et al. EXT-2 positive multiple hereditary osteochondromas with some features suggestive of metachondromatosis. Skeletal Radiol. 2012;41:507–10.CrossRef
Metadaten
Titel
Concurrent intraosseous cartilaginous lesions in patients with multiple osteochondromas identified on total-body MR imaging
verfasst von
Henk-Jan Van der Woude
Arnard L. Van der Zwan
Mark Flipsen
Chantal Welsink
S. John Ham
Publikationsdatum
17.01.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 7/2023
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-023-04277-9

Weitere Artikel der Ausgabe 7/2023

Skeletal Radiology 7/2023 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.