Chondromas are benign tumors of the cartilage, characteristic mainly of children and youth. The formations can be located on the internal (enhondromas) or external (ecchondromaa) bone surface. In the first case, there is a higher probability of tumor degeneration into a malignant one. This disease commonly affects the bones of the hands and feet, and rarely shoulders, thighs, and skullbase. The diagnosis is confirmed by biopsy.
Upon asymptomatic process, the patient is subject to a dynamic follow-up. Sometimes, the chondroma growth stops at the time of skeletal maturity. The emergence of negative symptoms, signs of bone loss or tumor malignancy is an indication for surgical intervention. The surgery tactics is selected based on the formation size and location.
For small chondromas of hands and feet, the curettage, i.e. tumor scraping from the bone, may be performed. The emerging cavity is filled with bone chips taken from the other bones of the same patient or from a donor. The removed tissue is sent for histological examination.
If a tumor has grown into the bone tissue, the bone resection is performed. During surgery, the defect is replace with an autograft or an allograft.
For lesions of long bones, the preference is always given to a radical intervention, since in these cases there is a high risk of tumor malignant transformation. The bone removal is also combined with transplantation. In the absence of the bone graft, a metal prosthesis can be installed.
Chondromas of the skull base are excised using endoscopic techniques, introducing instruments through the patient’s nasal cavity. Alternatively, or in addition to the surgery, a radiosurgery (Gamma Knife) is used. The method implies the tumor irradiation with a high-dose radiation, causing the cell death. Multiple radiation flows are formed so that to affect the pathological center to the maximum possible and to avoid damage to the healthy tissue. The procedure is performed only once. The treatment effect is manifested over the next 6 to 24 months.
For small chondromas, radiosurgery may be used as a sole therapy. After a conventional surgery, the technique is prescribed to destroy the residual tumor.