Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Dreier, M.
MRI long-term follow-up of incidentally detected enchondromas of the long bones
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2021. pp. 64
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Igrec Jasminka
- Leithner Andreas
- Altmetrics:
- Abstract:
- Introduction: The incidental finding of an enchondroma (EC) within a long bone is a common reason for referral to a bone tumor unit, and the population prevalence of incidental cartilage tumors on MRI scans is increasing due to the higher number of MRI scans performed. The reported risk of malignant transformation varies between 0 and 6% and there are no valid data on the long-term growth behavior of EC. There is no consensus or recommendation on follow-up for EC. The aim of this study was to analyze the long-term changes of incidentally detected ECs of the long tubular bones on MRI. Materials and Methods: This retrospective study included 110 patients with EC of the long bones suggestive of an EC diagnosed between 2006 and 2009. A follow-up period of at least 10 years after the initial diagnosis was the main inclusion criterion. To investigate the growth behavior, the change in size was analyzed. Malignant transformation was assessed using radiological criteria including cortical breach, endosteal scalloping, peritumoral edema, and soft tissue component. In addition, the rate of secondary surgeries was analyzed during the observation period. Results: 77/110 (70%) patients were reached by phone and 24/77 (31%) agreed to a follow-up MRI examination. The mean follow-up time for the MRI-group (n=24) was 140 months (range 120-172 months). The localization of EC was: 17 femur (71%), 3 tibia (13%), 2 humerus (8%), 1 fibula (4%), 1 ulna (4%). The mean age of the patients at initial diagnosis was 49 years (range, 27-67). 11 ECs (46%) increased in size, 10 ECs (42%) remained stable, and 3 ECs decreased in size. The mean increase in EC size was 3 mm (range -2 mm - +18 mm) between the initial and subsequent MRI. Two patients developed endosteal scalloping, one patient showed new peritumoral edema, in one patient cortical breach with periosteal reaction was found. Overall, 6/77 (8%) patients underwent secondary surgery, all lesions were histologically confirmed as EC. Conclusion: This study has shown that imaging follow-up is justified for all EC, irrespective of initial lesion size, as EC have shown unpredictable growth patterns. As progression is slow, it seems reasonable to extend follow-up intervals to several years. The newly occurrence of solitary features of biological aggressiveness, such as endosteal scalloping, without clinical symptoms, does not require surgery but follow–up.