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Enchondroma Treatment in Pune
Sancheti Hospital offers personalized Enchondroma treatment with precise diagnosis, expert surgical care, and follow-up for complete bone restoration.
Overview
An enchondroma is a type of benign bone tumor that grows from cartilage tissue inside your bones. These tumors are quite common, making up about 3% of all bone tumors and 13% of non-cancerous bone growths. They’re the second most common benign bone tumor after osteochondromas.
Enchondromas can develop in any bone, but they’re most often found in the small bones of your hands and feet. They’re actually the most common primary bone tumors in the hand. Less frequently, they can occur in larger bones like the thigh bone (femur), upper arm bone (humerus), or shinbone (tibia).
These tumors typically start growing during childhood, but doctors most often diagnose them in people between 10 and 40 years old. Both men and women are equally affected. Most of the time, only one enchondroma develops, but sometimes multiple tumors can occur throughout the body.
Symptoms
Many people with an enchondroma don’t experience any symptoms at all. These asymptomatic lesions are often discovered by accident during X-rays or other imaging tests done for different reasons, like checking an injury.
When symptoms do appear, they’re usually mild and can include:
- Pain – This typically happens with larger tumors or when the weakened bone breaks
- Swelling – You might notice swelling in the area around the tumor
- Deformity – This can cause fingers to look enlarged or, in children, slow down normal bone growth
The most common problem with enchondromas is pathologic fractures – breaks that happen because the tumor weakens the bone. These fractures occur in 40% to 60% of patients when they’re first diagnosed.
Causes
Doctors don’t know exactly what causes enchondromas to form. However, they believe these tumors might develop from problems with how cartilage grows during bone development.
The most accepted theory is that enchondromas form from leftover cartilage cells that were supposed to help bones grow during childhood but didn’t develop properly. Instead of disappearing as they should, these cells stayed in the bone and continued growing into adulthood.
Research has found some genetic factors that might contribute to enchondroma formation:
- Mutations in genes called IDH1 and IDH2, which can create abnormal substances that interfere with normal cell function
- Changes in the PTHR1 gene, which is important for bone development
- Problems with cellular pathways that control how bones form from cartilage
It’s important to note that environmental factors like radiation or chemical exposure are not thought to cause enchondromas.
Risk Factors
While most enchondromas occur randomly, certain conditions significantly increase the risk of developing multiple tumors or complications:
Ollier Disease: This rare condition causes multiple enchondromas throughout the body. It affects about 1 in 100,000 people and can cause bones to grow abnormally, leading to shortened limbs and bone deformities. People with Ollier disease have a much higher risk (5-50%) of their tumors becoming cancerous.
Maffucci Syndrome: This extremely rare condition combines multiple enchondromas with blood vessel tumors called hemangiomas. Fewer than 200 cases have been reported worldwide. People with this syndrome have a 15-20% risk of malignant transformation.
Other rare conditions that can increase risk include:
- Metachondromatosis (multiple enchondromas and osteochondromas)
- Various genetic skeletal disorders
Trauma to bones might also trigger enchondroma development, though this connection isn’t fully proven.
Diagnosis
Diagnosing an enchondroma usually starts when the tumor is found during imaging tests for other reasons, often after a fracture occurs.
Imaging Tests:
- X-rays: These show the tumor as a clear area in the bone, often with small spots of calcium that look like “rings and arcs”
- CT scans: These provide detailed pictures that help doctors see the tumor’s structure and check if the bone is weakened
- MRI: This gives the most detailed images and helps doctors see if the tumor has spread to nearby tissues
- Bone scans: These nuclear medicine tests can show if the tumor is active or if there are fractures
Biopsy: Sometimes doctors need to take a small sample of the tumor tissue to confirm the diagnosis. However, even with tissue samples, it can be difficult to tell the difference between a benign enchondroma and early cancer.
Doctors look for warning signs that might suggest the tumor could be cancerous:
- Large size
- Rapid growth
- Severe bone thinning
- Significant pain
- Soft tissue involvement
Types
Enchondromas are classified into two main types:
Solitary Enchondroma: This is the most common type, where only one tumor develops. These are usually smaller than 3 centimeters and have a very low risk of becoming cancerous.
Multiple Enchondromas (Enchondromatosis): This involves several tumors throughout the body and is associated with specific syndromes like Ollier disease and Maffucci’s syndrome.
Treatment
Treatment for enchondromas depends on whether they cause symptoms and the risk of complications.
Observation: For asymptomatic lesions that don’t cause problems, doctors often recommend simply watching the tumor over time. Regular follow-up X-rays may be suggested, but routine monitoring isn’t always necessary since solitary enchondromas rarely become cancerous (less than 1% chance).
Surgical Intervention: Surgery is typically recommended for:
- Tumors causing pain or swelling
- Pathologic fractures or high fracture risk
- Suspected malignant transformation
- Need for definitive diagnosis
Surgical Procedures:
The most common surgery is curettage, where the surgeon scrapes out the tumor tissue. After removing the tumor, the empty space in the bone is usually filled with:
- Autograft: Bone taken from another part of your body
- Allograft: Donor bone from a bone bank
- Synthetic bone substitutes: Artificial materials that help new bone grow
- Bone cement: A special material that hardens to provide immediate support
Some newer techniques include:
- Endoscopic surgery for finger tumors
- Minimally invasive procedures
- Radiofrequency ablation for certain locations
Rehabilitation
Recovery after enchondroma surgery often involves working with physical therapists and rehabilitation specialists to restore normal function.
Rehabilitation typically includes:
- Exercises to improve range of motion
- Strength training for affected muscles
- Functional activities to help you return to daily tasks
- Use of assistive devices if needed
Recovery time varies depending on the surgery:
- Without fracture: About 3 weeks
- With fracture: Up to 7 weeks
- Immediate fracture repair: About 1 month
- Delayed fracture repair: Up to 2.5 months
Complications
While enchondromas are non-cancerous, they can cause several problems:
- Pathologic Fractures: The most common complication, occurring when the tumor weakens the bone enough that it breaks easily.
- Growth Problems: In children, large tumors can interfere with normal bone development, potentially causing deformities.
- Surgical Complications: After surgery, especially in the hands, some people may experience stiffness or joint problems.
- Recurrence: While rare for single tumors, enchondromas can occasionally grow back after surgery.
- Malignant Transformation: Though very rare for solitary tumors, enchondromas can sometimes become cancerous (chondrosarcoma). This risk is much higher in people with multiple tumors.
Prevention
Since doctors don’t know what causes enchondromas, there’s no way to prevent them from developing. The genetic changes associated with these tumors usually happen randomly and can’t be predicted.
However, you can promote overall bone health by:
- Eating a diet rich in calcium and vitamin D
- Getting regular medical checkups
- Avoiding smoking and excessive alcohol
- Using safety equipment during sports and activities
- Seeking medical attention for persistent bone pain or swelling
Living With Enchondroma
For most people, living with an enchondroma doesn’t significantly impact daily life. Many tumors cause no symptoms and require no treatment beyond occasional monitoring.
If you have a symptomatic lesion or need surgery, working with a healthcare team is important. This team might include:
- Primary care doctors for overall health management
- Orthopedic surgeons for bone-related treatment
- Radiologists for imaging interpretation
- Physical therapists for rehabilitation
- Pain management specialists if needed
- Oncologists if cancer is suspected
Key Takeaways
- Enchondromas are common benign bone tumors that develop from cartilage tissue
- Most are asymptomatic lesions discovered incidentally during imaging
- Pathologic fractures are the most common presenting symptom
- Treatment ranges from observation to surgical intervention with curettage and bone grafting
- Malignant transformation risk is very low for single tumors but higher with multiple tumors
- Rehabilitation with physical therapists is important for recovery after surgery
- Multiple enchondromas are associated with rare syndromes requiring specialized care
At Sancheti Hospital, we understand that dealing with bone tumors like enchondromas can be concerning for patients and their families. Our comprehensive orthopedic team includes experienced surgeons, radiologists, and rehabilitation specialists who work together to provide personalized care for each patient.
We use the latest imaging technology for accurate diagnosis and offer both traditional and minimally invasive surgical options when treatment is needed. Our physical therapy department provides specialized rehabilitation programs to help patients recover fully after surgery.
Whether you need simple monitoring of an asymptomatic lesion or complex surgical intervention, we’re committed to providing compassionate, expert care throughout your treatment journey.
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Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
Balaji Kharat
I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.
Shantilal
My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!
Kalpana Lepcha
The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.
Kishore Bhosle
Frequently Asked Questions
Will I need to stop working or playing sports after enchondroma surgery?
Most people can return to desk jobs within 1-2 weeks. For physical work or sports, you’ll typically need 6-12 weeks depending on which bone was affected. Hand surgeries may require longer recovery for fine motor activities.
Can enchondroma come back in the same spot after surgery?
Malignant transformation to osteosarcoma is extremely rare and controversial. Some experts believe such cases may have been osteosarcoma from the beginning, highlighting the difficulty in distinguishing these tumors.
Is it safe to have children if I have multiple enchondromas?
Yes, it’s generally safe. Multiple enchondromas aren’t directly inherited, so your children won’t automatically develop them. However, genetic counseling may be helpful if you have Ollier disease or Maffucci syndrome.
Should I avoid certain activities to prevent my enchondroma from fracturing?
You don’t need to avoid normal activities unless your doctor specifically advises it. However, be cautious with high-impact sports or activities that stress the affected bone. Your doctor can assess your individual fracture risk.
