Enchondroma Protuberans of the Hand
Yeong-Yi An1,
Jee-Young Kim1,
Myeong-Im Ahn1,
Yong-Koo Kang2 and
Hyun-Joo Choi3
1 Department of Radiology, The Catholic University of Korea, St. Vincent's
Hospital, 93 Ji-dong, Paldal-ku, Suwon, Kyunggi-do 442-723, Republic of
Korea.
2 Department of Orthopedic Surgery, The Catholic University of Korea, St.
Vincent's Hospital, Suwon, Kyunggi-do 442-723, Republic of Korea.
3 Department of Pathology, The Catholic University of Korea, St. Vincent's
Hospital, Suwon, Kyunggi-do 442-723, Republic of Korea.
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Fig. 1A —14-year-old girl with enchondroma protuberans. Radiograph shows
exophytic protruding mass with geographic osteolytic lesion, which has
stippled calcifications in fifth metacarpal bone. Focal cortical defect is
seen in proximal portion and cortical ballooning is seen in distal portion of
lesion. Note cortical thickening in diaphysis of fourth metacarpal bone.
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Fig. 1B —14-year-old girl with enchondroma protuberans. Coronal
fat-suppressed fast spin-echo T2-weighted MR image shows hyperintense mass
with hypointense septa. There is peritumoral edema in adjacent bone marrow
(arrows) and soft tissue.
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Fig. 2A —11-year-old boy with enchondroma protuberans. Radiograph shows
juxtacortical mass with stippled and rim calcifications in proximal phalanx of
right index finger. Cortex is remodeled and there is small geographic
osteolytic lesion (thick arrow) in medullary cavity. Another small
geographic osteolytic lesion is located eccentrically in middle phalanx
(thin arrow).
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Fig. 2B —11-year-old boy with enchondroma protuberans. Coronal fat-suppressed
fast spin-echo T2-weighted MR image shows hyperintense mass with low-intensity
nodules and septa (thick arrow). Another small hyperintense mass is
noted in middle phalanx (thin arrow).
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Fig. 3A —52-year-old woman with enchondroma protuberans. Radiograph shows
eccentric geographic osteolytic lesion (arrow) with cortical
ballooning in distal phalanx of fifth finger. Focal cortical defect and
stippled calcifications are seen in adjacent soft tissue.
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Fig. 3B —52-year-old woman with enchondroma protuberans. Coronal
fat-suppressed fast spin-echo T2-weighted MR image shows separate hyperintense
masses (arrow) in intramedullary cavity and juxtacortical area that
are connected through cortical defect.
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Fig. 3C —52-year-old woman with enchondroma protuberans. Contrast-enhanced
axial fat-suppressed T1-weighted MR images show inhomogeneous enhancement in
both lesions (arrows). Adjacent nail bed is thickened
(arrow, D).
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Fig. 3D —52-year-old woman with enchondroma protuberans. Contrast-enhanced
axial fat-suppressed T1-weighted MR images show inhomogeneous enhancement in
both lesions (arrows). Adjacent nail bed is thickened
(arrow, D).
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Fig. 4A —34-year-old man with enchondroma protuberans. Radiograph shows ovoid
soft-tissue mass with stippled tumor matrix calcifications and rim
calcification in volar side of proximal phalanx of fifth finger. There is
central geographic osteolytic lesion, which erodes cortex, resulting in
endosteal scalloping and cortical thinning.
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Fig. 4B —34-year-old man with enchondroma protuberans. Sagittal spin-echo
T1-weighted MR image shows hypointense masses in intramedullary cavity and
adjacent soft tissue, which are connected through cortical defect.
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Fig. 4E —34-year-old man with enchondroma protuberans. Photomicrograph shows
benign cartilaginous tissue protruding (white arrows) beyond confines
of normal cortex (stars). Tumor is covered by thin fibrous connective
tissue (black arrow). (H and E, x30)
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