Clinico-radiological presentation and post excision prognosis of complicated solitary osteochondromas

ABSTRACT

This is a descriptive observational study based on review of cases of solitary osteochondroma [OC] excised in the last 20 years at JPMC Karachi. The purpose of this study was to evaluate the clinico-radiologicalpresentation and the complications that warranted excision of these benign tumours and also to know the number of malignant transformation. The material included case sheets, available x-rays, histopathology reports. Excluded were the cases of multiple osteochondromatosis, diaphyseal achalasia, enchondromas and patients', age <5 years. Patient whose report showed malignant transformation were called by special messenger. A total of 78 solitary osteochondroma were excised. Age range of these patients was 7-30 years except one whose age was 60 years. Average age was 17.30 years in males and 16.1 years in females. Male vs. female ratio was 21. Flat bones [Ilium and scapula] were involved in 8 cases and long bones in 63 cases. Other rare site included phalanges [2], metacarpals [2], clavicle [1], greater trochanter [1] and talus [1]. Malignant transformation warranted excision in 5[6.41%] cases that was in elder age group. The rapid growth of tumour during growth spurt period was the commonest [78.2%] presentation warranting excision in teenagers and adolescents. The other common presentation [38.46%] that warrant early excision in younger age group was development of deformity when tumour occurred in either of two distal radius / ulna or distal tibia/fibula. The other presentation warranting excision was neurovascular complications that were mostly around knee joint [16.66%], distal radius and upper humerus. All the patients remained well following excision and none has reported recurrence