Detaillierte Beitrags-Information
| Beitragstitel | Solitary Epiphysial Enchondroma of the Proximal Humerus in a 13-Year-Old Boy with short humerus lengthened with the PreciceR nail |
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| Beitragscode | P096 |
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| Präsentationsform | Poster |
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| Abstract |
Introduction Solitary epiphysial enchondromas are rare. Of 761 cases reviewed at the Armed Forces Institute of Pathology only 33 cases were located in the epiphysis with 8 in the humeral head and 2 in the tuberculi1. The enchondromas usually involve only parts of the epiphysis, e.g.1,2,3; . Complete involvement of the epiphysis is reported only in the case of a distal fibula enchondroma1. A review of the literature upon epiphysial enchondromas published until 2008 is given by 2. The case presented here is of interest because of complete involvement of the epiphysis and the resulting shortening of the arm as well as successful lengthening using the PreciceR nail. Methods The 13-year-old boy complained of shortness of his left arm with the the desire for lengthening. The X-Ray surprisingly showed the enlarged elliptoid shaped humeral epiphysis in varus position and irregular joint surface. The MRI documented a distorted bone structure involving the complete epiphysis and partial closure of the physis. MR-angiography revealed normally appearing vessel formation. Tru-cut needle biopsy confirmed the diagnosis of enchondromatous changes. Results As the patient felt strongly disturbed by the shortness of his arm lengthening was performed using the fully inserted magnetic driven PreciceR nail, which had to be exchanged twice to achieve 12cm as telescoping of the nail is limited to 5 cm. At 1 year f/u the patient has equal arm length and full function, no signs of progression of the chondromatous 'malformation'. Conclusion This case is of interest as epiphysial enchondromas are extremely rare and complete involvement of the proximal humeral epiphysis to our knowledge has never been described before. Lengthening using a device penetrating the cartilaginous region is debatable; however so far sarcomatous dedifferentiation in epiphysial enchondromas has not been described. References 1.Potter BK, et al. Solitary Epiphyseal Enchondromas. J Bone Joint Surg Am 2005; 87 (7):1551-60. 2. Ojeda-Thies C, et al. Solitary Epiphyseal Enchondroma of the Proximal Femur in a 23-Month-Old Girl. J Pediatr Orthop 2008;28(5):565-568 3. Crim JR and Mirra JM. Enchondroma protuberans. Report of a case and its distinction from chondrosarcoma and osteochondroma adjacent to an enchondroma. Skeletal Radiol 1990;19:431-4 |