OSTEOCHONDROMA

Is Osteochondroma Serious?

Osteochondroma is not generally considered to be serious. However, if the growth begins to put pressure on nearby tissue, nerves, blood vessels, or other bones, treatment may be necessary. There is a small chance (approximately 1%) that osteochondroma may become cancerous over time. This benign tumor has about a 1% chance of becoming cancerous over time. For this reason, doctors may want to keep it under surveillance.

While the likelihood of malignancy is low, it’s important to be aware of certain signs that might indicate a change. Healthcare providers will monitor for:

• Unexplained pain caused by the tumor.
• The tumor continuing to grow after the skeleton has stopped developing.
• A tumor cap that is more than 1.5 cm thick in a fully grown patient.

When multiple osteochondromas occur, the condition might affect a child’s ability to build bones normally. Occasionally, this condition might restrict movement. Our doctors will observe and monitor the patient for any issues in these circumstances. When a child has multiple osteochondromas, there is a 5% chance that one will develop into a malignancy.

By staying vigilant and recognizing these indicators, timely interventions can be made to ensure the well-being of the patient.

What Causes Osteochondroma?

A solitary osteochondroma, which has no known source, is present in the majority of cases. It does not follow an injury. It is an anomaly in the development of bones. Multiple osteochondromas are often hereditary disorders brought on by a gene mutation. However, it can also happen at random (approximately one-third of the time) for unexplained causes.

What Does an Osteochondroma Look Like?

Osteochondromas range in size from 1 to 10 cm and extend outward from the line of a bone. They could resemble mushrooms or cauliflower because of their bulbous top and visible stem. Sessile osteochondromas are more frequent with inherited multiple exostoses, while pedunculated osteochondromas are more frequent in lone instances.

Should I be Worried?

It is quite uncommon for osteochondromas to need substantial medical care and surgery, and it’s even less frequent for benign bone tumors to develop into a malignancy. Our orthopedic expert for your child will guide you through the following procedures and collaborate with you and your child to track the tumor’s development.

What are the Symptoms of Osteochondroma?

Most of the time there are no symptoms. However, please note the following:

• On one of your bones, a little, firm bump.
• Symptoms of pain when performing a certain action if the tumor is pressing against a tendon.
• When a tumor presses against a nerve, you may experience numbness or tingling in a specific area.
• If the tumor is restricting a blood artery, it may cause circulation issues in a limb.

Multiple osteochondromas can interfere with a child’s natural bone development in more severe circumstances. Those kids who have this disease could have:

• A short stature
• A crooked limb
• One arm or leg is bigger than the other
• Displaced hip joint (hip dysplasia).

Key Points about Osteochondroma

• An osteochondroma is an overgrowth of bone and cartilage at the growth plate at the end of the bone.
• The shoulder blade, pelvis, and long bones of the leg are most frequently affected.
• Osteochondroma’s precise etiology is unknown.
• A hard, painless growth on an immobile bone, small stature for age, painful muscles, and an elongated arm or leg are possible symptoms.
• Surgery to remove the growth or pain medications is a possible form of treatment.
• To monitor bone development, parents should schedule follow-up exams with their doctor.

How are Pediatric Osteochondromas Identified?

In addition to a thorough physical examination and medical history, the following tests can identify osteochondroma in children:

X-ray: An X-ray takes photographs of a child’s bones and internal organs. This makes it easier to locate the growth. Most osteochondromas are easy to spot since they appear on an X-ray as a hard mass close to the growth plate on a normal bone. With the exception of cases when the tumor is discovered in an atypical site, such as the pelvis, the following diagnostic tests are often not necessary:

Magnetic resonance imaging (MRI): A diagnostic procedure that uses a combination of large magnets, radio frequencies, and computers to create detailed pictures of organs and structures inside the body. This test is especially useful for identifying tumors in areas that are difficult to show on plain X-rays. It also helps determine the size of the tumor and distinguish it from other types of bone tumors.

Computerized tomography scan: A diagnostic imaging procedure that combines X-rays and computer technology to create horizontal and vertical images of the body. A CT scan quickly provides excellent pictures of various parts of the body, including bones, muscles, fat, and organs. A CT scan provides far better detail than a typical X-ray.

Bone scans: A nuclear imaging procedure to look for malignancies, inflammation, and bone disorders. Doctors who treat children with several inherited exostoses may occasionally utilize this to look for additional osteochondromas.

Understanding the Differences: Osteochondroma, Chondrosarcoma, and Osteosarcoma

When diving into the world of bone-related conditions, it’s crucial to distinguish between osteochondroma, chondrosarcoma, and osteosarcoma, which each have unique characteristics.

Osteochondroma

• Nature: This is a non-cancerous (benign) tumor found predominantly in younger individuals. It consists of both bone and cartilage, usually forming around the growth plate of bones.
• Development: These tumors often appear during childhood or adolescence and can grow as the child grows. They typically stop growing once skeletal maturity is reached.
• Symptoms: Generally symptomless, unless they press on surrounding tissues.

Chondrosarcoma

• Nature: A malignant (cancerous) tumor that arises in cartilage cells, typically in adults. It often develops as a progression from a pre-existing benign lesion, like an osteochondroma.
• Development: The cancer emerges from the cartilage cap of the osteochondroma, turning a benign growth into a malignancy.
• Symptoms: Present as pain and swelling, sometimes affecting mobility.

Osteosarcoma

• Nature: This is a primary malignant bone tumor and one of the most common types of bone cancer.
• Development: It originates deep within the bone tissue and is most commonly found in teenagers and young adults, especially during their growth spurts.
• Symptoms: Typically include pain and swelling in the affected area, often leading to fractures.

Understanding these differences is fundamental to identifying proper care routes. While osteochondroma remains benign, vigilance is required to catch any malignant transformation. Meanwhile, both chondrosarcoma and osteosarcoma necessitate prompt medical intervention due to their cancerous nature.

Treatment

In most cases, if your child has an osteochondroma, they will need to have frequent follow-up checkups to observe the tumor’s development and make sure it isn’t causing them any discomfort or even weakening of their bones. Osteochondromas can occasionally cause issues that need surgical treatment. The tumor may occasionally grow in a region where it may be painful, swollen, numb, disfiguring, exhibit aberrant development, or exert strain on nearby blood arteries, nerves, or tissues. Our pediatric orthopedic surgeons will conduct surgery to remove the tumor in these situations without harming the growth plate. Your child’s pediatric orthopedic surgeon will arrange follow-up appointments to check on bone development if surgery is necessary.

When a child is still developing and needs specific care, it’s crucial that they receive it from a pediatric orthopedic surgeon rather than an orthopedic surgeon who treats adults. Pediatric specialists are trained to understand the unique needs of growing bodies, ensuring the best possible outcomes.

What to Expect from Osteochondroma Surgery

The surgery is typically performed under general anesthesia, ensuring that your child is comfortable and unaware during the procedure. The surgeon will make a small incision over the tumor and carefully remove it at the bone level. This is generally a straightforward process, but in certain instances where blood vessels or nerves are involved, the surgery might be more complex.

Rest assured, your healthcare provider will discuss any individual risk factors with you, especially if they pertain to the tumor’s location. Most children are able to return home the same day, allowing them to recover in the comfort of their own surroundings.

By choosing a pediatric orthopedic surgeon, you are ensuring that all these factors are considered with the expertise necessary for treating young, developing bodies.

When is Surgery Needed?

If your child is in pain, has a fracture or nerve irritation, has a big or uncomfortable tumor, or if your child is experiencing any of these conditions in addition to discomfort, our doctors may advise surgery. Here are some specific reasons why removal might be recommended:

• Pain or Functional Problems: If the osteochondroma is causing pain or affecting your child’s ability to function normally by putting pressure on nearby tissues, blood vessels, or nerves, removal may be necessary.
• Inhibition of Normal Bone Growth: When the tumor inhibits normal bone growth, surgical intervention could be required to ensure healthy development.
• Malignant Appearance: If the osteochondroma appears malignant or has the potential to become cancerous, removal could be essential for your child’s safety.

Complete removal of the tumor is the preferred course of action when surgery is required. This entails removing the osteochondroma from the healthy bone by cutting it off and opening the skin around the tumor. Surgically removing the lesion is typically effective, depending on where the osteochondroma is located. However, it may be more challenging to do the surgery if the tumor is close to the blood vessels and nerves.

There is a very slight probability (5%) that additional tumors will develop in the same place after they have been surgically removed. However, this mainly concerns very young children with multiple osteochondromas. In such cases, even after a complete removal, there’s a small chance of a new tumor appearing in the same location. It’s important to note that osteochondromas typically do not grow back once the skeleton has stopped growing. Complete removal generally ensures that these growths won’t return. Understanding these factors can help manage expectations and provide reassurance about the effectiveness of surgical intervention.

Understanding Recovery Time for Osteochondroma Surgery

Recovery from osteochondroma surgery can vary depending on the individual’s condition and the specifics of the surgery performed. Generally, many patients find themselves able to return to daily activities shortly after the procedure. However, the journey to full recovery involves a few key phases:

• Immediate Post-Surgery: In the first few days, your healthcare provider will discuss strategies for managing pain, which may include medication and other pain relief options.
• Rest and Mobility Support: Depending on the location and size of the osteochondroma, you might need to use a sling or crutches. These aids can help reduce movement or relieve weight from the affected limb, typically for a couple of weeks.
• Gradual Return to Activities: As healing progresses, your doctor will guide you on when and how to resume specific activities. Physical rehabilitation exercises might be recommended to ensure a smooth transition back to your routine.

Overall, the outlook for full recovery is very positive, with most people resuming their normal lifestyle efficiently. Always follow personalized advice from your healthcare provider to optimize your recovery process.

Make an Appointment with the Best

At the Medical City Children’s Orthopedics and Spine Specialists, we treat children with osteochondromas.  We specialize in this area and accept new patients.  Give us a call to make an appointment if your child has these benign tumors. We have four offices for your convenience in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX.

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Footnote:

National Institute of Orthopaedic Surgeons:  Osteochondroma