Sunday, December 9, 2012

Not All Tumors Are Cancerous: Osteochondromas

An osteochondroma is a benign (noncancerous) tumor that develops during childhood and adolescence. It is an abnormal growth that forms on the surface of the bone near the growth plate. The osteochondroma is an outgrowth of the growth plate and is made up of both bone and cartilage. As a child growths, the osteochondroma may grow larger, but once they have reached skeletal maturity, the osteochondroma typically stops growing as well.
Osteochondromas may grow as solitary or multiple tumors, with solitary being the most common benign tumor in the body. As a child grows, a solitary osteochondroma may develop if bone grows out from the growth plate instead of in line with it. Solitary osteochondromas are commonly found at the end of long bones where they form to meet joints. This bone outgrowth may have a stalk or stem that sticks out from the normal bone. If the tumor has a stalk, the structure is called predunculated. If the tumor outgrowth is attached to the bone with a broader base, it is called sessile.
The cause for osteochondromas is not known, occurs equally in both males and females, and is not from an injury. They may be associated with a particular gene, EXT1, but the link between the two is not well understood.
If you have an osteochondroma, you probably do not know you have the tumor. They are most commonly diagnosed in people between the ages of 10 and 30. Symptoms include:
  • A painless bump near the joints.
  • Pain with activity. An osteochondroma may be located under a tendon, and it may move and snap over the bony tumor, causing pain.
  • Numbness or tingling. Osteochondromas may be located near a nerve. When the tumor puts pressure on the nerve, there may be numbness or tingling in the associated limb. 
  • Changes in blood flow. A tumor that presses on a blood vessel may cause periodic changes in blood flow. This can cause loss of pulse or changes in color of the limb. 
Before a physical examination, your doctor will talk with you about your general health, as well as your symptoms in order to get a good history of the problem. During the physical examination, your doctor will look for tenderness over the bone and check your range of motion in the area of your pain.
The podiatrist will order x-rays and possible CT scans or a MRI. If the doctor feels that the tumor is not an osteochondroma he will take a biopsy to check for cancer.
Most solitary cases of osteochondroma are left alone, watched over time by your podiatrist. Surgery may be considered if the osteochondroma:
  • Causes pain
  • Puts pressure on a nerve or blood vessel.
  • Has a large cap of cartilage. 
To completely remove the osteochondroma the podiatrist will perform a surgical procedure called excision. The tumor will be removed at the level of the normal bone.

If you are experiencing a foot problem, call one of our six locations to make an appointment.
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