Spinal osteochondroma with malignant transformation and pushing border kidney infiltration in a patient with multiple osteochondromas

Multiple Osteochondromas (MO) is a disease of benign bony growths with a low incidence of malignant transformation. Secondary chondrosarcoma in children is rare even in children with MO. Making a diagnosis of malignancy in low-grade cartilage tumors is challenging and requires consideration of clinical, radiographic, and histopathological factors. We report two cases of skeletally immature patients with MO who presented with rapidly enlarging and radiographically aggressive lesions consistent with malignant transformation. Both underwent allograft reconstruction of the involved site with no signs of recurrence or metastatic disease at a minimum of four-year follow-up.

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Malignant transformation in an 11-year-old child with multiple hereditary exostosis

SA Orthopaedic Journal ◽

10.17159/2309-8309/2021/v20n3a8 ◽

2021 ◽

Vol 20 (3) ◽

Author(s):

Janet L de Stadler ◽

Neil Kruger ◽

Shivani Singh ◽

Ebrahim Banderker ◽

Stewart Dix-Peek ◽

...

Keyword(s):

Malignant Transformation ◽

Index Patient ◽

Paediatric Population ◽

Team Approach ◽

Autosomal Dominant Disorder ◽

En Bloc ◽

Level Of Evidence ◽

Proximal Fibula ◽

Multiple Osteochondromas ◽

Multiple Hereditary Exostosis

ABSTRACT BACKGROUND: Multiple hereditary exostosis (MHE) is a rare autosomal dominant disorder predisposing to the development of multiple osteochondromas. Malignant transformation is an uncommon complication of osteochondromas and is especially rare in the paediatric population. Making a diagnosis of malignant transformation is recognised as a challenge globally METHODS: We obtained informed consent and ethics approval prior to reviewing the hospital file, radiology and pathology of our index patient, as well as conducting a directed literature search RESULTS: An 11-year-old male with MHE presented with new onset pain in the right leg with an associated inability to weight bear. Plain radiographs and magnetic resonance imaging (MRI) showed features consistent with malignant transformation. The child underwent a Malawer 1 resection of the proximal fibula with no complications. The pathology confirmed a grade 1 secondary peripheral chondrosarcoma (CS) arising in an osteochondroma The rate of malignant transformation in MHE is as high as 36.3% in select specialist tertiary centres. Ninety per cent of the resultant malignancies are chondrosarcomas. Malignant transformation before the age of 20 years is exceptional. Plain radiology is routinely used for monitoring of patients with MHE. Other modalities exist to assess for cartilage cap thickness, a much-debated criterion of malignant change. Pathology is essential for confirmation of malignant transformation as well as to exclude high grade lesions. Treatment is wide local excision (WLE) with limb-sparing surgery and long-term follow-up to detect for local recurrences. CONCLUSION: The malignant transformation of osteochondromas occurs more frequently in individuals with MHE and may even arise in the paediatric population. In the presence of suspicious clinical or radiological features, en-bloc surgical resection and histopathological correlation is mandatory to make the diagnosis. We encourage a multidisciplinary team approach with collaboration between the orthopaedic surgeon, radiologist and pathologist Level of evidence: Level 5 Keywords: multiple hereditary exostosis (MHE), chondrosarcoma, osteochondroma, malignant transformation

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Rare case of malignant transformation of a solitary spinal osteochondroma into recurrent metastatic chondrosarcoma

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2019.05.045 ◽

2019 ◽

Vol 67 ◽

pp. 280-288

Author(s):

Akshay Hari ◽

Bhadrakant Kavar

Keyword(s):

Malignant Transformation ◽

Rare Case ◽

Spinal Osteochondroma

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Multiple Osteochondromas with Evidence of Malignant Transformation in a Cat

Veterinary Pathology ◽

10.1177/030098588702400515 ◽

1987 ◽

Vol 24 (5) ◽

pp. 457-459 ◽

Cited By ~ 10

Author(s):

C. E. Doige

Keyword(s):

Malignant Transformation ◽

Multiple Osteochondromas

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Application of Transmission Electron Microscope and Scanning Electron Microscope in experimental tumor studies

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100159084 ◽

1990 ◽

Vol 48 (3) ◽

pp. 306-307

Author(s):

Gao Fengming

Keyword(s):

Electron Microscope ◽

Scanning Electron Microscope ◽

Malignant Transformation ◽

Transmission Electron Microscope ◽

Experimental Tumor ◽

Transmission Electron ◽

Embryo Cells ◽

Tumor Studies ◽

Scanning Electron

Transmission electron microscope(TEM) and scanning electron microscope(SEM) were widely used in experimental tumor studies. They are useful for evaluation of cellular transformation in vitro, classification of histological types of tumors and treating effect of tumors. We have obtained some results as follows:1. Studies on the malignant transformation of mammalian cells in vitro. Syrian golden hamster embryo cells(SGHEC) were transformed in vitro by ThO2 and/or ore dust. In a few days after dust added into medium, some dust crystals were phagocytized. Two weeks later, malignant transformation took place. These cells were of different size, nuclear pleomorphism, numerous ribosomes, increasing of microvilli on cell surface with various length and thickness, and blebs and ruffles(Figs. 1,2). Myelomonocytic leukemic transformation of mouse embryo cells(MEC) was induced in vitro by 3H-TdR. Transformed cells were become round from fusiform. The number of mitochondria and endoplasmic reticulum was reduced, ribosomes and nucleoli increased, shape of nuclei irregular, microvilli increased, and blebs and ruffles appeared(Fig. 3).

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