Enchondroma Are Tumors Found Inside Bones

bone health
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An enchondroma is a benign tumor found inside of bone.The typical scenario is that a patient had an x-ray for an injury to a joint, commonly the shoulder, knee, or ankle. While the joint looks normal, an abnormality is seen inside the bone. Often these are completely unrelated to the cause of pain, and one of the most common reasons is an enchondroma.

Benign Bone Tumors

When a patient hears they have a tumor, this can cause anxiety and fear; many patients are initially worried they have cancer. Benign bone tumors are noncancerous conditions, that do not spread to other locations. While some benign bone tumors can cause problems, others often go unnoticed and don't have any impact on the patient's health.

The word benign is a word often used to describe tumors. It means that a tumor is not aggressive and will not spread. It is the opposite of the word malignant; a word used to describe tumors that are aggressive and can spread throughout the body.Most tumors have characteristics of one or the other. There are some slow-growing malignant tumors, and there are some locally aggressive benign tumors, but most fall into one of the two basic categories. 

What Are Enchondromas?

An enchondroma is a type of tumor that causes the formation of cartilage cells within a bone. Usually, these tumors occur in the hands or in the long bones of the extremities including the humerus (arm bone), femur (thigh bone) and tibia (shin bone).

The most common signs of an enchondroma include:

  • No symptoms whatsoever
  • Thickening of a finger with an enchondroma
  • Pain after an injury

As mentioned, most enchondromas behave without aggression. There is a related condition where the tumor can be malignant, called a chondrosarcoma. A low-grade chondrosarcoma (malignant cancer) can behave like an enchondroma, and vice versa. If patients do have pain that is coming from the tumor, or if the x-rays have the appearance of a more aggressive problem, then a low-grade chondrosarcoma should be considered as a possible diagnosis.

There is a syndrome called Ollier's Disease in which patients have many enchondromas. Patients with this condition are generally monitored more closely, as they are more likely to develop chondrosarcomas from what was previously an enchondroma.

Treatment and Monitoring

Typically, no treatment is necessary for an enchondroma. Most abnormalities detected within the bone can be rechecked with normal x-rays over a period of time. If the tumor looks like an encxhondroma, stays the same or goes away, then there is generally no need for ongoing surveillance. If the tumor starts to grow, shows signs of becoming more aggressive, it may be determined that the tumor needs to be treated more like a chondrosarcoma. Unfortunately, biopsy results can be very difficult to distinguish between a normal enchondroma and a low-grade chondrosarcoma, therefore treatment decisions are generally based on symptoms and radiographic findings, rather than on biopsy results.

Within the hand, enchondromas can weaken the bone sufficiently that a fracture occurs. When this happens, the injury is called a pathologic fracture. The usual treatment of a pathologic fracture caused by an enchondroma in the hand is first to allow the broken bone to heal. This may stimulate the enchondroma to heal as well. If not, your surgeon may recommend a procedure to remove the tumor cells and place a bone graft in the bone the strengthen the bone and prevent re-injury.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Deckers C, Rooy JWJ de, Flucke U, Schreuder HWB, Dierselhuis EF, Geest ICM van der. Midterm mri follow-up of untreated enchondroma and atypical cartilaginous tumors in the long bones. Cancers. 2021;13(16):4093. doi: 10.3390/cancers13164093

  2. Patel A. Benign vs Malignant Tumors. JAMA Oncol. 2020;6(9):1488. doi:10.1001/jamaoncol.2020.2592

  3. Na, K., Park, YK. (2020). Enchondroma. In: Santini-Araujo, E., Kalil, R.K., Bertoni, F., Park, YK. (eds) Tumors and Tumor-Like Lesions of Bone. Springer, Cham. doi: 10.1007/978-3-030-28315-5_18

  4. Lu H, Chen Q, Yang H, Shen H. Enchondroma in the distal phalanx of the finger: An observational study of 34 cases in a single institution. Medicine. 2016;95(38):e4966. doi: 10.1097/MD.0000000000004966

  5. UpToDate. Chondrosarcoma.

  6. Ferrer-Santacreu EM, Ortiz-Cruz EJ, Díaz-Almirón M, Pozo Kreilinger JJ. Enchondroma versus chondrosarcoma in long bones of appendicular skeleton: clinical and radiological criteria—a follow-up. Journal of Oncology. 2016;2016:e8262079. doi: 10.1155/2016/8262079

  7. U.S. National Library of Medicine. Ollier disease.

  8. Akoh CC, Craig E, Troester AM, Miller BJ. Radiographic enchondroma surveillance: assessing clinical outcomes and costs effectiveness. Iowa Orthop J. 2019;39(1):185-193. PMID. 31413693

  9. Choi, W.H., Han, E.J., Chang, K.B. et al. Quantitative SPECT/CT for differentiating between enchondroma and grade I chondrosarcoma. Sci Rep 10, 10587 (2020). doi:10.1038/s41598-020-67506-4

  10. National Cancer Institute. Pathologic fracture.

  11. Xu B, Ma R, Zhang W sheng, Zhang Q, Zhao C song, Wang J. Reconstruction and repair, using mini-plate and bone graft for persons living with HIV with giant cell tumor of long bone: retrospective analysis of a single-center experience. AIDS Research and Therapy. 2021;18(1):82. doi: 10.1186/s12981-021-00406-3

Additional Reading

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.