Enchondroma and chondrosarcoma of bone: clinical, radiologic, and histologic differentiation

Intraosseous cartilage tumors are commonly encountered by orthopaedic surgeons during evaluation of a patient for undetermined pain; however, the possibility of missing a malignancy during examination is cause for concern. Surgery for enchondromas is not generally necessary but when clinical and radiographic features suggest a potential chondrosarcoma, prompt referral is necessary. Chondrosarcoma almost always occurs in adults. Patients usually present with pain and have characteristic findings on staging studies. Lucencies developing within the calcification, periosteal reactions, and a soft-tissue mass all are characteristic features of chondrosarcoma. Biopsies are not typically indicated because of the histologic similarity of benign and malignant cartilage lesions.