Osteochondroma of the distal tibia. A case study

Osteochondromas can undergo malignant transformation, and although the incidence is low, it is important to recognize symptoms that might suggest transformation. Complaints of increasing pain or a dramatic increase in the size of the lesion must not be ignored. If the physician is confident that the lesion is benign and chooses not to resect it, the patient should be monitored periodically with serial radiographs in order to identify any potential degenerative changes that might develop. Since osteochondromas are usually associated with the growth plate of a long bone, the potential for progressive growth exists. This growth takes place through the process of enchondral ossification until closure of the physis occurs. After physiologic fusion of the physis, remnants of the cartilaginous cap may remain, possibly explaining the occasional development of peripheral chondrosarcomas later in life.