engleski

Enchondroma of the hand thumb: a case report

Hand bones tumors are very rare. Although most of the bone tumors are benign (about 90%), a small number of tumors show signs of malignancy (about 5%). Among benign hand bone tumors the most common are enchondromas (from 35-65%). Enchondroma is a rare tumor that rises from an intramedullary enchondroma with an exophytic growth pattern, with its origin from the cartilage. It occurs most often between the second and fourth decades of life. The are usually detected after a bagatelle trauma. Although it causes an interesting clinical picture it is benign, and marginal resection of the tumour with bone grafting of the intramedullary defect of the bone is the way of surgical treatment. For accurate diagnosis, conventional X-ray examination and if necessary, a contrast medium MRI should be performed. Histological investigation is compulsory due to the risk of malignancy. Enchondroma may appear on X rays in several ways that Tajigawa classifies as follows: central (the most common form, accounting for 58% of cases), eccentric (19% of cases), combined (21% of cases), polycentric (11% of cases) and giant enchondroma (3% of cases). Enchondroma protuberans is another variations of enchondroma that could very well be included in this classification as a new type. Our case report refers to the 28-year-old girl who was received at the Department of Surgery in our hospital for clinically and radiologically verified tumor of distal phalanx of her right hand thumb. Patient has reported to a doctor after an insignificant trauma of the thumb when done X-ray treatment verified tumor of mentioned finger. After that, biopsy was done which verified enchondroma. After the presurgery preparation, the patient was treated with entirely extirpation of enchondroma distal phalang of the thumb and curettage of intramedular bone defect. Bone defect was filled by minor part gotten from excohleation of radius spongiosa of the right arm and placing autologous bone graft in bone defect of the thumb. Osteosynthesis was performed with Kirschner wire fixation. Final pathohistologically finding was consistent with the referral enchondroma diagnosis. Postoperative course went neatly with orderly distal neurocirculatory status of the thumb and motility of the joints. Second postoperative day the patient was discharged to home treatment with recommendations for elevation of the arm an rest of the same. Surgical examinations control were conducted regularly.

enchondroma ; benign tumor ; thumb ; Takigawa classification

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