Malignant Transformation Of Solitary Phalangeal Enchondroma To High Grade Chondrosarcoma- A Case Report
Cases Series | Volume 8 | Issue 1 | JBST January – June 2022 | Page 03-06 |Ebin Rahman, Subin Sugath, Nanda Kachare.
DOI: 10.13107/jbst.2021.v08i01.65
Author: Ebin Rahman [1], Subin Sugath [1], Nanda Kachare [2]
[1] Department of Orthopaedic Oncology, Aster Medcity, Kochi, Kerala, India
[2] Department of Pathology, Aster Medcity, Kochi, Kerala, India.
Address of Correspondence
Dr. Ebin Rahman,
Department of Orthopaedic Oncology, Aster Medcity, Kochi, Kerala, India.
E-mail: rahmanebin@gmail.com
Abstract
Introduction: Chondrosarcoma (CS) is a malignant neoplasm of mesenchymal origin characterized by the formation of cartilaginous matrix by neoplastic cells. It may arise as a primary lesion or occur secondarily at the site of a previous benign lesion such as enchondroma. Primary CS is rare in the hand with a frequency of <0.5–3.2% of all CS. Malignant transformation of a benign solitary enchondroma to secondary CS, especially in the hand, is extremely rare. This transformation is seen more often in multiple enchondromatosis than in solitary lesions, but even this event is rare in the hands. Here, we report a case of solitary enchondroma of proximal phalanx of middle finger initially treated with intralesional curettage and bone grafting, later recurring to high grade (Grade 3) CS.
Case Report: We report the case of 44-year-old lady presenting with pain and progressive fusiform swelling of the entire right middle finger of 4 months duration. She had a similar history 5 years back for which she had underwent intralesional curettage and bone graft substitute application. Curetted specimen was reported as enchondroma. Radiographical evaluation showed an expansile, intramedullary, and lytic lesion severe cortical destruction over proximal phalanx of the right middle finger. Magnetic resonance imaging detailed the soft-tissue component. She underwent a core needle biopsy which reported as low-grade CS arising from enchondroma. Resection of middle ray including distal 2/3 of 3rd metacarpal was performed. Excised specimen was reported as high-grade CS (Grade 3) with tumor free margins. At 2-year follow-up, she is symptom free without any local recurrence or distant lesions.
Conclusion: Diagnosis of CS in the hand can pose problems to clinicians and pathologists alike. To definitely set a diagnosis of CS in the hand, comparison of histological and radiological finding is paramount. CS are malignancies resistant to both radiation and chemotherapy. CS of the hand is characterized by local recurrence and very low metastatic potential. Hence, wide excision is the recommended approach.
Keywords: Phalanx, Enchondroma, Chondrosarcoma, High grade, Amputation.
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| How to Cite this article: Rahman E, Sugath S, Kachare N. | Malignant transformation of solitary phalangeal enchondroma to high grade chondrosarcoma – A case report. | Journal of Bone and Soft Tissue Tumors | Jan-Jun 2022; 8(1): 3-6. |
