Epidemiology
A very common benign cartilaginous lesion; often an incidental finding. It mainly affects the small bones of the hands and feet and the long bones. In the hands it may first present with a pathologic fracture; in long bones the key is to distinguish it from an atypical cartilaginous tumor when there is pain or aggressive changes.
Basic features
In the long bones it is usually symptom-free and found by chance on an X-ray taken for another reason. In the small bones of the hands and feet, however, it can cause symptoms —pain or swelling— and may even first appear as a pathologic fracture through the lesion.
Usual treatment
When it is typical and symptom-free —especially in the long bones— it needs no treatment. In many cases a follow-up scan is done to confirm that the lesion is stable, and if it is, indefinite follow-up is not needed. Surgery (curettage with bone void filling) is reserved for symptomatic lesions, usually in the hands and feet, or when there is a fracture, growth, or doubt about a more aggressive cartilaginous lesion.
Outcomes and prognosis
Most do well; after curettage, recurrence is low. The risk of transformation into chondrosarcoma is very low in solitary lesions, but rises significantly in syndromes such as Ollier disease and, even more so, in Maffucci syndrome.