Publish in this journal
Journal Information
Vol. 16. Issue 2. P2.
Pages 183-184 (March - April 2020)
Vol. 16. Issue 2. P2.
Pages 183-184 (March - April 2020)
Images in Clinical Rheumatology
Full text access
Incidental finding of pelvic osteochondroma
Hallazgo incidental de osteocondroma pélvico
Visits
...
Ana Moreno-Ballesteros
Corresponding author
, M. Cinta Calvo-Morón, Francisco Javier García-Gómez, Juan Castro-Montaño
Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, Spain
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Full Text

Male aged 74, with a background of de novo prostate cancer was referred for staging and treatment assessment. The patient was asymptomatic and denied suffering from any previous trauma or infections.

A complete whole body bone scan was performed with 99mTc-HDP in anterior and posterior projections (Fig. 1A) where an increase in uptake of the tracer of slight to moderate intensity was observed, together with lineal morphology in the projection region of the right anterior inferior iliac spine, of doubtful pathological significance (arrow).

Fig. 1.

(A) Complete whole-body anterior and posterior bone scan with 99mTc-HDP. (B) Simple AP X-ray of the abdomen.

(0.18MB).

Retrospectively reviewing the medical background and additional tests, in the plain X-ray of the abdomen in supine position (Fig. 1B) the presence of a radiodense image was observed, with well-defined edges and radiolucent areas on the inside, which appeared to depend on the iliac bone (arrow).

For further determination of the finding, SPECT/CT with 3D reconstruction was performed (Fig. 2A and B, respectively), confirming correlation with a bony outgrowth (arrow heads) of approximately 2.35×1.47cm towards superficial planes, anteriorly displacing the muscular belly of the sartorius which in the image morphology is continuous with the bone cortex and bone marrow tissue, and is suggestive of osteochondroma.

Fig. 2.

(A) Axial slices of the SPECT/CT image fusion with 99mTc-HDP. (B) 3D reconstruction of the SPECT/TC imaging.

(0.2MB).

Osteochondroma or cartilage-capped bone spur, is the most commonly worldwide benign bone tumour,1 accounting for 20%–50% of benign tumours and between 10%–20% of all primary bone tumours, with a prevalence of approximately 3%.2

It is a proliferation of bone composed of the marrow and cortex capped by cartilage, an area of growth, which usually diminishes after skeletal maturity. Predilection is for long bone mataphysis, although they have been described throughout the skeleton.3 They have a certain potential for malignancy, evolving into chondrosarcoma in 0.5%–5% of cases.2,3 They may be single or multiple4 and appear spontaneously or after an injury.5

To sum up, when there is an incidental finding of a bony outgrowth with continuity of the cortical bone, cartilage-capped, osteoblastic activity similar to that of the adjacent bone tissue and without other morphofunctional malignancy criteria, the diagnosis of osteochondroma must be suggested as a first line option.

Conflict of interests

The authors have no conflict of interests to declare.

References
[1]
G.H. Herget, U. Kontny, U. Saueressig, D. Baumhoer, O. Hauschild, T. Elger, et al.
Osteochondroma and multiple osteochondromas: Recommendations on the diagnostics and follow-up with special consideration to the occurrence of secondary chondrosarcoma.
Radiologe, 53 (2013), pp. 1125-1136
[2]
E.L. Staals, P. Bacchini, M. Mercuri, F. Bertoni.
Dedifferentiated chondrosarcomas arising in preexisting osteochondromas.
J Bone Joint Surg Am, 89 (2007), pp. 987
[3]
K. Tong, H. Liu, X. Wang, Z. Zhong, S. Cao, C. Zhong, et al.
Osteochondroma: review of 431 patients from one medical institution in South China.
J Bone Oncol, 8 (2017), pp. 23-29
[4]
C.M. Czajka, M.R. DiCaprio.
What is the proportion of patients with multiple hereditary exostoses who undergo malignant degeneration?.
Clin Orthop Relat Res, 473 (2015), pp. 2355-2361
[5]
R. Parada López, E. Montano Navarro, A.L. Lafraya Puente, M. Rodríguez Ortega.
Exostosis tibial: osteocondroma.
Rev Pediatr Aten Primaria, 46 (2010), pp. 251-255

Please cite this article as: Moreno-Ballesteros A, Calvo-Morón MC, García-Gómez FJ, Castro-Montaño J. Hallazgo incidental de osteocondroma pélvico. Reumatol Clín. 2020;16:183–184.

Copyright © 2018. Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología
Idiomas
Reumatología Clínica (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?