Correlation of Topographic Localization and Clinical Manifestation for Indications for Surgical Treatment of Osteochondroma

. Osteochondroma is the most common type of benign bone tumorwhich appears in two forms, sessile and pedunculated. It accounts for 50% of all benign tumors of bone tissue with a double tendency towards male population. It is covered by cartilage cap of different thickness. The thickness of the cap over 30 mm can indicate a malign transformation into the secondary chondrosarcoma. Aim of the study. Determine if there is a correlation between epidemic characteristics of the patients, pathohistologic characteristics, thickness of the cartilage cap and biological behavior of the tumor. Patientsand methods. Cross-sectional study included 37 patients which were diag nosed with osteochondroma in the period of 12 months, during the year 2014, at the Institute for pathology of Medical Faculty in Belgrade. The patients’ age, sex, localization, clinical manifestation and length of the case history were descriptively determined. The thickness of the cartilage cap was morphometrically determinedon pathohistologic devicesof re-sectioned tumors.Out of 37 patients with diagnosed osteochondroma, 3 of them (8%) had malign alteration of the cartilage cap. The thickness of the cartilage cap in all the 3 of them was over 30 mm, ranging from 68-120 mm. Relapse was found in 3 patients (8%). Discussion. The highest importance of this lesion comes from the fact that it is the most common bone tumor with high incidence and possibility for malign transformation of the cartilage cap into secondary chondrosarcoma which makes this tumor interesting for medical staff at the clinic and pathologists. Conclusion. The width of a cartilage cap, in correlation with clinical and radiology parameters, is a signifi cant predictive parameter of biological behavior of osteochondroma. Key words. osteochondroma, thickness of the cartilage cap, malign alteration. (Scr Med 2016:47:16-20) % & ' ( ) * + ) , . / 0 1 2 1 + 1 0 + 3 + ) 4 + * 5 6 7 8 ( 4 ) 4 9 * * 4 + 5 8 : ; < = = + > = 9 < 7 ( . * ) 4 4 17 S. KUNARAC, J., M. DOMUZIN, M. MARAN, S. MIHAJLOVIĆ Introduction ? @ A B C D E F G B H I J H D K D L H M @ K J B G @ N H D I O F P Q D I A M @ E J B C H N H C B C H E F D Q @ K H L E @ E C J B E H L E F P Q D I A R S P Q D I A D T F G B J D E B A U A F B Q H E F G B G H L G B A F V B I M B E F @ L B J B K D E L F D J B E H L E F P Q D I A D T W G H M G F G B Q D A F M D Q Q D E F P Q D I A @ I B D A F B D M G D E C I D Q @ F P Q D I A X B Y Z D A F D A H A [ O B E M G D E C I D Q @ O E D E Z D A A H T U H E L \ J I D Q @ O L H @ E F Z M B K K F P Z Q D I A O ] G D E C I D Q U Y D H C \ J I D Q @ O @ E C F P Q D I A D T J D E B D I H L H E D A F B D J K @ A F D Q @ O D A F B D H C D A F B D Q @ R̂ _ @ F H B E F A W H F G F G H A F U V B D T F P Q D I @ I B Q @ H E K U @ F U D P E L B I @ L B L I D P V A W G H M G @ C C H F H D E @ K K U C I @ W A F G B @ F F B E F H D E F D @ C B K H M @ F B @ V V I D @ M G H E C B @ K H E L W H F G F G H A F U V B D T V @ F G D K D L U R ` S G B J @ A H M C H @ L E D A F H M V I H E M H V K B A D T @ K K J B E H L E J D E B E B D V K @ A Q @ I B A H Q H K @ I @ E C Q B @ E V G U A H M @ K M K H E H M @ K B Y @ Q H E @ F H D E O K B A A H E Z N @ A H N B H Q @ L H E L Q B F G D C A H T E B M B A A @ I U O @ E C J H D V A U D T F G B A P A Z V B M F B C J D E B E B D V K @ A Q R a E C H M @ F H D E A T D I A P I L H M @ K F I B @ F Q B E F D T F G B J B E H L E J D E B F P Q D I A @ I B O @ F F G B \ I A F V K @ M B O V @ H E @ E C C @ Q Z @ L B C T P E M F H D E D T F G B L H N B E A B L Q B E F D T F G B K D M D Q D F D I A U A F B Q O T D K K D W B C J U A W B K K H E L @ E C M D Q V I B A A H N B A U E C I D Q B D E F D F G B @ C b D H E H E L E B P I D N @ A M P K @ I M D Q V D E B E F A R c S G B F U V B A D T A P I L H M @ K H E F B I N B E F H D E A T D I J B E H L E M @ I F H K @ L B E B Z D V K @ A Q A @ I B C H B I B E F Z T I D Q H E F I @ Z K B A H D E H E F B I N B E F H D E A @ E C B E Z J K D M I B A B M F H D E A F D @ Q V K B I B A B M F H D E A D T F G B J D E B A W G H M G I B d P H I B P A B D T @ P F D @ E C @ K K D L I @ T F H E D I C B I F D I B M D E A F I P M F F G B M @ I F H K @ L B C B T B M F R e Aim of the study f B F B I Q H E B H T F G B I B H A @ M D I I B K @ F H D E J B F W B B E B V H C B Q H M M G @ I @ M Z F B I H A F H M A D T F G B V @ F H B E F A O V @ F G D G H A F D K D L H M M G @ I @ M F B I H A F H M A D T F G B F P Q D I O F G H M g E B A A D T F G B M @ I F H K @ L B M @ V @ E C J H D K D L H M @ K J B G @ N H D I R Patients and methods ] I D A A Z A B M F H D E @ K A F P C U H E M K P C B C h i V @ F H B E F A W G H M G W B I B C H Z @ L E D A B C W H F G D A F B D M G D E C I D Q @ H E F G B V B I H D C D T j k Q D E F G A O C P I H E L F G B U B @ I k l j m O @ F F G B a E A F H F P F B T D I V @ F G D K D L U D T n B C Z H M @ K o @ M P K F U H E ? B K L I @ C B R S G B V @ F H B E F A p @ L B O A B Y O K D M @ K H q @ F H D E O M K H E H M @ K Q @ E H T B A F @ F H D E A @ E C K B E L F G D T F G B M @ A B G H A F D I U W B I B C B A M I H V F H N B K U C B F B I Q H E B C R S P Q D I F H A A P B F @ g B E T I D Q F G B I @ C H M @ K B Y M H A H D E I B A B M F H D E W @ A @ E @ K U q B C J U Q H M I D A M D V B O @ E C I B V I B A B E F @ F H N B M P F A B M F H D E A D T F G B F P Q D I W B I B F @ g B E T D I V @ F G D G H A F D K D L H M @ E @ K U A H A D T F G B F H A A P B R S G B F H A A P B W @ A C B M @ K M H \ M @ F B C J U F G B Q B F G D C D T T @ A F M @ K M H \ M @ F H D E O P A H E L r ] a @ E C r k s t m R n D I V G D Q B F I H M @ E @ K U A H A D T F G B M @ I F H K @ L B M @ V F G H M g E B A A W @ A C D E B @ F F G B A Q @ K K B A F Q @ L Z E H \ M @ F H D E X m l Y [ W H F G Q H M I D Q B F B I A M @ K B R S G B M @ I F H K @ L B M @ V H A Q B @ A P I B C D E F G B W H C F G W G H M G V I @ M F H M @ K K U A P H F B C F G B Q @ Y H Z Q P Q F G H M g E B A A D T F G B M G D E C I @ K M D Q V D E B E F R S G B A F P C U H E M K P C B C h i V @ F H B E F A W G D W B I B C H @ L E D A B C W H F G D A F B D M G D E C I D Q @ R S G B @ N B I @ L B @ L B W @ A k u v j w U B @ I A R t P F D T F G B F D F @ K E P Q J B I O F G B I B W B I B k m Q B E X w u x [ @ E C j h W D Q B E X h u x [ R y K K F G B V @ F H B E F A W G D W B I B H E M K P C B C H E F G B A F P C U W B I B C H N H C B C H E F D u H E F B I N @ K A D T @ L B O H E F G B I @ E L B T I D Q l Z j l l R y T Z F B I F G H A C H N H A H D E O H F W @ A C B F B I Q H E B C F G @ F Q D A F D T F G B V @ F H B E F A J B K D E L F D F G B \ I A F H E F B I N @ K T I D Q l Z k l U B @ I A D T @ L B O B N B E u m x R S G B Q D A F M D Q Q D E K D M @ K H q @ F H D E D T F G B F P Q D I H E V @ F H B E F A H E D P I A F P C U H A T B Q P I O T D K K D W B C J U F H J H @ @ E C A M @ V P K @ R z @ I B K D M @ K Z H q @ F H D E A @ I B D A V P J H A @ E C M @ K M @ E B P A R f B V B E C H E L D E F G B F U V B D T F G B J D E B M D E F B Y F P I B O u x D T D A F B D M G D E C I D Q @ W B I B H E F G B { @ F @ E C | u x H E F G B K D E L J D E B A R y T F B I F G B W G D K B A @ Q V K B D T F G B V @ F H B E F A W @ A C H N H C B C H E F D M G H K C I B E @ E C @ C P K F A O W H F G j } U B @ I A D T @ L B J B H E L @ K H Q H F O H F W @ A T D P E C D P F F G @ F D A F B D M G D E C I D Q @ W @ A Q D I B M D Q Q D E H E F G B K D E L J D E B A D T M G H K C I B E X } | x [ O W G H K B K B A H D E H E { @ F J D E B A W @ A Q D I B M D Q Q D E H E F G B J D E B A D T @ C P K F A X j u x [ R ~ B A H D E A D E K D E L J D E B A W B I B @ K W @ U A K D M @ K H q B C H E Q B F @ V G U A H A R X  I @ V G j R [ Graph 1. Localization of osteochondroma ] K H E H M @ K Q @ E H T B A F @ F H D E A F G @ F W B I B H E M K P C B C J U F G H A I B A B @ I M G W B I B V @ H E @ E C M D Q V I B A A H D E R ? @ A H M M K H E H M @ K A U Q V F D Q W @ A V @ H E O V I B A B E F H E h w € h i V @ F H B E F A O W G H K B D E K U j € h i C H C E D F G @ N B V @ H E H E @ E @ Q E B A F H M C @ F @ R ] D Q V I B A A H D E A U E C I D Q B W @ A C B Z A M I H J B C H E i u x D T F G B V @ F H B E F A R S G B K B E L F G D T F G B @ E @ Q E B A H A W @ A H E F G B I @ E L B T I D Q Q H E H Q @ K k F D Q @ Y H Q @ K j l } Q D E F G A O W G H K B F G B @ N B I @ L B K B E L F G W @ A k m Q D E F G A R X S @ J K B j R [ S G B @ N B I @ L B K B E L F G D T F G B T B Q @ K B @ E @ Q E B Z A H A W @ A j | O @ E C Q @ K B k i Q D E F G A R _ @ H E O @ A @ I B @ M F H D E F D V I B A Z A P I B D T D A F B D M G D E C I D Q @ D E F D F G B A P I I D P E C H E L A F I P M F P I B A O @ V V B @ I B C H E h w X | i x [ V @ F H B E F A O W G H K B D E K U D E B V @ F H B E F C H C E D F I B L H A F B I F G B V I B A B E M B D T @ V @ H E R S G B M K H E H M @ K I B M D I C N @ I H B C C B V B E C H E L D E F G B F U V B D T F G B J D E B W H F G D A F B D M G D E C I D Q @ R y K K V @ F H B E F A W G D G @ C D A F B D M G D E C I D Q @ D E K D E L J D E B A @ F F G B A @ Q B F H Q B G @ C V @ H E O W G H K B V @ H E @ V V B @ I B C H E } l x D T V @ F H B E F A W G D G @ C D A F B D M G D E C I D Q @ D E { @ F J D E B A R ] D Q V I B A A H D E D T A D T F 18 Scripta Medica Vol. 47 • No 1 • April 2016. • www.scriptamedica.com F H A A P B A W @ A V I D N B C H E | X k m x [ V @ F H B E F A O D P F D T W G H M G K D M @ K H q @ Z F H D E D T D A F B D M G D E C I D Q @ W @ A B Y M K P A H N B K U D E K D E L J D E B A R Table 1. Length of case history Months N % 2 2 5.4 5 1 2.7 6 4 10.8 7 1 2.7 8 3 8.1 10 4 10.8 11 1 2.7 12 4 10.8 14 1 2.7 24 5 13.5 36 4 10.8 44 1 2.7 48 3 8.1 54 1 2.7 96 1 2.7 108 1 2.7 TOTAL 37 100.0 t P F D T h i V @ F H B E F A W G D W B I B C H @ L E D A B C W H F G D A F B D M G D E C I D Z Q @ O h m G @ C J B E H L E K B A H D E O @ E C h D T F G B Q G @ C A D Q B A H L E A D T Q @ K H L E H F U R t P F D T h V @ F H B E F A W G D W B I B C H @ L E D A B C W H F G Q @ K H L E F I @ E A T D I Q @ F H D E O D A F B D