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Case of the Week 245

What's the most likely diagnosis?

  • 25 year-old with pain in hand


  1. Enchondroma
  2. Sarcoid
  3. Neuroblastoma
  4. Paget disease
  5. Ganglion cyst



1. Enchondroma with a pathologic fracture



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General considerations

  • Benign cartilaginous tumor
  • Develops in the medullary cavity
  • Usually solitary, although they can occur as multiple lesions in syndromes to be discussed
  • Arise from ectopic rests of hyaline cartilage
  • Occur mostly in 2nd to 3rd decade
  • Most common site is small bones of the hands and feet
    • Most occur in the proximal phalanx
  • Most common tumor of the hand
    • Also occur in the humerus, femur, tibia and ribs
  • In long bones, their calcification is similar to an intramedullary bone infarct
    • Bone infarcts tend to have a well-circumscribed, sclerotic margin

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