Osteochondroma: A Benign Bone Tumor Commonly Found in Children

Osteochondroma is a non-cancerous (benign) bone tumor that frequently develops during childhood and adolescence. It's one of the most common types of benign bone tumors, accounting for a significant percentage of all such cases.

What is Osteochondroma?

Essentially, an osteochondroma is an overgrowth of cartilage and bone that occurs near the end of a bone, typically near a growth plate. The growth plate is the area of cartilage in growing bones where new bone tissue is formed, allowing the bone to lengthen. As the child grows, the osteochondroma can also grow.

Where Does it Occur?

Osteochondromas most commonly appear near the joints, particularly around the knee, shoulder, hip, and ankle. They can occur in any bone but are less frequent in the skull or face.

Causes

The exact cause of osteochondroma isn't entirely understood. However, it's believed to be related to a problem with the growth plate during bone development. Some cases are linked to genetic factors or may occur after an injury to the bone. In rare cases, it can appear as part of a genetic disorder like Multiple Hereditary Exostoses (MHE), where multiple osteochondromas develop.

Symptoms

Many people with osteochondroma don't experience any symptoms, especially if the tumor is small. However, when symptoms do occur, they can include:

• A palpable, hard lump near a joint.
• Pain, especially with activity.
• Limited joint movement.
• Pressure on nearby nerves or blood vessels, which can cause numbness, tingling, or changes in circulation.
• Differences in limb length or deformities if the osteochondroma affects bone growth.

Diagnosis

Diagnosis typically involves:

• Physical Examination: A doctor will examine the area for a lump and assess joint movement.
• X-rays: X-rays are usually the first imaging test ordered and can clearly show the bony outgrowth.
• Other Imaging: In some cases, MRI (magnetic resonance imaging) or CT (computed tomography) scans may be used to get a more detailed view of the tumor and surrounding tissues.
• Biopsy: A biopsy (taking a small sample of the tumor) is rarely needed but might be performed to confirm the diagnosis, especially if there's any concern about the possibility of a malignant (cancerous) tumor.

Treatment

Treatment depends on the size and location of the osteochondroma and whether it's causing symptoms.

• Observation: If the tumor is small and not causing any problems, the doctor may recommend simply monitoring it with regular checkups and X-rays.
• Surgery: Surgery to remove the osteochondroma may be necessary if:
• It's causing pain.
• It's limiting joint movement.
• It's pressing on nerves or blood vessels.
• It's affecting bone growth.
• There is concern about it becoming cancerous (very rare).

Prognosis

The prognosis for osteochondroma is generally excellent. Most osteochondromas stop growing when the child reaches skeletal maturity (when bone growth is complete). The risk of an osteochondroma becoming cancerous is very low (less than 1%). However, if pain increases or the tumor starts to grow again after growth has stopped, it's important to see a doctor to rule out any complications.

When to See a Doctor

It's important to see a doctor if you or your child notices a new lump near a bone, especially if it's causing pain or other symptoms. Early diagnosis and treatment can help prevent complications.