Periosteal Chondroma

  • What is periosteal chondroma?

    Chondromas are very rare, benign tumors made of cartilage. Cartilage is the tough, flexible connective tissue found in many areas in the body, including the joints between bones, the rib cage, the ear, the nose, the elbow, the knee and the ankle.

    These tumors are found mostly in the small bones of the hands and feet, and in the upper arms, pelvis, thigh bones and ribs.

    There are two types of chondromas:

    • Periosteal chondroma, which forms on the surface of the bone in what is called the periosteum — the fibrous membrane made up of numerous blood vessels and connective tissue that covers the bone
    • Endochondroma, which forms in the central area of the bone where bone marrow is stored

    Fifty percent of periosteal chondromas occur in the long bone of the arm.

  • Causes

    The exact cause of periosteal chondromas is unknown. Research is underway to determine if there is a genetic or environmental relationship to this benign tumor.

  • Signs and symptoms

    Periosteal chondromas are usually asymptomatic, meaning they don’t cause symptoms, but they can cause bones to break.

    In some children, symptoms of periosteal chondroma can include:

    • Dull, achy pain
    • Swelling
    • A mass that can be felt
    • A broken bone

    If pain is a symptom, this can indicate a malignant tumor. Your child’s doctor should perform tests to determine if the tumor is chondrosarcoma, a cancerous growth.

    Generally, periosteal chondromas don’t spread to other parts of the body, but they can continue to grow as your child grows. Some periosteal chondromas can become cancerous in adulthood and become chondrosarcomas. Tumors in the pelvis and shoulder are more at risk of becoming malignant.

  • Testing and diagnosis

     At The Children’s Hospital of Philadelphia, our clinical experts use a variety of diagnostic tests to diagnose periosteal chondroma in children, including:

    • X-rays, which produce images of bones on film.
    • Radioisotope bone scan, which can help locate an area of abnormal bone growth.
    • Magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.
    • Computed tomography (CT) scan, which uses a combination of X-rays and computer technology to produce cross-sectional images ("slices") of the body.
    • EOS imaging, an imaging technology that creates 3-dimensional models from two planar images. Unlike a CT scan, EOS images are taken while the child is in an upright or standing position, enabling improved diagnosis due to weight-bearing positioning.
    • Blood tests.
  • Treatments

    If your child’s periosteal chondroma is not causing any symptoms, clinicians generally recommend a “watch-and-see” approach that includes ongoing monitoring to ensure the benign tumor does not grow.

    For children experiencing symptoms from the periosteal chondroma — such as pain or a bone fracture — surgical resection or curettage may be recommended.

    Surgery involves removing all or part of the tumor from the bone and filling the space with material such as methyl methacrylate cement, phenol or liquid nitrogen. Any bone fractures will be set during the resection-curettage surgery.

    Though surgery for periosteal chondroma is highly effective, we understand that any surgery can be a stressful experience for your child and family. At CHOP, we offer a wealth of resources about how to prepare your child for surgery and what to expect during surgery.

    Additionally, we employ numerous best practices before, during and after surgery to decrease the risk of infection and increase positive outcomes. See safety in surgery for details about safety protocols at The Children's Hospital of Philadelphia.

  • Follow-up care

    Follow-up care and ongoing support and services for your child and family are available at our Main Campus and throughout our CHOP Care Network. Our team is committed to partnering with parents and referring physicians to provide the most current, comprehensive and specialized care possible for your child.

    If your child had surgery to remove a periosteal chondroma, your child will see the orthopedic surgeon about one to two weeks after surgery, then again at three and six months post-surgery. During follow-up visits, X-rays and other diagnostic testing may be done to monitor your child’s health.

    Periosteal chondromas have the potential to become malignant chondrosarcomas, so it is imperative for your child to see a physician if any symptoms recur.

  • Outlook

    For children with a periosteal chondroma that is causing no symptoms, full recovery is anticipated. 

    In other circumstances, recovery depends on the seriousness of the child's growth, where it is located and whether it continues to grow.

Reviewed by John P. Dormans, MD, FACS on May 19, 2014