I have received useful comments re the fibular lesion. They differ in the
details, but generally agree it is non-aggressive. Very helpful.
From Dr. Rob Lambert (Edmonton, Canada):
3x volume over 13 years. Likely still benign. What you do depends on the
patient and the surgeon. If it was my fibula, I would leave it.
From Dr. David Hanff (Rotterdam, The Netherlands):
It’s difficult. The question is do you also treat low grade chondrosarcomas
(ACT/CS-1) or not? The differentation between enchondroma en ACT can be
difficult but the lesion doesn’t have signs of a hige grade CS,(deep
scalloping, perilesional edema, periostitis or cortical breach or soft
tissue mass). That’s I think what’s most important. Also the lesion
contains entrapped fat which favours low grade CS (Yoo et al Eur radiol
2009). Both enchondroma and low grade chondrosarcoma can be treated with
wait and see policy, well that’s how we do it in the Netherlands nowadays.
From Dr. Anna Hirschmann (Basel, Switzerland):
It looks benign. Seems to be cystic with an ossification, it reminds me of
necrotic areas which may ossify over time.
For a cartilage process I would expect a lobulated appearance with somewhat
arcs and rings-likish, def no chondrosarc as there is no aggressive feature.
Cysts may increase in size, what I assume in the case.
I have received useful comments re the fibular lesion. They differ in the
details, but generally agree it is non-aggressive. Very helpful.
From Dr. Rob Lambert (Edmonton, Canada):
3x volume over 13 years. Likely still benign. What you do depends on the
patient and the surgeon. If it was my fibula, I would leave it.
From Dr. David Hanff (Rotterdam, The Netherlands):
It’s difficult. The question is do you also treat low grade chondrosarcomas
(ACT/CS-1) or not? The differentation between enchondroma en ACT can be
difficult but the lesion doesn’t have signs of a hige grade CS,(deep
scalloping, perilesional edema, periostitis or cortical breach or soft
tissue mass). That’s I think what’s most important. Also the lesion
contains entrapped fat which favours low grade CS (Yoo et al Eur radiol
2009). Both enchondroma and low grade chondrosarcoma can be treated with
wait and see policy, well that’s how we do it in the Netherlands nowadays.
From Dr. Anna Hirschmann (Basel, Switzerland):
It looks benign. Seems to be cystic with an ossification, it reminds me of
necrotic areas which may ossify over time.
For a cartilage process I would expect a lobulated appearance with somewhat
arcs and rings-likish, def no chondrosarc as there is no aggressive feature.
Cysts may increase in size, what I assume in the case.
Hilary
On Wed, Jan 20, 2021 at 10:11 AM hilary umans <hilary.umans@gmail.com>
wrote:
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