Osteokondrom Tanısında Histopatolojinin Yeri: Seksen Sekiz Olgu ile Deneyimlerimiz

Öz

Amaç: Osteokondrom, kemiğin jukstaepifizer bölgesinden ortaya çıkan hyalin kıkırdak ile kaplı, kendi medüller boşluğu bulunan, iyi huylu, en sık primer kemik tümörüdür. Sıklıkla asemptomatik olmakla birlikte kozmetik mutsuzluk, komşu dokulara bası semptomları, ağrı ve nadiren malign transformasyon nedeni ile opere edilirler. Bu çalışmada konvansiyonel olgular ile birlikte farklı yerleşim ve klinik bulgular ile prezente olan osteokondrom tanılı olgularımızın retrospektif olarak değerlendirip, güncel literatür ışığında sunmayı amaçladık. Materyal ve metod: Tıp fakültesi Patoloji anabilim dalında Ocak 2010-Aralık 2023 yılları arasında osteokondrom tanılı 88 hastaya ait hematoksilen&eozin ve varsa immünhistokimyasal boyalı preparatlar retrospektif olarak değerlendirildi. Olguların yaş, cinsiyet, nüks durumları, klinik sonuçları hastane kayıtlarından elde edildi. Tümörün lokalizasyonu, radyolojik görüntüleme bulguları ve histopatolojik özellikleri retrospektif olarak değerlendirildi. Bulgular: Seksen sekiz olgunun, 50’si (%56,8) erkek, 38’i (%43,2) kadın olup olguların yaşlarının 3 ile 58 arasında değiştiği ve ortalama yaşın 22,83, ortanca yaşın ise 20 olduğu saptandı. Olguların en sık ağrı yakınması(n:55, %62,5) ile kliniğe başvurduğu tespit edildi. Tümörlerin en sık yerleşim yeri distal femur (n:33, %37,5) olup olguların büyük çoğunluğunda (47 olgu, %53,4) lezyon diz çevresinde lokalize idi. Multiple kitlesi olan 10 olguda en sık yerleşim yeri distal femur (n:3, %33,3) iken, onu humerus ve proksimal tibia (n:2, %20), proksimal femur, fibula ve ayak falanksı yerleşimi (n:1, %10) izlemekteydi. Yalnızca 1 olguda (%1,1) osteokondrom zemininde grade II kondrosarkomun geliştiği dikkati çekti. Diğer olgularda malign transformasyon veya nüks gözlenmedi. Sonuç: Osteokondrom erkek cinsiyette daha sık görülen, en sık distal femurda yerleşen kemiğin primer benign tümörüdür. Kliniğe en sık ağrı yakınmasıyla başvuran olgularda tedavi seçeneği cerrahidir. Lezyonlarda nadiren nüks görülmektedir. Osteokondromların çoğunluğu uzun kemiklerde görülmekle birlikte farklı, atipik lokalizasyon ve klinik bulgular ile karşımıza çıkabilirler. Olguların çoğu soliter olup multipl formlar da görülebilmektedir. Nadir de olsa osteokondrom zemininde malign transformasyon gelişebileceği akılda tutulmalıdır.

Anahtar Kelimeler

• osteokondrom
• kemik
• benign
• kondrosarkom
• lokalizasyon

The role of histopathology in the diagnosis of osteochondroma: our experience with eighty-five cases

Öz

Aim: Osteochondromas are the most common, benign, primary bone tumors with a medullary cavity, covered with hyaline cartilage arising from the juxtaepiphyseal region of the bone. Although they are often asymptomatic, they are operated on due to cosmetic unhappiness, symptoms of pressure on adjacent tissues, pain, and rarely malignant transformation. In this study, we aimed to retrospectively evaluate our cases diagnosed with osteochondroma, which presented with different localization and clinical findings, along with conventional cases, and present them in the light of the current literature. Materials and methods: Hematoxylin-eosin and immunohistochemical stained preparations, if any, of the materials belonging to 88 patients diagnosed with osteochondroma between January 2010 and December 2023 in pathology department of faculty of medicine alwere evaluated. Age, gender, recurrence status, radiological findings and clinical results of the cases were obtained from hospital records. The localization and histopathological features of the tumor were evaluated retrospectively. Results: Of the 88 cases, 50 (56.8%) were male and 38 (43.2%) were female, the ages ranged between 3 and 58, the average age was 22.83 and the median age was 20. It was determined that the cases most frequently applied to the clinic with the complaint of pain (n: 55, 62.5%). The tumors were most frequently localized in the distal femur (n: 33, 37.5%), and around the knee in most cases (47 cases, 53.4%). In 10 cases with multiple masses, the most common location was the distal femur (n:3, 33.3%), followed by the humerus and proximal tibia (n:2, 20%), followed by the proximal femur, fibula and foot phalanx (n:1, 10%) were watching. It was noted that grade II chondrosarcoma developed based on osteochondroma in only 1 case (1.1%). No malignant transformation or recurrence was observed in the other cases. Conclusions: Osteochondroma is a primary benign tumor of the bone that is more common in males and is most commonly located in the distal femur. The most frequent admission to the clinic is with the complaint of pain, and preferred treatment method is surgical resection. Recurrence of osteochondroma is rarely observed. Although most osteochondromas are seen in long bones, they may present with different atypical localization and clinical findings. Most cases are solitary but multiple forms are seen. It should be kept in mind that, although rare, malignant transformation may develop based on osteochondroma.

Anahtar Kelimeler

• osteochondroma
• bone
• benign
• chondrosarcoma
• localization

Kaynakça

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