J Korean Soc Radiol.  2016 Feb;74(2):137-141. 10.3348/jksr.2016.74.2.137.

MR Features of Multiple Enchondromas with Associated Chondrosarcoma in the Lower Extremities

• Yang KY
• Sung MS
• Lee HJ
• Park IJ
• Lee JY
• Yu WJ
• Lee GJ
• Jeon SH
• Yu MN
• Yoon SC

• KMID: 2152607
• DOI: http://doi.org/10.3348/jksr.2016.74.2.137

Abstract

Multiple enchondromas are well described in the literature, however, the associated spectrum of MR imaging findings remains unclear. Secondary chondrosarcoma of the hand and feet associated with multiple enchondromas is extremely rare. Herein, we reported a case of multiple enchondromas of intramedullary, intracortical, and periosteal location with associated low-grade chondrosarcomas in the lower extremities on MR imaging in a 57-year-old woman.

MeSH Terms

Chondroma
Chondrosarcoma*
Enchondromatosis*
Female
Foot
Hand
Humans
Lower Extremity*
Magnetic Resonance Imaging
Middle Aged

Figure

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  Fig. 1 A 57-year-old female with multiple enchondromas and associated grade 1 chondrosarcoma. A. Anteroposterior and lateral radiographs of the left foot show multiple osteolytic lesions with sclerotic border at the middle phalanx of the 2nd toe and proximal phalanx of the 3rd toe, and subtle osteolytic lesion in the 5th metatarsal bone and calcaneus (arrows). B. Coronal fat suppressed T2-weighted MR image shows high signal intensity of intracortical chondroma of the proximal phalanx of the 3rd toe (arrow). C. Sagittal fat suppressed T1-weighted MR image with contrast enhancement shows rim enhanced lesions of enchondroma in the calcaneus (arrows). D. Axial and sagittal fat suppressed T2-weighted MR images show eccentric cartilage lobules and sessile bony protuberance with smooth cartilage cap (arrows) in the posterolateral aspect of the distal tibia. E. Consecutive coronal fat suppressed T2-weighted MR images reveal intramedullary high signal intensity mass of 5th metatarsal bone and a well-defined lobulated high signal intensity of soft tissue mass attached to the plantar surface of the bone. Saucerization of the plantar aspect of the cortex adjacent to the soft tissue mass is present (arrow). However, no connection of the intramedullary mass and soft tissue mass is observed. Mild soft tissue edema is present dorsal to the mass (empty arrow). F. Corresponding consecutive coronal fat suppressed T1-weighted MR images after contrast enhancement shows rim enhancement of the 5th metatarsal bone lesion and focal nodular enhancement in the soft tissue mass (arrow). G, H. Photomicrographs of grade 1 chondrosarcoma show moderate cellularity, mild to moderate nuclear atypism, and pleomorphism (hematoxylin and eosin, × 200) (G) and Haversian canal involvement (arrows) (hematoxylin and eosin stain, × 40) (H).

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