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. 2019 Nov-Dec;33(6):2235-2240.
doi: 10.21873/invivo.11728.

Distribution of Solitary and Multiple Enchondromas of the Hand

Shinji Miwa  1   2 , Hideki Okamoto  3 , Satoshi Yamada  1 , Yohei Kawaguchi  1 , Kojiro Endo  1 , Hisaki Aiba  1 , Katsuhiro Hayashi  1   2 , Hiroaki Kimura  1   2 , Isato Sekiya  4 , Takanobu Otsuka  1 , Hiroyuki Tsuchiya  2
Affiliations

Distribution of Solitary and Multiple Enchondromas of the Hand

Shinji Miwa et al. In Vivo. 2019 Nov-Dec.

Abstract

Background/aim: Although some patients with enchondroma have multiple lesions, no study has investigated the distribution of lesions in patients with multiple enchondromas.

Patients and methods: This retrospective study included 118 patients with enchondroma of the hand. The incidence and characteristic feature of multiple enchondromas of the hand were investigated.

Results: Four patients (3.4%) had multiple enchondromas. In all the patients with multiple enchondromas, the lesions occurred in the middle phalanx, proximal phalanx, and metacarpal bone in the same digital ray.

Conclusion: The development of the hand rapidly progresses from intrauterine day 33 to day 54. The digital rays are evident on intrauterine day 41, and separation of the distal phalanx, middle phalanx, proximal phalanx, and metacarpal bone is completed until intrauterine day 54. The successive occurrence of multiple enchondroma lesions in the same digital ray in all four cases suggests that the occurrence of lesions preceded the separation of the hand bones and the lesions were divided during the development of these bones.

Keywords: Enchondroma; distribution; hand; multiple.

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Conflict of interest statement

The Authors declare that they have no competing interests regarding this study.

Figures

Figure 1
Figure 1. Case 1. A 16-year-old male patient. Radiograph showing osteolytic lesions in the proximal phalanx and metacarpal bone of the ring finger (a). Magnetic resonance imaging (MRI) showing multiple lesions in the middle phalanx, proximal phalanx, and metacarpal bone (b).
Figure 2
Figure 2. Case 2. A 19-year-old male patient. Radiograph (a) and MRI (b) showing abnormal lesions in the middle phalanx, proximal phalanx, and metacarpal bone of the index finger.
Figure 3
Figure 3. Case 3. A 17-year-old male patient. Radiograph and MRI showing abnormal lesions in the middle phalanx, proximal phalanx, and metacarpal bone of the middle finger.
Figure 4
Figure 4. Case 4. A 10-year-old female patient. Radiograph showing osteolytic lesions in the proximal phalanx and metacarpal bone of the middle finger (a). MRI showing low-intensity lesions on T1-weighted images and high-intensity lesions on T2-weighted images in the middle phalanx, proximal phalanx, and metacarpal bone of the middle finger (b).
Figure 5
Figure 5. Hand development in the human embryo. The limb bud appears on intrauterine day 26 and hand paddle on day 33. On day 36, chondrification of the humerus, radius, and ulna occurs. On day 41, digital rays are evident within the hand paddle. On day 47, chondrification of the middle phalanges, initial separation of the finger bones, and joint interzones are apparent in the hand. On day 50, chondrification of the proximal parts of the distal phalanges occurs. On day 54, finger bones are completely separated.
Figure 6
Figure 6. Occurrence of multiple enchondromas during hand development. For patients with multiple enchondromas occurring successively in the same digital ray, it is hypothesized that the lesions preceded the chondrification of the phalanges and metacarpals. If an enchondroma occurs before the development of phalanges and metacarpals, it can be separated by chondrification around the lesion during limb development, and the divided lesions can grow in separate bones as multiple enchondromas.
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