Multiple Chondromas

Abstract

In presenting the following case of multiple chondroma, I appreciate that cases of chondroma are not uncommon. However, the following case demonstrates a chondroma in one of the long bones of the forearm, which is not a common site for such a tumor. This case is of some interest because it was treated with radiation with good results and not by surgery, which form of treatment is so frequently employed in some quarters. Patient (H. M.), white female, aged 20 years, apparently in good health. In 1933, while driving an automobile, patient fractured lower third of left forearm. Was treated as a fracture, but no x-rays were taken for several months, and at that time cystic bone changes with trabeculation were noted in lower end of ulna, distal end of fourth metacarpal, proximal phalanges of ring and little fingers. These cystic changes were a thinning of the bone near the epiphyseal line. No destruction and no periosteal involvement. X-ray examination of the following: skull, pelvis, chest, dorsal spine, shoulders, both legs and feet, all revealed no bone changes other than a small area of increased radiability in the lower third of the left tibia, in anterior aspect of left medullary canal. No other destruction or proliferation noted. No elevation of periosteum. General physical examination did not reveal any gross abnormal findings other than tumefaction of lower third of left forearm, left ring and little fingers. No abnormal findings in the blood, urine, stool, blood calcium, or phosphorus. Past history: Usual childhood diseases with no complications. Pneumonia, influenza, tonsils and adenoids, no complications. Left hand, crushed in childhood, apparently healed normally. Family history, irrelevant; menstrual history, normal. Progress: This patient was given medium doses of x-ray (300–600 r) — 180 kv. p., 0.5 mm. Cu, 1 mm. Al filter, distance 60 cm., port 5×5 at intervals, calcium and vitamin therapy. We have watched this patient at intervals for the past three years. The x-rays of the left forearm and hand show a definite increase in bone with a decrease in cystic changes. No change in left tibia. Now the patient apparently is healthy and active; she is careful not to injure her arm. I am indebted to John C. Hope, M.D., for the opportunity of studying this case.