Chondroma of the Distal Phalanx of the Fingers: Clinical and Therapeutic Features: About 3 Cases

Abstract

Introduction: Chondromas are benign bone tumors that develop at the expense of the cartilage of skeletal tissue. The localization of chondromas in the hand is very frequent and represents 50 to 90% of cases. The localization in the distal phalanx is very rare. Clinically, it can be misleading and evoke digital hippocratism, which can make us think about several general diseases. Their diagnosis must imperatively be based on the comparison of clinical, radiological and histopathological data. The chondroma can be recurrent and can rarely degenerate into malignant lesions. Methods: We are sharing 3 cases of chondroma of the distal phalanx of the hand of patients who consulted in Taher El Maamouri hospital of Nabeul during these late 10 years. Results: The analysis of the 3 cases showed the almost constant presence of pain and deformity of the nail which looks like digital hippocratism. X-rays showed osteolytic lesions in the 3 cases. 1 case was about the thumb, 2 were about the index. The diagnosis is evoked depending on clinical data and X-rays. The confirmation was made by the histopathological study. Surgical excision associated with a bone graft allowed us to have good results, without recurrence at the last follow-up. We have not seen any cases of malignant degeneration. Conclusion: At the end of this study, it was concluded that the request for a systematic X-ray in front of every distal deformation of the fingers is necessary. The clinical and radiological data, the surgical biopsy excision with histopathological confirmation, represents the best attitude for the management of bone chondromas in the hand. Post-operative monitoring can detect a recurrence that depends on the quality of the surgical excision. Malignant degeneration is rare for solitary chondromas.