Extraskeletal Chondroma of the Foot–A Case Report

Abstract

A 58-year-old male presented to the Outpatients Department for a painless swelling of great toe of right foot, of six months duration. Physical examination revealed a well-defined, firm, fixed, swelling of 2x2 cms on the distal phalanx of great toe of right foot. X-ray of the mass showed a dense soft tissue mass, with no bone involvement. The same was excised and sent for a histopathological examination.Gross examination revealed a well-defined mass of 2x2 cms. Cut section showed a firm, whitish tumour with gelatinous and chalky white areas of calcification, which were covered by a piece of skin on one side [Table/ Fig-1].Microscopic examination showed structure of skin with a tumour in the dermis, which was arranged in lobules which were separated by fibrous septa [Table/ Fig-2,3]. There were islands of mature hyaline cartilage, myxoid areas and foci of granular calcification. Some of the chondrocytes showed atypical nuclei 4]. A histopathological diagnosis of an extraskeletal chondroma was made. DisCussionESC-Soft tissue chondroma is a rare benign cartilaginous tumour and nearly 80% of ESCs are found in the fingers and the rest is seen in hands, feet, toes and trunk [1][2][3][4][5]. Few cases are reported at rare sites like dura, larynx, pharynx, oral cavity, skin, fallopian tube and parotid gland [6][7][8][9][10][11][12]. Pathology Section aBstRaCtExtraskeletal Chondroma (ESC) is uncommon which occurs predominantly in hands and feet. It has a variable histology, with two thirds of the ESCs showing mature hyaline cartilage which is arranged in distinct lobules with fibrosis, or ossification, or myxoid areas and few showing immature patterns, with chondroblasts mimicking extraskeletal myxoid chondrosarcomas (ESMCSs). ESCs can recur but they never metastasize, whereas ESMCSs can metastasize, which require aggressive treatment.We are reporting a case of ESC which was located in the distal phalanx of right foot great toe in a 58-year-old male patient. The histopathology in our case showed features of ESC, with some foci showing myxoid stroma and few chondroblasts with atypical pleomorphic nuclei mimicking ESMCS. Hence, the case had to be carefully evaluated to exclude ESMCS and to make the diagnosis of ESC. The treatment was limited to simple excision of the tumour and extensive surgery and post operative radiotherapy were avoided.

Tenosynovitis with psammomatous calcification arising from the volar plate of the proximal interphalangeal joint of the finger

“…9 Fourth, extraskeletal chondroma occurs predominantly in the distal extremities, and often contains calcifications detected on radiographs. 10 Histologically, extraskeletal chondroma can show diffuse granular calcifications which resemble the psammomatous calcifications of this case. 10 However, no cartilaginous tissue was observed in the present case, which ruled out this diagnosis.…”

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“…Foci of calcification and ossification are features, which are commonly seen only in ESC's, in contrast to ESMCS's [4]. ESC's can recur but they never metastasize, whereas ESMCS's can metastasize, which require aggressive treatment [6].…”

A rare benign soft-tissue chondroma in the plantar foot: A case report

“…STCs account for only 1.5% of benign soft tissue tumors 2 . Soft-tissue chondromas are usually small round masses that are firm and are made of hyaline cartilage 2,3 . Hyaline cartilage is found throughout the body and typically lines joint surfaces.…”