Osteochondroma after total body irradiation: An age‐related complication

Abstract

Younger patients are at increased risk of osteochondroma following TBI. Review of the available literature suggests a low malignant potential of radiation-induced osteochondromas. Knowledge about the behaviour of post-irradiation osteochondromas will help clinicians manage patients appropriately.

Final adult height of patients who received hematopoietic cell transplantation in childhood

“…Children receiving GH develop osteochondromas earlier and at a shorter time after transplantation than children not receiving GH. [45][46][47] These data suggest that in this population of children given TBI, use of GH may stimulate radiotherapy-disturbed epiphyses resulting in an increased incidence of osteochondromas. 45,47 GH recipients in the present study developed osteochondromas longer after transplantation but were younger at HCT than the non-GH-treated patients.…”

“…Radiation-induced osteochondromas occur at an incidence of 10% to 12% after radiotherapy and an incidence of 10% to 24% after TBI. [44][45][46][47] Younger children are at greatest risk because of their greater growth potential. Chemotherapy and radiotherapy can arrest growth and cause epiphyses to remain open longer than usual, permitting osteochondromas to develop.…”

“…Malignant degeneration of the osteochondromas has been rare. 46 All TBI recipients should be monitored carefully for the development of secondary malignancies, including those who develop osteochondromas. None of the children in the present report who have been receiving GH have experienced malignant degeneration related to osteochondroma, and GH therapy has not been discontinued because of the osteochondroma.…”

Long-term outcomes in children with high-risk neuroblastoma treated with autologous stem cell transplantation

“…34 Previously, we and others have reported osteochondromas arising in patients following ASCT for high-risk NB. 35,36 Since our previous report of five cases, 36 we have identified a further three cases. Other musculoskeletal complications including fractures and slipped capital femoral epiphyses were observed in six patients.…”

The effect of X-rays on bone: a pictorial review

“…In the past the incidence of osteochondroma has been claimed to be as high as 12% of skeletally immature patients undergoing radiotherapy [58]. Two more recent studies have quoted an incidence varying from 4.8 to 10% [63,64]. Other benign radiation-induced tumours such as osteoblastoma have rarely been reported [65].…”