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A remarkable form of unilateral hypertrophy and diffuse osteoma of the skull, following the distribution of the fifth nerve, has seen described by Jonathan Hutchinson and Alexis Thomson. #Chondroma.# Cartilaginous tumours, apart from those giving rise to multiple exostoses, grow from the long bones and from the scapula, ilium, ribs, or jaws.
When growing in the interior of a bone it causes a spindle-shaped enlargement of the shaft, which in the case of a phalanx or metacarpal bone may resemble the dactylitis resulting from tubercle or syphilis. A chondroma appears as a clear area in a skiagram.
When there is hyperostosis and sclerosis, the shaft appears denser and broader than normal, and the contour is uneven or wavy. When there is a central gumma, the shadow is interrupted by a rounded clear area, like that of a chondroma or myeloma, but there is sclerosis round about. Diagnosis.
The enlargement of adventitious bursæ over the head of the first metatarsal in hallux valgus; over the tarsus, metatarsus, and digits in the different forms of club-foot; over the angular projection in Pott's disease of the spine; over the end of the bone in amputation stumps, and over hard tumours such as chondroma and osteoma, are described elsewhere.
The myeloma is also to be diagnosed from chondroma, from sarcoma, and from osteomyelitis fibrosa cystica. [Illustration: FIG.
Chondroma, or enchondroma, is a cartilaginous tumor occurring principally where cartilage is normally found, but sometimes in regions containing no cartilage. Enchondroma may be composed of osteoid tissue, such as is found in the ossifying callous between the bone and the periosteum, and, according to Virchow, then takes the name of osteochondroma.
Portions of a chondroma, which have undergone calcification or ossification, throw a dark shadow with the X-rays; unaltered cartilage and myxomatous tissue appear as clear areas. [Illustration: FIG.
All intermediate forms between the innocent chondroma and the malignant chondro-sarcoma are met with. Chondroma may occur in a multiple form, especially in relation to the phalanges and metacarpal bones.
A tumour of bone may grow from the cellular elements of the periosteum, the marrow, or the epiphysial cartilage. Primary tumours are of the connective-tissue type, and are usually solitary, although certain forms, such as the chondroma, may be multiple from the outset. Periosteal tumours are at first situated on one side of the bone, but as they grow they tend to surround it completely.
CLASSIFICATION OF TUMOURS: I. Connective-tissue tumours: Innocent: Lipoma, Xanthoma, Chondroma, Osteoma, Odontoma, Fibroma, Myxoma, Endothelioma, etc.; Malignant: Sarcoma II. Epithelial tumours: Innocent: Papilloma, Adenoma, Cystic Adenoma; Malignant: Epithelioma, Glandular Cancer, Rodent Cancer, Melanotic Cancer III. Dermoids IV. Teratoma.
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