Multiple Osteochondroma

Also known as

  • hereditary multiple osteocartilaginous exostoses
  • diaphyseal aclasis

Epidemiology

  • Rare

Aetiology

  • Autosomal dominant. 
  • Associated with mutations in EXT1 & EXT2, which leads to a maldistribution of Indian hedgehog in the extracellular matrix
  • Usually associated with short stature

Clinical

  • Clinically multiple osteochondromas.
  • Lesions are radiologically, grossly & microscopically similar to solitary osteochondromas
  • A good sign is defects of tubulation of the long bones, particularly around the femoral neck

Malignant Transformation

  • THERE IS A MUCH HIGHER RATE OF MALIGNANT TRANSFORMATION – AROUND 2-5%
  • The presence of a thick, active cartilage cap on an exostosis in a skeletally mature individual alerts one to the possibility of malignant transformation