Distinguishing enchondroma from low-grade central chondrosarcoma

Distinguishing enchondroma from low-grade central chondrosarcoma depends on interpreting histologic findings in the light of clinical and radiologic features. In the long bones, enchondromas do not grow, whereas low-grade chondrosarcomas grow slowly. The distinction should be made-based on answers to the question, "Is the lesion growing?" Serial radiographs are the best way to answer this question. Other clues are present in the clinical, radiographic, and histologic findings. In the short tubular bones of the hands and feet and in Ollier's disease, enchondromas do grow. Therefore, the threshold for regarding central cartilage-lesions in these settings should be higher. Extreme cortical expansion and/or infiltration of soft tissues should be present to diagnose chondrosarcoma.