# Enchondroma in the Fibular Diaphysis: A Case Report

## TL;DR

A 46-year-old woman with a suspected enchondroma in her fibula underwent imaging and surgical treatment due to diagnostic uncertainty and bone cortex disruption.

## Contribution

This case report highlights the diagnostic challenges and treatment decisions in differentiating enchondroma from low-grade chondrosarcoma.

## Key findings

- A solitary bony lesion with calcifications and sclerotic margin was identified in the fibular diaphysis.
- Surgical treatment was chosen over non-surgical management due to advanced age and bone cortex disruption.
- Computed tomography, MRI, and bone scintigraphy were used to guide the treatment decision.

## Abstract

Chondroma is a benign tumor formation that occurs through the proliferation of cartilaginous tissue. It can be located centrally (enchondroma) or peripherally, often appears between 10-30 years of age, and is commonly discovered incidentally. This case report describes a 46-year-old woman presenting with pain in the left calf and partial functional impotence. The onset of her symptoms was affirmatively marked by a mild skiing-related trauma. Following protocol, X-ray imaging (antero-posterior and lateral views) of the calf was performed, with the only finding being a solitary bony lesion, with internal calcifications, sclerotic margin and radiolucent internal matrix. Facing the uncertainty of diagnosis from a clinical and radiographic standpoint, it was decided to admit the patient for further evaluation and start the standard protocol of imaging investigations - computed tomography, magnetic resonance imaging, and bone scintigraphy - and determine the subsequent therapeutic behavior. Differential diagnosis between enchondroma and low-grade chondrosarcoma can be difficult due to their histopathological similarity. The therapy of choice in enchondroma comprises non-surgical treatment (observation) if the lesion remains unaltered in imaging, or curettage/filling with bone substitutes/allografts, but considering the advanced age and interruption of the bone cortex in our case, we opted for curative surgical treatment.