PMC8350023_01
Diagnostics and surgical treatment. (A) Macroscopic observation of the hand on admission: a round infiltrated formation with a fistulous opening was located at the base of the ring finger. (B) X-ray of the hand on admission: an enchondroma with an heterogenous structure was visualized at the base of the proximal phalanx. (C) Intraoperative macroscopic revision of necrotic bone and soft tissues. (D) Macroscopic observation of the hand upon discharge from the hospital: wound healed by primary intention.
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F1
On admission to the hospital, the deformity on the back surface of the right hand was painful, increased in volume (2.5 x 3.0 cm), with skin hyperemia and a fistula wound up to 0.5 cm containing dense serous-purulent masses (Figure 1A). X-ray of the right hand revealed a round shape with bone density and heterogeneous structure on the proximal phalanx of the ring finger (Figure 1B). The bone-cartilaginous formation was excised with the surrounding necrotic tissues (Figure 1C). The wound healed by primary intention (Figure 1D).
Histological examination of excised tissues. (A) Large area of embryonic cartilage (*). Small chondrocytes without lacunae, dystrophic changes in some cells, uneven distribution of chondrocytes, an increased amount of extracellular matrix. Small area of mature cartilage (arrow). (B) Fibrous connective tissue (arrow). Granulation tissue with numerous blood vessels (*). (C) Fibrous tissue infiltrated with immune cells (arrow). (D) Fragment of mineral deposition (*) surrounded by tissue infiltrated with leukocytes and macrophages (arrow).
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F2
It was majorly replaced by an embryonic cartilaginous tissue (Figure 2A). Examination of the excised periosteal soft tissues revealed foci of maturing granulation tissue with numerous vessels and scar-fibrous tissue with extensive areas of hyalinosis (Figures 2B,C). Tissue around the fragments of mineral deposits was infiltrated with leukocytes and macrophages (Figure 2D).