Evidence map›Paper›PMID 41670645›Full record

ArticleSkeletal radiology2026

Investigating possible predictors of malignant transformation of osteochondroma: a retrospective cohort study with an illustrative case report.

Lucy L Hederick, Megan H Goh, Adrián Ibáñez-Navarro, Joseph J Connolly, Shreya R Halur, Aiden R Miller, Blake A Flood, G Petur Nielsen, Connie Y Chang, Santiago A Lozano-Calderón

Abstract readCase Reports
PubMed Publisher
In one paragraph

Article in Skeletal radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lucy L HederickDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Megan H GohDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Adrián Ibáñez-NavarroDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Joseph J ConnollyDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Shreya R HalurDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Aiden R MillerDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Blake A FloodDepartment of Pathology, Harvard Medical School, Boston, MA, USA.
G Petur NielsenDepartment of Pathology, Harvard Medical School, Boston, MA, USA.
Connie Y ChangDivision of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Santiago A Lozano-CalderónDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. slozanocalderon@mgh.harvard.edu.ORCID http://orcid.org/0000-0002-0681-9004

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the relationship between cartilage cap thickness, osteochondroma subtype (pedunculated vs. sessile), patient age, and multiple hereditary exostoses (MHE) diagnosis with malignant transformation of osteochondromas.

methodsA single-institution retrospective study of patients who underwent surgical excision of one or more osteochondromas between 1983 and 2025 was conducted. The relationship between cartilage cap thickness, osteochondroma subtype (pedunculated vs. sessile), patient age, and MHE diagnosis with malignant transformation was investigated.

resultsAmong 1138 pathology-confirmed osteochondromas, 1097 (96.4%) were benign osteochondromas and 41 (3.60%) underwent malignant transformation. In tumors with a pathology-measured cartilage cap (n = 411), benign tumors (n = 397) had a smaller median cap size than malignant lesions (0.3 cm [IQR: 0.2-0.6 cm] vs. 3.15 cm [IQR: 1.93-4.78 cm]; p < .0001). Among 27 malignant cases with preoperative imaging, 63% were sessile and 37% pedunculated. Patients with benign tumors were younger than those with malignant transformations (27.1 ± 15.9 vs. 37.8 ± 12.2 years; p < .0001). Patients with MHE had a greater incidence of malignant transformation compared to patients without (17% vs. 1.98%) (p < .0001). 137 MRIs and 37 CTs were compared to pathology measurements, yielding a concordance correlation coefficient of 0.80 and 0.92, respectively. The sensitivities and specificities were 29% and 91% for MRI and 67% and 94% for CT, respectively.

conclusionA thicker cartilage cap, older age, and confirmed MHE diagnosis were each significantly associated with a higher rate of malignant transformation. Multidisciplinary teams should factor in a patient's clinical presentation and past medical history in addition to the tumor characteristics in deciding the proper course of treatment.

Indexed as

Bone NeoplasmsCell Transformation, NeoplasticExostoses, Multiple HereditaryOsteochondromaAdolescentAdultChildFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesTomography, X-Ray ComputedYoung AdultCartilage capMalignant transformationMultiple hereditary exostosesOsteochondroma

Identifiers

PMID41670645

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.