ArticleJoint diseases and related surgery2026
Assessment of radiological and clinical follow-up strategies for intrathoracic osteochondromas in hereditary multiple osteochondromas patients.
Article in Joint diseases and related surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study aims to evaluate the incidence, distribution, clinical implications, and surgical criteria for intrathoracic osteochondromas in hereditary multiple osteochondroma (HMO) patients. PATIENTS AND
methodsBetween January 2010 and January 2024, a total of 246 patients (146 males, 100 females; mean age: 8.2 ± 4.5 years; range, 1 to 18 years) who were diagnosed with HMO and had thoracic imaging using computed tomography (CT) with at least one year of clinical follow-up were retrospectively analyzed. Lesion characteristics (type, size, number, and location), symptoms, and surgical data were recorded. The receiver operating characteristic (ROC) curve analysis was performed to identify the size threshold associated with surgical indication.
resultsIntrathoracic osteochondromas were detected in 35% of chest X-rays and in 81.8% of CT scans. Among 45 CT-confirmed cases, 68.9% had multiple lesions and 77.8% were pedunculated. Surgical excision was performed in 12 patients (4.9%), most commonly due to chest pain or paracardiac location. Tumor size was significantly higher in excised cases (median: 26 mm vs. 12 mm, p < 0.001). A lesion size > 15 mm predicted surgical need with 91.67% sensitivity and 72.73% specificity (area under the curve [AUC] = 0.883, p < 0.001).
conclusionRoutine chest radiography, reinforced by selective thoracic CT in symptomatic or suspicious cases, should be integrated into the follow-up of HMO patients to detect intrathoracic osteochondromas early. A lesion size of > 15 mm, chest pain, and paracardiac localization are strong predictors of surgical intervention and should guide clinical decision-making.
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