Enchondroma vs Chondrosarcoma (low grade) : Mnemonic

Among cartilaginous tumors, 2 pathologies can be misleading when trying to reach a correct diagnosis: enchondroma (E), a benign tumor, and low-grade chondrosarcoma (LGC), which is a low-aggressivity malignancy. This can be a problem when deciding treatment because E only requires regular follow-up, but LGC needs surgical treatment. 

cartilage tumors
From: Cartilage tumors with special attention to Atypical Cartilaginous Tumors by Kirsten van Langevelde and Robin Smithuis (The Radiology Assistant : Cartilage tumors)
EnchondromaLow grade chondrosarcoma
AgeYoung adultsMiddle-aged
Bone scan uptakeIncreased in 20%Increased in 80%
Cortical breachSeen in 8%Seen in 88%
Deep endosteal scalloping (involving >2/3 cortical thickness)Seen in 10%Seen in 90%
Extra-osseous soft tissue massNot seenSeen
SiteAppendicular skeleton almost exclusively (when in phalanx, almost 100%)In axial skeleton, a chondral lesion is always a chondrosarcoma until the opposite is proven
Size<5 cm>5 cm
SufferingPainless unless pathologic fracturesInflammatory pain (almost always)


  1. Enchondroma vs low grade chondrosarcoma | Radiology Reference Article | Radiopaedia.org
  2. Ferrer-Santacreu EM, Ortiz-Cruz EJ, González-López JM, Pérez Fernández E. Enchondroma versus Low-Grade Chondrosarcoma in Appendicular Skeleton: Clinical and Radiological Criteria. J Oncol. 2012;2012:437958. doi: 10.1155/2012/437958. Epub 2012 Apr 22. PMID: 22593766; PMCID: PMC3346996.

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