title: Chondrosarcoma in a family with multiple hereditary exostoses.
abstract: Multiple hereditary exostoses is an autosomal dominant skeletal disorder in which there are numerous cartilage-capped excrescences in areas of actively growing bone. The condition is genetically heterogeneous, and at least three genes, ext1, ext2 and ext3 are involved. The reported risk for malignant transformation to chondrosarcoma has been from 0.6% to 2.8%. We have reviewed six generations of a family with 114 living adult members, 46 of them with multiple exostoses. Four have had operations for chondrosarcoma, giving the risk for malignant transformation as 8.3% in this family. Clinical and radiological examination revealed two additional patients with a suspicion of malignancy, but in whom the histological findings were benign. Reported elsewhere in detail, genetic linkage analysis mapped the causative gene to chromosome 11 and molecular studies revealed a guanine-to-thymine transversion in the ext2 gene. Patients with multiple hereditary exostoses carry a relatively high risk of malignant transformation. They should be informed of this possibility and regularly reviewed.
authors.affiliation: Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Kivioja
authors.forename: H
authors.initials: H
authors.lastname: Ervasti
authors.forename: J
authors.initials: J
authors.lastname: Kinnunen
authors.forename: I
authors.initials: I
authors.lastname: Kaitila
authors.forename: M
authors.initials: M
authors.lastname: Wolf
authors.forename: T
authors.initials: T
authors.lastname: Böhling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000235:genetics* / Q000601:surgery; D001842:Bone and Bones / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000235:genetics; D002813:Chondrosarcoma / Q000235:genetics* / Q000601:surgery; D002880:Chromosomes, Human, Pair 11; D005097:Exostoses, Multiple Hereditary / Q000235:genetics* / Q000601:surgery; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010375:Pedigree