Multiple Chondroma: Report of Case*

Multiple Chondroma: Report of Case*

MULTIPLE CHONDROMA: REPORT OF CASE* B y L . P . H E N N E B E R G E R , D .D .S ., a n d L . W . B IM E S T E F E R , D .D .S ., B a ltim o re , M d ...

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MULTIPLE CHONDROMA: REPORT OF CASE* B y L . P . H E N N E B E R G E R , D .D .S ., a n d L . W . B IM E S T E F E R , D .D .S ., B a ltim o re , M d .

History.—H., a colored man, aged 32, came in the dental clinic of the Baltimore City Hospitals, for the extraction of badly broken down teeth, with the following history: At 17 years of age, owing to trauma, a large bruise occurred on his right leg. Following this, large cartilagi­ nous growths developed, which were diag­ nosed as multiple chondroma. During a period of years, these tumors developed

Fig. 1.— A bnorm al grow th of cartilage com­ posing chondrom a. Com parison of the little finger w ith the others reveals the enlargem ent of the other fingers.

rather slowly. At the age of 31, the right leg was amputated owing to this large growth, which weighed 52 pounds. During this time, the right hand also had become involved, as can be seen in Figure 1. The left hand is partially involved, and at pres­ ent is being treated with radium. Associated with the multiple chondroma are the he­ mangiomas (blood vessel tumors). Oral Examination.—A tumor, possibly an angiochondroma, about the size of a *From the D ental Clinic, B altim ore City H ospitals.

Jour. A.D.A., Vol. 23, March, 1936


5-cent piece, and containing fibrous tissue and many blood vessels, was seen on the mucous membrane of the lip. (Fig. 2.) MacCallum says: “In the cartilaginous tumor, however, the tissue is in relatively small districts well supplied with nourish­ ment from abundant blood vessels which accompany its fibrous stoma. The intercel­ lular substance is more variable in consist-

Fig. 2.— Possible angiochondrom a, bright red, h a rd on palpation and richly supplied w ith blood vessels.

ence and less dense than that of normal cartilage, and often shows a distinctly fibril­ lar stoma.” On the palate, there appeared three or four smaller tumors, which were red and were hard on palpation. COMMENT

The possible etiology of the tumors of the lip and palate is trauma, most likely biting the lip, or scraping of the palate by abrasive foods. The blood red appearance of the tumors in the palate can be explained by the ex-

Price— Eskimo and Indian Field Studies cessive development of blood vessels around the tumor. Virchow and von Reckling­ hausen stated that the excessive develop­ ment of blood vessels is of primary influ­ ence in the metastasis and development of the tumors. The majority of chondromas occur in early life, about puberty. The multiple chondroma is congential and may be hered­


itary. These tumors may appear at birth. The patient has two children, 2 and 3 years old, one of whom had chondromas at birth. These tumors were removed and there has been no recurrence. Virchow and von Recklinghausen have shown that rickets is an important factor in the disturbance of growth of bone that leads to chondroma formation.


H E relationship between dental ca­ ries, physical degeneration, lowered defense for disease and facial and dental deformities has apparently not been recognized or the factors therein defined. D ata w ill be presented in this communication which throw light on these factors and on means for their con­ trol. In an investigation to ascertain the role of nutrition in the etiology of dental caries, modern civilization’s universal ex­ pression of degeneration, my field studies have also included the recording of data which relate to facial development, the arrangement of the teeth in the dental arches, resistance to disease and associ­ ated problems. Since many of the primi­ tive races have had a high immunity to dental caries, in striking contrast with modern civilization, an effort has been made to study remnants of racial stocks whose isolation has preserved them from modernization. Among these have been


*Read before the Section on Histology, Physiology, Pathology, Bacteriology and Chem istry (Research) at the Seventy-Sixth A n ­ nual Session of the A m erican D ental Associa­ tion, St. Paul, M inn., A ugust, 1934.

Jour. A.D.A., Vol. 23, March, 1936

included Eskimos in Alaska and the In ­ dians in northern and central Canada in various stages of modernization, the study noting particularly the changing factors in the environment just at the point where the normal high immunity is lost. T h e data routinely studied have in­ cluded the examination of each individual tooth, recording the location of dental caries when present, missing teeth, anom­ alies in growth, irregularities of the teeth in the arches and abnormal relationships between the dental arches. Both normal and irregular facial expression and den­ tition were recorded photographically and the latter frequently also by impres­ sion taking. Samples of saliva were ob­ tained for chemical analysis and, in spe­ cial cases, samples of blood. In order to evaluate the influence of nutrition, samples of various foods were obtained for chemical analysis and data recorded as to the proportion of the various foods eaten. Ales H rdlicka, curator, Division of Physical Anthropology, the Smithsonian Institution, assisted me in the selection of districts for making studies in western Alaska. F or reaching the less modern­