Cases reported "Osteochondroma"

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11/100. Osteochondromyxoma of bone: a congenital tumor associated with lentigines and other unusual disorders.

    This article describes the clinical and pathologic features of four unusual bone tumors. Three were congenital or most likely so; the fourth, detected at age 1 year, was probably of considerable duration. The patients, three boys and one girl, each presented with a painless mass. Two had the carney complex, a familial lentiginous and multiorgan tumorous syndrome; another probably had this disorder; the fourth did not show it, but his mother did. The tumors occurred in the nasal region (n = 2) and the diaphysis of the tibia and radius (n = 1 each). Roentgenographically, three had benign characteristics; the fourth, malignant features. Grossly, the tumors were gelatinous, cartilaginous. and bony. Microscopically, they featured benign-appearing polymorphic cells with few division figures arranged in sheets and lobules set in a myxomatous, cartilaginous, osseous, and hyaline fibrous matrix. Cellularity was low to moderate. The tumors eroded bone, one infiltrated between bony trabeculae, and three had soft tissue extension. Complete resection of one tumor was curative; incomplete excision of two tumors resulted in local recurrence (intracranial and fatal) in one and persistence in the other; the fourth tumor remains under observation after biopsy. No tumor metastasized.
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12/100. Two cases of osteochondroma recurrence after surgical resection.

    Osteochondromas are the most common bone tumor found in children. A review of 114 resected osteochondromas over a 10-year period revealed recurrence in 2 cases. The overall recurrence rate of these lesions is less than 2% and was found to be 1.8% in this review.
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13/100. Infantile cartilaginous hamartoma of the rib. A case report.

    BACKGROUND: Infantile cartilaginous hamartoma of the rib is a rare condition occurring in newborn infants, with an incidence of 1 in 3,000 (0.03%) among primary bone tumor cases. Reports of this condition so far have presented the clinical, radiologic and histopathologic features. To the best of our knowledge, reports of the cytopathologic features have not been documented. In the present case report, clinical, radiologic and cytopathologic features and differential diagnosis are enumerated. CASE: A 1-month-old, male infant presented with a chest wall mass with a clinical diagnosis of osteochondroma. On fine needle aspiration cytology, a diagnosis of infantile cartilaginous hamartoma of the rib was suggested; it was supplemented by the clinical history and radiologic findings. CONCLUSION: Although rare, this condition ought to be kept in mind while dealing with infantile chest wall masses to avoid an erroneous diagnosis of malignancy, owing to its ominous cytopathologic features.
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14/100. fibrosarcoma in bizarre parosteal osteochondromatous proliferation.

    Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare benign lesion predominantly involving the small bones of the hands and feet. Malignant transformation in BPOP has not been documented in the English literature. This report presents the coexistence of fibrosarcoma with BPOP in the right distal fibula of an 18-year-old woman.
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15/100. osteochondroma of the thoracic spine and scoliosis.

    STUDY DESIGN: The case of a 16-year-old patient with an osteochondroma in T11 and scoliosis is reported. OBJECTIVE: To describe the treatment of an osteochondroma with scoliotic deformity and the imaging methods used for the diagnosis. SUMMARY OF BACKGROUND DATA: Osteochondromas arising in the vertebral column are rare. However, spinal involvement is found with some regularity because osteochondromas are among the most common benign tumors of bone. methods: The clinical history, plain radiographs, computed tomography, and magnetic resonance imaging, and pathologic findings of the reported patient were reviewed. The medical literature also was reviewed. RESULTS: The patient was treated with surgery in an attempt to remove the tumor and correct the aesthetic deformity. The results were satisfactory, with an improvement of the thoracolumbar scoliosis from 45 degrees to 18 degrees. CONCLUSIONS: Osteochondromas of the vertebral column may cause scoliosis. Computed tomography and magnetic resonance imaging are necessary for evaluating the origin, size, and characteristics of the tumor. In this case, surgical management involved resection of the tumor and correction of the scoliotic deformity.
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16/100. Florid reactive periostitis and bizarre parosteal osteochondromatous proliferation: pre-biopsy imaging evolution, treatment and outcome.

    OBJECTIVE: To report on the imaging evolution of florid reactive periostitis (FRP) and bizarre parosteal osteochondromatous proliferation (BPOP) of the phalanges of the hands from prospective diagnosis to operation and on postsurgical outcome. DESIGN AND patients: Three patients (2 female, 1 male; age range 11-34 years) presented with a swollen digit of the hand. Following presumptive radiographic diagnosis of FRP, they were closely observed both clinically and radiographically until operation. All three patients had radiographs of the involved digit, and one patient had an MR imaging examination. The interval between presumptive diagnosis and operation ranged from 2 to 8 months. Following operation, the patients have been clinically followed for 9-13 months (mean 10 months). RESULTS: In each of the patients, maturing of periosteal reaction without bone destruction was observed within 1-2 weeks of the presumptive diagnosis of FRP. Periosteal reaction was initially minimal in relation to the extent of soft tissue swelling and subsequently became more florid. In one patient, the lesion ossified, became adherent to the phalanx, and had an "osteochondromatous" appearance. In another patient, periosteal reaction was seen on both sides of the phalanx with an intact phalanx. In the sole patient who had MR imaging, edema was seen in the phalanx distal to the symptomatic site and the metacarpal proximal to the symptomatic site. CONCLUSIONS: Close clinical and radiographic correlation permits an accurate pre-biopsy diagnosis of FRP. The first follow-up radiograph taken within 2 weeks usually provides re-assurance of the accuracy of the diagnosis. FRP may progress to BPOP. Arbitrary antibiotic treatment can be avoided, and a planned surgical approach can be adopted.
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17/100. Bizarre parosteal osteochondromatous proliferation with cortical invasion.

    A 15-year-old male presented with an 18-month history of increasing swelling on the radial aspect of his left forearm. Radiographs and MR images showed a partly calcified mass on the lateral border of the radius with erosion of the underlying cortex. Following a CT-guided needle biopsy, the mass was excised by segmental resection of the radial shaft with replacement by a vascularised fibular graft. Histological examination of the resected specimen showed many features typical of a bizarre parosteal osteochondromatous proliferation (BPOP) but with destruction of the underlying cortical bone by cellular spindle cell tissue. Although there were no cytological signs of malignancy, we believe that this unusual disease should be regarded as a particularly aggressive form of BPOP and treated by wide excision. Clinical follow-up of our patient at 2 years shows no sign of local recurrence or metastasis.
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18/100. Subungual osteochondroma: a case report.

    Osteochondromas are among the most common bone tumors of the foot. However, they rarely occur in subungual locations. Clinically they appear as slow-growing masses causing deformity of the overlying nail. Here we present a case of subungual osteochondroma with characteristic clinical, radiologic, and histopathologic features. The lesion was successfully treated by total excision.
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19/100. Arthroscopic resection of an osteochondroma of the knee.

    We present a case of arthroscopic resection of a symptomatic periarticular osteochondroma of the knee. A competitive tennis athlete presented to our clinic at the beginning of the season with a contact lesion, a distal femoral osteochondroma, with a 3-year history of painful synovial inflammation and lateral patellar maltracking. She was treated symptomatically throughout the season until it was decided to perform surgery. The benign bone tumor, a sessile osteochondroma, was arthroscopically resected, which led to complete relief of symptoms and return to full competitive activity within 8 weeks. There has been no return of symptoms in 32 months of follow up. An arthroscopic resection of a symptomatic osteochondroma may be less painful, more cosmetically accepted, and result in quicker recovery than the traditional open incision approach.
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20/100. Bizarre parosteal osteochondromatous proliferation. Difficulty in diagnosis.

    Nora's tumor, also known as bizarre paraosteal osteochondromatous proliferation, is an exophytic outgrowth from the cortical surface that consists of a mixture of bone, cartilage, and fibrous tissue. It is a benign lesion with atypical microscopic features and a tendency to recur. Nora reported 35 cases emerging from the bones of the hands and feet. The largest published series is of 65 cases, with 17 lesions involving the long bones. With this exception, most authors report isolated cases. Age range from 8 to 74 years but most patients are between 20 and 35 years of age, and with the lesion affecting males and females in equal proportions. Usually the presenting symptoMs are due to bony mass, with a variable growth rate (months-years), and infrequent pain. In 15-20% of the cases there was trauma in the patient history: nevertheless, Fechner and Mills report no association with trauma. radiography shows a calcified, rounded mass emerging directly from the surface of the bone. Isotope bone scans show intense tracer uptake in the lesion. With time, the appearance progresses to the more characteristic mature bone architecture.
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