1/279. Dural osteochondroma: case report, review of the literature and proposal of a new classification. Complete excision of a dural osteochondroma is presented. Upon reviewing the literature we noted that basal and convexity osteochondromas, although considered as a single pathological entity, differ in epidemiology, pathogenesis, management and natural history. A new classification is proposed. ( info) |
2/279. Fibrodysplasia ossificans progressiva and associated osteochondroma of the coronoid process in a child. The article reports the occurrence of osteochondroma in a fibrodysplasia ossificans progressiva patient. A 5-year-old boy presented with limited mouth opening and firm swelling of the right zygomatic complex area. The boy had bilateral hallux valgus of the great toes and heterotopic endochondral ossification of facial and neck regions. Associated osteochondroma of the coronoid process and aggressive heterotopic ossification of masticatory and neck muscles were found in response to traumatic injuries. Natural and clinical histories of fibrodysplasia ossificans progressiva were reviewed. An early diagnosis and avoidance of factors that aggravate ossification are key factors in reducing the expected degree of physical disabilities of patients. An early recognition of congenital skeletal deformities, early detection of abnormal ossification, and awareness of the disease by the involved physicians are important factors in the early diagnosis of the disease and in reducing any unnecessary trauma. Bone scintigrams and CT scans are effective noninvasive tools for an early detection of ossification and for monitoring the progression of the disease. Further investigation of its pathogenesis at a molecular level is important to understand better the nature of the disease and to develop an effective treatment protocol. ( info) |
3/279. Atypical decubital fibroplasia associated with bizarre parosteal osteochondromatous proliferation (Nora's reaction). We describe recurring bizarre parosteal osteochondromatous proliferation (Nora's reaction) associated with atypical decubital fibroplasia in the region of the greater trochanter of the femur in a 52-year-old man. We hypothesize that these two recently introduced entities may represent two forms of tissue response to injury (ischemia) inducing proliferative reaction of bone and cartilage in the vicinity of periosteum, and necroses with hyperplastic granulation tissue and myxoid stroma in the subcutaneous tissues. ( info) |
4/279. Osteochondroma of the first rib presenting as a prominent clavicle. A report of 2 cases. We describe and discuss two patients with osteochondromas of the first rib which presented as prominence of the medial end of the clavicle. ( info) |
5/279. Osteochondroma and secondary synovial osteochondromatosis. Secondary synovial osteochondromatosis (SOC) is a rare disorder caused by a variety of joint disorders. Two unusual cases of secondary SOC are presented. The first patient is a 43-year-old man with extensive SOC developing within a bursa surrounding an osteochondroma of the pubic bone. The second patient is a 23-year-old man who developed florid and progressive SOC of his hip joint following excision of a femoral neck osteochondroma. SOC recurred despite three excisions over a 15-month period. Imaging was useful in pre-operative diagnosis of bursal SOC in the first patient and in detecting multiple recurrences in the second patient. Both cases illustrate prominent SOC developing secondary to osteochondroma. The different hypotheses regarding bursal and secondary SOC are reviewed. ( info) |
6/279. Evanescent exostosis. A new case. Much has been written about the natural history of osteochondromas, but there are only a few reports in the literature reflecting the spontaneous disappearance of this lesion. For that reason, we report an additional case which makes the total number of reported cases eleven, and also includes a review of the literature. ( info) |
7/279. Para-articular chondroma and osteochondroma of the infrapatellar fat pad: a report of three cases. We report three cases of para-articular chondroma and osteochondroma in the region of infrapatellar fat pad. All three lesions were resected and examined histologically. Two of them were primarily cartilaginous with a lobular pattern internally, and one uniformly osseous with peripheral cartilage. We conclude that these lesions are not the same. The former should be designated para-articular chondroma after Jaffe and the latter, osteochondroma. ( info) |
8/279. An extra-articular cause of locking knee. We report an uncommon case of locking of the knee in a 23-year-old girl. It was due to an osteochondroma at the medial aspect of the proximal tibia. ( info) |
9/279. Popliteal pseudoaneurysm caused by an adjacent osteochondroma: a case report and review of the literature. A male 17-year-old with multiple hereditary exostoses presented with a mass in the distal left thigh several days after lifting weights. An arteriogram showed a popliteal artery pseudoaneurysm adjacent to a femoral osteochondroma. The osteochondroma was excised and the artery was repaired with a saphenous vein interposition graft. A review of the literature identified 23 similar reports. The average age of the patients was 21.3 years. Seventy-eight percent were men and half of the patients had multiple hereditary exostoses. Ten patients were initially misdiagnosed. The clinician should consider the diagnosis of pseudoaneurysm in a young patient with an osteochondroma and a mass about the knee. ( info) |
10/279. osteosarcoma arising in a solitary osteochondroma of the fibula. We present a case of osteosarcoma arising in an osteochondroma of the right fibula in a 30-year-old woman. The available radiographic studies of the lesion were not suggestive of malignant transformation. The lesion and underlying bone were excised. Histologic examination showed a conventional high-grade osteoblastic osteosarcoma that focally eroded the fibrocartilaginous cap. The patient received postoperative chemotherapy and shows no evidence of disease 27 months following operation. The occurrence of osteosarcoma in an osteochondroma is an extremely rare event, and only a few cases are on record in the literature. ( info) |