111/279. Biceps tendinitis caused by an osteochondroma in the bicipital groove: a rare cause of shoulder pain in a baseball player. Tendinitis of the long head of the biceps brachii muscle is commonly seen in athletes who do repetitive overhead motions. Common causes of biceps tendinitis include impingement syndrome, subluxation of the biceps tendon, and attrition tendinitis, whereas biceps tendinitis secondary to a bone neoplasm is rare. A case of biceps tendinitis caused by an osteochondroma arising in the left humeral bicipital groove in a 25-year-old male baseball player is reported. The tumor was hook-shaped, originated from the inferomedial portion of the humeral lesser tubercle, and surrounded the biceps tendon. Symptoms of increasing pain and inability to throw resulted from direct irritation of the biceps tendon by the tumor. Total excision of the tumor relieved the symptoms within 3 weeks. To our knowledge, there have been no reported cases in the English-language literature of biceps tendinitis caused by an osteochondroma. ( info) |
| An extraskeletal osteochondroma is an infrequently encountered benign cartilaginous tumor with a predilection for the hands and feet that usually does not exceed 3 cm in diameter. This diagnosis can be misleading because it bears the same name as the osseous neoplasm more commonly referred to as an exostosis. The authors present an unusual case of a painful enlarging mass in the foot of a 28-year-old man who was later diagnosed as having an extraskeletal osteochondroma measuring in excess of 4 cm. Clinical, radiographic, and magnetic resonance images are provided along with intraoperative and histopathologic figures. There was no sign of recurrence 1 year after surgical excision. A review of the literature regarding this uncommon lesion is also presented. ( info) |
113/279. Cervical myelopathy caused by an exostosis of the posterior arch of C1. We report a case of vertebral osteochondroma of C1 causing cord compression and myelopathy in a patient with hereditary multiple exostosis. We highlight the importance of early diagnosis and the appropriate surgery in order to obtain a satisfactory outcome. ( info) |
114/279. Extraskeletal osteochondroma of the thigh: a case report. A case of histopathologically proven extraskeletal osteochondroma of the thigh is presented along with its radiographic, CT and MRI findings. This is the first such case reported, to the best of our knowledge. The diagnosis of extraskeletal osteochondroma should be considered when a discrete ossified mass is localised in the soft tissue. ( info) |
| osteochondroma, or exostosis, is the most common of all benign bone tumors. Spinal osteochondromas are uncommon but may cause neurological compromise. We report two cases of spinal cord compression by osteochondromas. One patient was a 17-year-old man with hereditary multiple exostoses who was presented with spastic paraparesis, a sensory level at T3-T4, and a pyramidal syndrome. Vertebral exostosis was suspected by magnetic resonance imaging and confirmed by histological examination. Surgical decompression was followed by complete resolution of the neurological impairments. The other patient was a 19-year-old man with spastic paralysis of the right lower limb and a pyramidal syndrome. Whereas magnetic resonance imaging suggested a neurofibroma, histological features were those of osteochondroma. Nine months elapsed from symptom onset to surgery. This delay led to residual neurological impairments, which resolved almost completely after rehabilitation therapy. Vertebral osteochondromas contribute only 1.3-4.1% of all osteochondromas. The lesion may be solitary or a manifestation of hereditary multiple exostosis. magnetic resonance imaging shows the exact location of the lesion, most notably with relation to neighboring neurological structures. spinal cord compression is uncommon and usually has a favorable outcome provided surgical decompression is performed before major neurological damage develops. ( info) |
116/279. Costal osteochondroma presenting as haemothorax and diaphragmatic laceration. We report the unusual case of an 11-year-old girl who suffered a large haemothorax and lacerated left hemidiaphragm because of a costal osteochondroma arising from the left sixth rib near the costochondral junction. Surgical excision of the osteochondroma was performed and the lacerated diaphragm was repaired. ( info) |
117/279. Solitary asymptomatic nodule of the great toe. Subungual exostosis is a benign osteocartilaginous tumor of the ungual apparatus, particularly of the toes. It affects both sexes equally, more frequently in the second and third decades of life. We describe a 6-year-old girl who came to our attention because of the enlargement of a pinkish nodule in the distal part of the nail bed of the first toe, progressively elevating the nail plate. history, X-ray imaging and histopathologic examination led us to confirm our clinical suspicion, excluding any other possible cause of the subungual mass. The peculiar features of this clinical entity, and the possibility of effective treatment by practical surgical techniques, are discussed. ( info) |
118/279. Osteogenic melanoma. A case of osteogenic melanoma arising in the sole of the foot of a 75-year-old male is described. The patient had a history of cutaneous malignant melanoma of the left sole from 15 years previously with local recurrence 5 years previously. A second recurrence presented as an unencapsulated, poorly circumscribed mass measuring 7.5x6x3 cm, located in the dermis, subcutis and muscle, and composed of a lobular growth of malignant osteocartilaginous elements with foci of epithelioid cells. The tumor was strongly positive for HMB45 and S-100 protein. No conventional melanoma was found in the skin. The patient had no evidence of recurrence or metastasis 10 months after surgery. Pathologists and clinicians should be aware of the existence of osteogenic melanoma and should differentiate it from mimics. ( info) |
119/279. osteochondroma of the sacrum with a correlative radiographic and histological evaluation. Primary benign sacral tumors are rare representing only 1-4% of solitary exostoses and constituting 4% of all solitary spinal tumor. The tumor usually comes to attention in childhood or adolescence. The treatment of symptomatic lesions is resection. We present here a case of a sacral osteochondroma with characteristic histological and radiological features in an adolescent presenting with radicular pain. ( info) |
120/279. osteochondroma of the talar neck: a rare cause of callosity of the foot dorsum. osteochondroma is the most common benign bone tumor. It rarely affects rearfoot bones, and only a few cases of talar osteochondroma have been reported. We report a case of a solitary osteochondroma of the talus that presented as a painful callus on the anterior portion of the ankle that was refractory to dermatologic treatment. ( info) |