Autologous Fat Grafting as a Last Resort for Unsustainable Pain in a Woman with Multiple Osteochondromas

Abstract

Multiple osteochondromas (MO) is characterized by the formation of osteochondromas throughout the entire body. Although the evidence regarding its pathogenesis is well understood, no curative treatment for the disorder is available. Patients can be treated symptomatically by surgical removal of painful osteochondromas. Unfortunately, some patients still suffer from severe pain, even after surgery. We report on a case concerning a 48-year-old woman with a history of MO who presented with persistent pain after surgical removal of a symptomatic osteochondroma of the left scapula and multiple symptomatic osteochondromas of the left foot and trochanteric region. Several interventions to reduce the pain did not have any lasting effect. Subsequently, she was treated with autologous fat grafting (AFG). After each session she was pain-free for at least one year and reported only partial recurrence of the pain. This is the first case report describing AFG for the treatment of pain after both surgical removal of an osteochondroma and symptomatic osteochondromas in a patient suffering MO with promising results. The treatment is more effective and clearly continues to remain active longer than injection therapy or pain medication. Future studies are necessary to confirm our results.

Subungual Osteochondromas of the Toe: Two Case Reports for Diagnosis and Treatment

“…Various characteristics including tumor size, shape, location, and vascularity can be valuable data at the preoperative stage. 16 …”

“…Various characteristics including tumor size, shape, location, and vascularity can be valuable data at the preoperative stage. 16 Benign cartilaginous tumors mostly have a slowly progressive course and do not show significant symptoms. However, they are occasionally located in the subungual area and are accompanied by toenail deformities.…”

Identification of a novel mutation in EXT2 in a fourth‐generation Korean family with multiple osteochondromas and overview of mutation spectrum

“…In this context, a bone scan to check for sarcomatous change is recommended at least once after entering puberty. It also needs to be noted that the topics of orphan drugs and next-generation pain control for MO have been underinvestigated (Beltrami et al, 2016;Karibe, Fukui, Sekikawa, Shiratori, & Fujimori, 2008;Negenborn, Moerman, & Ham, 2017).…”

Remission Strategies with Fat Grafting to Prevent Recurrence of Pedal Ulcerations and Pain: A Case Series

“…14 PFG has been successfully implemented as treatment for a number of pedal conditions such as diabetic foot ulcers, pedal fat pad atrophy, thromboangiitis obliterans, plantar fibromatosis, and plantar osteochondromas. 4,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Although it has be shown that grafted lipoaspirate redistributes over time in the plantar foot surface, it retains its supportive and analgesic function. 22 Considering this, the investigators expected that PFG holds potential therapeutic benefit to treat conditions, which results in elevated localized pedal pressure by providing a mechanism to dissipate said elevated pressure.…”