Cortico-medullary continuity in bizarre parosteal osteochondromatous proliferation mimicking osteochondroma on imaging

Rybak, Leon; Abramovici, Luigia; Kenan, Samuel; Posner, Martin A.; Bonar, Fiona; Steiner, German C.

doi:10.1007/s00256-007-0300-z

Cited by 55 publications

(54 citation statements)

References 10 publications

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“…There are however radiographic reports in the literature of corticomedullary continuity [18], cortical destruction [10], and intramedullary inflammation [17] in histologically confirmed BPOP. We would recommend, if the clinical and radiographic appearances are typical and the site also is typical, then radiographic diagnosis is satisfactory.…”

Section: Resultsmentioning

confidence: 99%

Bizarre Parosteal Osteochondromatous Proliferation: A Locally Aggressive Benign Tumor

Joseph

Ritchie

MacDuff

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Bizarre parosteal osteochondromatous proliferation (BPOP) is a benign lesion of bone, and numerous questions remain unresolved regarding its etiology, diagnosis, and treatment. Questions/purposes We present the Scottish Bone Tumour Registry experience of this rare lesion. Patients and MethodsWe performed a retrospective analysis of the Scottish Bone Tumour Registry records. Histologic specimens were reexamined by a musculoskeletal pathologist. Radiographs were reevaluated by a musculoskeletal radiologist.Results From 1983 to 2009, 13 cases (13 patients; six male, seven female) were identified. Their ages ranged from 13 to 65 years. All patients presented with localized swelling. Pain was present in five. Antecedent trauma was present in two. Nine lesions affected the hand, three the foot, and one the tibial tuberosity. Twelve lesions were excised and one was curetted. There were seven recurrences of which six were excised. One lesion recurred a second time and was excised. There were no metastases. Radiographs showed densely mineralized lesions contiguous with an uninvolved cortex. Cortical breakthrough was present in one case and scalloping in another. Histologic analysis characteristically showed hypercellular cartilage with pleomorphism and calcification/ossification without atypia, bone undergoing maturation, and a spindle cell stroma. Conclusions BPOP is a rare benign lesion that probably is neoplastic, with no gender predilection, and affecting patients over a wide age range. Previously trauma was considered an etiologic factor, but this no longer seems to be the case. The rate of recurrence was 50%, which may indicate a more extensive resection is required for this locally aggressive lesion. No metastases were reported.

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Section: Resultsmentioning

confidence: 99%

Bizarre Parosteal Osteochondromatous Proliferation: A Locally Aggressive Benign Tumor

Joseph

Ritchie

MacDuff

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…MRI is useful to further characterize the radiographic features and display pertinent negatives, such as the absence of soft tissue swelling, soft tissue mass, and cortical destruction. Several case reports described histologically confirmed BPOP with atypical radiographic features, including cortical invasion, corticomedullary continuity, and medullary inflammation [1,10,12,19,21,22,26]. In these studies, histologic examination of the lesions was necessary to make the diagnosis.…”

Section: Discussion and Treatmentmentioning

confidence: 99%

Asymptomatic Upper Arm Mass in a 37-year-old Woman

Rothenberg¹,

Zhang²,

Rosenberg³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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A 37-year-old woman presented with a painless left upper extremity mass that she first noticed after a long strenuous workout 2 weeks before presentation. The patient denies any medical history, significant family history, and history of recent or remote trauma.On physical examination, there was a firm, fixed 3 cm 9 2 cm nontender mass palpable in the upper anterior aspect of the humerus. There were no overlying skin changes and she had full painless ROM of her shoulder and elbow.Plain radiographs (Fig. 1) and MRI ( Fig. 2) of the humerus were obtained.

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“…The characteristic radiological findings that differentiate BPOP from osteochondroma are the lack of cortical flaring at the margin of the protruberance and the absence of continuity of the lesion with medulla of underlying bone. Rybak et al however have reported a series of histologically proven BPOP cases where medullary communication was demonstrated leading them to hypothesize that a continuum also exists between BPOP and osteochondroma (Rybak et al 2007). None of the cases in this series were in the hand.…”

Section: Bizarre Parostealmentioning

confidence: 95%