Distinct Chromosomal Rearrangements in Subungual (Dupuytren) Exostosis and Bizarre Parosteal Osteochondromatous Proliferation (Nora Lesion)

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.

Section: Resultssupporting

confidence: 67%

“…It therefore was suggested by Zambrano et al [26] that BPOP could represent a neoplastic process. Subsequent work by Nilsson et al [15] and Endo et al [6] supports this and suggests t(1;17) represents a distinct translocation point unique to BPOP, thereby excluding the unitary hypothesis.…”

mentioning

confidence: 99%

Bizarre Parosteal Osteochondromatous Proliferation: A Locally Aggressive Benign Tumor

Joseph

Ritchie

MacDuff

et al. 2011

“…This topic is underrepresented in the orthopaedic literature, because many of the important clinical series have been published in journals from other specialties [4,8,9,12,15,20,21,29,30,33,34,41], reflecting the fact that the condition is treated by many kinds of nonorthopaedic providers. Complete marginal excision of the exostosis appears to mitigate recurrence.…”

Section: Discussionmentioning

confidence: 99%

Subungual Exostosis of the Toes: A Systematic Review

DaCambra

Gupta

Ferri-de-Barros

2014

“…This maturation process has been hypothesized to represent a reparative etiology in the response to trauma [11,24,27], despite that the majority of patients described in case reports lack a traumatic history. More recently, some reports have suggested BPOP is a neoplastic process instead of a reparative one [7,12,17,22,26,28].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

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

Rothenberg¹,

Zhang²,

Rosenberg³

et al. 2013

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.