Regression of a solitary osteochondroma of the distal humerus in a toddler following trauma

Abstract

Osteochondromas are bone exostoses, with the vast majority extending from the metaphyseal region of long bones and are capped by cartilage. A review of the current literature reveals spontaneous regression of osteochondromas is a rarely documented event, with all but two of these recorded events resolving before skeletal maturity and within 6 years of identification. We present a case of trauma-induced resolution of a solitary osteochondroma after less than 3 months in a 15-month-old male, with a review of current literature.

Spontaneous regression of solitary osteochondromas in children: An option to consider in clinical practice

“…In the literature, the average age at the time of diagnosis is 9.61 (range, 1.25 to 16) years and 13.51 (range, 1.5 to 23) years at the time of resolution. [5][6][7][8][9][10][11][12][13][14][15][16][18][19][20] In our study, the average age at time of diagnosis was 8.75 (range, 4 to 11) years and 12.5 (range, 7 to 15) years at the time of resolution. In addition, the four cases we present follow a similar pattern: they are all males in the first or second decade of their lives who noticed an unpainful bony mass in their extremities (proximal humerus and distal femur).…”

“…[5] In most cases, radiographs are sufficient to establish the diagnosis and follow-up. [5][6][7][8][9][10][11][12][13][14][15][16][17] Pathological diagnosis is not usually necessary. Nevertheless, Hoshi [18] used computed tomography (CT) and Minami [19] magnetic resonance imaging (MRI) to analyze the tumor.…”

“…They suggested that, under the stimulus of trauma, the cells with osteogenic potencies in the periosteum became actively engaged in the remodeling of bone. In total, four of the cases revised mentioned a trauma antecedent [7,8,15] that could have triggered the shrinkage of the tumor and reduce the time to its regression; however, due to the inaccuracy between the time of exostosis appearance and its diagnosis, the exact time of regression is uncertain. In relation to the regression modes described by Aiba, [16] our cases were included in the incorporation theory, since the osteochondromas became mature before growth plate closure and were incorporated into bone growing in a vertical axis.…”

Minor Shoulder Injury Reveals Spontaneous Regression of Proximal Humerus Osteochondroma

“…The regression of solitary osteochondromas is a rare entity [ 3 ]. Many theories have been proposed to explain these regressions, like active resorption or metaphyseal remodeling [ 3 - 4 , 7 - 8 ].…”

“…The regression of solitary osteochondromas is a rare entity [ 3 ]. Many theories have been proposed to explain these regressions, like active resorption or metaphyseal remodeling [ 3 - 4 , 7 - 8 ]. In the present case, the progressive incorporation of the lesion in the cortex by positional growth of the adjacent bone seems the most plausible explanation.…”