1
|
Fujita T, Hayasaka K, Kobayashi K, Eba S, Sato N. Successful complete thoracoscopic resection of costal osteochondroma: A case report. Asian J Endosc Surg 2024; 17:e13354. [PMID: 38970446 DOI: 10.1111/ases.13354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/17/2024] [Accepted: 06/22/2024] [Indexed: 07/08/2024]
Abstract
Osteochondroma rarely occurs in the ribs; therefore, the treatment is not standardized. There are few studies of resection via complete thoracoscopic surgery (CTS), although video-assisted thoracoscopic surgery with mini-thoracotomy has been reported. Herein, we report a case of costal osteochondroma managed with CTS. A 23-year-old woman presented to our hospital due to left chest pain. Chest computed tomography revealed a bone-like structure protruding into the thoracic cavity from the left fourth rib. Thus, surgery was performed to obtain a definitive diagnosis and provide appropriate treatment. The tumor was resected from the base at the border of the normal bone via CTS using three 5.5-mm ports. A pathological diagnosis of costal osteochondroma was made. The patient had an uneventful clinical course and did not present with a recurrence 1 year after surgery. Therefore, CTS can be a good approach for cases with slim and stalked costal osteochondroma.
Collapse
Affiliation(s)
- Tomohiro Fujita
- Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomorishi, Aomori, Japan
- Department of Thoracic Surgery, NHO Hamada Medical Center, Hamadashi, Shimane, Japan
| | - Kazuki Hayasaka
- Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomorishi, Aomori, Japan
| | - Kazuma Kobayashi
- Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomorishi, Aomori, Japan
| | - Shunsuke Eba
- Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomorishi, Aomori, Japan
| | - Nobuyuki Sato
- Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomorishi, Aomori, Japan
| |
Collapse
|
2
|
Xie V, Yan Y, Lu M, Perrin D, Garvin G, Stillwater L. Tibial osteochondroma with thick cartilage which mimicked a chondrosarcoma: A case report. Radiol Case Rep 2024; 19:1685-1691. [PMID: 38384709 PMCID: PMC10877103 DOI: 10.1016/j.radcr.2024.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 02/23/2024] Open
Abstract
We report a case of tibial osteochondroma in a 25-year-old female who presented with a palpable calf mass. This mass was associated with a thick cartilaginous cap on cross-sectional imaging, suggesting chondrosarcoma. A CT-guided biopsy was performed, and histology, however, was consistent with osteochondroma. Orthopedic oncology recommended surgical excision due to the potential high sampling error with chondroid lesions. The patient underwent surgical resection, resulting in a final diagnosis of osteochondroma. No post-surgical complications occurred, and a 12-month follow-up showed no evidence of local recurrence. This case highlights the atypical imaging feature of a thick cartilaginous cap in a benign etiology without malignant transformation.
Collapse
Affiliation(s)
- Victoria Xie
- Department of Health Science, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Yi Yan
- Department of Diagnostic Radiology, University of Manitoba, Room O2055, St Boniface General Hospital, 409 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada
- Department of Medical Imaging, St. Joseph's Health Care London, 268 Grosvenor St, London, Ontario N6A 4V2, Canada
| | - Miao Lu
- Department of Pathology, Rady Faculty of Health Sciences, University of Manitoba, 820 Sherbrook Street, Winnipeg, Manitoba R3A1R9, Canada
| | - David Perrin
- Department of Surgery, Section of Orthopedic Surgery, Max Rady College of Medicine Radiology, University of Manitoba. AD-401 820 Sherbrook Street, Winnipeg, Manitoba, Canada R3A 1R9
| | - Gregory Garvin
- Department of Medical Imaging, St. Joseph's Health Care London, 268 Grosvenor St, London, Ontario N6A 4V2, Canada
| | - Laurence Stillwater
- Department of Diagnostic Radiology, University of Manitoba, Room O2055, St Boniface General Hospital, 409 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada
| |
Collapse
|
3
|
Leveille CF, Zhu XM, Chen J, Burrow SR, Wang Y, Tarnopolsky M, Barkho JO. Pediatric Peroneal Nerve Palsy Secondary to Fibular Osteochondroma. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202310000-00005. [PMID: 37856702 PMCID: PMC10589584 DOI: 10.5435/jaaosglobal-d-23-00123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/21/2023] [Indexed: 10/21/2023]
Abstract
Peripheral nerve injuries due to mass effect from bony lesions can occur when the nerve exists in an anatomically constrained location, such as the common peroneal nerve at the fibular head which passes into the tight fascia of the lateral leg compartment. We report a case of a pediatric patient who developed a common peroneal nerve palsy secondary to an osteochondroma of the fibular head and describe the clinical evaluation, radiographic findings, and surgical approach. Rapid diagnosis and nerve decompression after the onset of symptoms restored full motor function at the 8-month postoperative mark.
Collapse
Affiliation(s)
- Cameron F Leveille
- From the Department of Surgery, Division of Plastic Surgery (Dr. Leveille, Dr. Zhu, Dr. Barkho), the Michael G. DeGroote School of Medicine (Mr. Chen), the Department of Pediatric Orthopedic Surgery (Dr. Burrow), the McMaster Children's Hospital (Dr. Burrow, Dr. Barkho, and Dr. Tarnopolsky), the Department of Pediatric Radiology, McMaster Children's Hospital (Dr. Wang), McMaster University, Hamilton, Ontario
| | | | | | | | | | | | | |
Collapse
|
4
|
Daher M, Zalaquett Z, Mekhael E, Aoun M, Chalhoub R, Abdo M, Aoude M, Farraj SA, Ghoul A, Tarchichi J, Rassi J, Sebaaly A, Trak-Smayra V, Kesrouani C, Kourie HR, Ghanem I. Epidemiology of bone tumors in Lebanon: a retrospective study from 2000 to 2022 at a tertiary center. Future Sci OA 2023; 9:FSO886. [PMID: 37752923 PMCID: PMC10518824 DOI: 10.2144/fsoa-2023-0102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/17/2023] [Indexed: 09/28/2023] Open
Abstract
Aim Bone tumors are rare and have an uneven geographic distribution. Methods 730 patients diagnosed with bone tumors were included in this retrospective analysis. Results With a 64% rate of malignancy, the most common tumors were metastasis (40%) mostly in the axial skeleton, Osteosarcoma (9%) mostly in the femur, Osteochondroma (8%) mostly in the femur, giant cell tumors (7%) mostly in the knee, and Ewing's sarcoma (6%) mostly in the axial skeleton. Conclusion Even though a some of the tumors have a predilection for certain localizations in the human body, they may differ in the middle-eastern population. One must also pay attention to the higher rates of malignancies as compared with other cohorts.
Collapse
Affiliation(s)
- Mohammad Daher
- Hôtel Dieu de France, Orthopedic Department, Beirut, Lebanon
| | - Ziad Zalaquett
- Hôtel Dieu de France, Hematology-Oncology Department, Beirut, Lebanon
| | - Elio Mekhael
- Hôtel Dieu de France, Orthopedic Department, Beirut, Lebanon
| | - Marven Aoun
- Hôtel Dieu de France, Orthopedic Department, Beirut, Lebanon
| | - Ralph Chalhoub
- Hôtel Dieu de France, Hematology-Oncology Department, Beirut, Lebanon
| | - Majd Abdo
- Hôtel Dieu de France, Hematology-Oncology Department, Beirut, Lebanon
| | - Marc Aoude
- Hôtel Dieu de France, Hematology-Oncology Department, Beirut, Lebanon
| | - Sami Abi Farraj
- Hôtel Dieu de France, Orthopedic Department, Beirut, Lebanon
| | - Ali Ghoul
- Hôtel Dieu de France, Orthopedic Department, Beirut, Lebanon
| | - Jean Tarchichi
- Hôtel Dieu de France, Orthopedic Department, Beirut, Lebanon
| | - Joe Rassi
- Hôtel Dieu de France, Orthopedic Department, Beirut, Lebanon
| | - Amer Sebaaly
- Hôtel Dieu de France, Orthopedic Department, Beirut, Lebanon
| | | | | | | | - Ismat Ghanem
- Hôtel Dieu de France, Orthopedic Department, Beirut, Lebanon
| |
Collapse
|
5
|
Chen P, Shen L, Long Q, Dai W, Jiang X, Li C, Zuo J, Guo J, Zhang X. Clinical Effect of Arthroscopic Resection of Extra-Articular Knee Osteochondroma. J Clin Med 2022; 12:52. [PMID: 36614849 PMCID: PMC9821279 DOI: 10.3390/jcm12010052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/27/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Objective: The aim of this study was to investigate clinical outcomes of arthroscopic resection of extraarticular knee osteochondroma. Methods: A retrospective analysis was performed in 74 patients with extra-articular knee osteochondroma treated by arthroscopic resection between August 2011 and August 2021, including 43 males and 31 females. Overall, 26 Distal femur cases and 48 proximal tibia cases were involved, with an average age of 31.7 ± 11.3 (11−57) years. Preoperative routine knee X-ray, CT, and MRI were performed before the operation. The Lysholm knee score, International Knee Documentation Committee (IKDC) score, Tegner knee motor function score, and visual analogue scale (VAS) were used to evaluate symptoms and functions before surgery and 3, 6, 12, and ≥24 months after surgery. Results: The average course of disease was (7.9 ± 3.7) months (range, 3−14 months) in 74 patients. The average follow-up was (22.6 ± 6.4) months (range, 10−37 months). There were no cases of vascular or nerve injury or wound infection. Compared with the preoperative function, the average scores of VAS, Lysholm, IKDC, and Tegner joint motor function decreased or increased significantly compared with the last follow-up (3.6 ± 1.1 vs. 0.1 ± 0.02, 44.5 ± 2.3 vs. 91.3 ± 4.9, 53.7 ± 2.6 vs. 94.2 ± 5.1, 4.6 ± 1.2 vs. 9.4 ± 1.4, p < 0.001). There was no recurrence or metastasis during the follow up. Conclusions: With the advantages of less trauma, high precision, less pain, and rapid recovery, arthroscopic resection of extra-articular knee osteochondroma can significantly improve the function of knee. It can be gradually extended to the treatment of other benign bone tumors.
Collapse
Affiliation(s)
- Peng Chen
- Department of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Li Shen
- Shenzhen Healthcare Committee Office, Shenzhen 518020, China
| | - Qiong Long
- Department of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Wei Dai
- Department of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Xiaocheng Jiang
- Department of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Canfeng Li
- Department of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Jianwei Zuo
- Department of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Jiang Guo
- Department of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Xintao Zhang
- Department of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen 518036, China
| |
Collapse
|
6
|
Adachi R, Nakamura T, Asanuma K, Hagi T, Uchiyama T, Sudo A. Thin Cartilage Cap May Be Related to the Spontaneous Regression in Pediatric Patients with Osteochondroma. Curr Oncol 2022; 29:9884-9890. [PMID: 36547191 PMCID: PMC9777135 DOI: 10.3390/curroncol29120777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/10/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The spontaneous regression of osteochondromas is rare, and only a few cases have been reported. Furthermore, the precise mechanism underlying spontaneous regression is unknown. This study aimed to examine the radiological findings of osteochondromas that had spontaneous regression and to identify potential indicators of this uncommon phenomenon in skeletally immature patients with osteochondromas. METHODS We included 28 patients (15 males and 13 females) who met the eligibility criteria between 2002 and 2019. The mean age at initial diagnosis was 9.7 years old (2-16 years). The mean follow-up period was 6.4 years (3-16 years). RESULTS Of the 28 patients, 10 (35.7%) had osteochondroma resolution. The osteochondroma resolved in one patient and regressed in nine. Tumor shrinkage is related to the thickness of the cartilage cap. The thickness of the cartilage cap did not correlate with age. CONCLUSIONS Tumor shrinkage is associated with a thinner cartilage cap on magnetic resonance imaging. The thickness of the cartilage cap may be an important predictor of spontaneous regression in pediatric patients with osteochondroma.
Collapse
|
7
|
Premalignant Conditions of Bone. JAAOS: GLOBAL RESEARCH AND REVIEWS 2022; 6:01979360-202210000-00004. [PMID: 36227850 PMCID: PMC9575816 DOI: 10.5435/jaaosglobal-d-22-00097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/29/2022] [Indexed: 01/10/2023]
Abstract
Development of malignancy is a multifactorial process, and there are multitude of conditions of bone that may predispose patients to malignancy. Etiologies of malignancy include benign osseous conditions, genetic predisposition, and extrinsic conditions. New-onset pain or growth in a previously stable lesion is that should concern for malignant change and should prompt a diagnostic workup for malignancy.
Collapse
|
8
|
When a Pilar Cyst Is Not a Pilar Cyst: Answer. Am J Dermatopathol 2022; 44:611-612. [PMID: 35830700 DOI: 10.1097/dad.0000000000002165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
9
|
Conservative Management of Knee Pain Associated With a Benign Femoral Osteochondroma in a Youth Athlete: A Case Report. J Chiropr Med 2022; 21:136-139. [DOI: 10.1016/j.jcm.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 11/21/2022] Open
|
10
|
Subramanyam P, Palaniswamy S. Recurrent intra articular osteochondroma of left 4 th finger. Indian J Nucl Med 2022; 37:204-205. [PMID: 35982801 PMCID: PMC9380807 DOI: 10.4103/ijnm.ijnm_169_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022] Open
Abstract
Osteochondromas are common benign bone tumors arising from metaphyseal region of long bones. They are notorious for undergoing malignant transformation. We present a case of a middle aged woman with recurrent episodes of swelling in the middle of left 4th finger post excision. Bone scan was performed to look for any malignant transformation of finger lesion and also to rule out skeletal metastases due to recent onset bone pains. 99m Tc MDP (Technetium methylene diphosphonate) bone scan demonstrated a focal hot spot in middle of left 4th finger along the radial side. There was no evidence of skeletal metastases. Surgery is usually curative (70-90%). Limb sparing wide local excision is treatment of choice.
Collapse
|
11
|
Bailescu I, Popescu M, Sarafoleanu L, Bondari S, Sabetay C, Mitroi M, Tuculina MJ, Albulescu DM. Diagnosis and evolution of the benign tumor osteochondroma. Exp Ther Med 2021; 23:103. [DOI: 10.3892/etm.2021.11026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/21/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Iulia Bailescu
- Department of Radiology and Medical Imaging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihai Popescu
- Department of Radiology and Medical Imaging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Lavinia Sarafoleanu
- Department of Histopathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Simona Bondari
- Department of Radiology and Medical Imaging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Corneliu Sabetay
- Department of Pediatric Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Mitroi
- Department of Otorhinolaryngology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela-Jana Tuculina
- Department of Restorative Dentistry, Craiova University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Dana-Maria Albulescu
- Department of Anatomy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| |
Collapse
|
12
|
Tepelenis K, Papathanakos G, Kitsouli A, Troupis T, Barbouti A, Vlachos K, Kanavaros P, Kitsoulis P. Osteochondromas: An Updated Review of Epidemiology, Pathogenesis, Clinical Presentation, Radiological Features and Treatment Options. In Vivo 2021; 35:681-691. [PMID: 33622860 DOI: 10.21873/invivo.12308] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023]
Abstract
Osteochondroma, the most common benign bone tumor, is a projection on the external surface of the bone, which can be sessile or pedunculated. 85% of osteochondromas present as solitary lesions, while 15% occur in the context of hereditary multiple exostoses (HME), a genetic disorder that is inherited in an autosomal dominant manner. Although often asymptomatic, symptoms may eventuate from compression of adjacent vessels or nerves, fractures, osseous deformities, bursa formation, or malignant transformation. Cartilage cap thickness >2 cm in adults or >3 cm in children as well as new onset of pain or growth, or rapid growth of the lesion, especially after the closure of the growth plate, might reflect cancerous transformation. Surgical resection is indicated for symptomatic lesions, complications, cosmetic reasons or malignant transformation. Excision of the tumor with free margin is the treatment of choice. Local recurrence is less than 2% if complete resection is achieved.
Collapse
Affiliation(s)
- Kostas Tepelenis
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece;
| | | | | | - Theodoros Troupis
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandra Barbouti
- Anatomy - Histology - Embryology, University of Ioannina, Ioannina, Greece
| | | | | | - Panagiotis Kitsoulis
- Anatomy - Histology - Embryology, University of Ioannina, Ioannina, Greece.,Orthopaedics, University of Ioannina, Ioannina, Greece
| |
Collapse
|
13
|
Peroneal Nerve Palsy due to Bulky Osteochondroma from the Fibular Head: A Rare Case and Literature Review. Case Rep Orthop 2020; 2020:8825708. [PMID: 33274093 PMCID: PMC7676958 DOI: 10.1155/2020/8825708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/19/2020] [Accepted: 10/28/2020] [Indexed: 11/17/2022] Open
Abstract
Common peroneal neuropathy is the most common compressive neuropathy in the lower extremities. The anatomical relationship of the fibular head with the peroneal nerve explains entrapment in this location. We report the case of a 14-year-old boy admitted with a left foot drop. The diagnosis was an osteochondroma of the proximal fibula compressing the common peroneal nerve. The patient underwent surgical decompression of the nerve and resection of the exostosis. Three months postoperatively, there was a complete recovery of the deficits. The association of osteochondroma and peroneal nerve palsy is rare. Early diagnosis is required in order to adjust the management and improve the results. It is worth to underscore that surgical resection is proven to be the appropriate treatment method ensuring high success rates.
Collapse
|
14
|
Mordenti M, Shih F, Boarini M, Pedrini E, Gnoli M, Antonioli D, Tremosini M, Sangiorgi L. The natural history of multiple osteochondromas in a large Italian cohort of pediatric patients. Bone 2020; 139:115499. [PMID: 32592948 DOI: 10.1016/j.bone.2020.115499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/04/2020] [Accepted: 06/14/2020] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Multiple osteochondromas is a rare hereditary skeletal disorder, characterized by bony protrusions arising from growth plates on long bones during skeletal development. The disorder frequently leads to diminished stature, deformities and functional limitations. Understanding of the natural history of multiple osteochondromas and its evolution in children and adolescents is limited. OBJECTIVE To provide valuable information on the natural history of multiple osteochondromas, to inform recommendations for treatment and prevent impairments caused by osteochondromas. DESIGN This retrospective cohort study in children with multiple osteochondromas includes longitudinal data collected from first to last follow-up visit for patient demographics, and over 36 months for disease evolution. SETTING Data were collected from the Registry of Multiple Osteochondromas, which includes data from circa 1200 patients with multiple osteochondromas treated from 2003 to 2017 at IRCCS Istituto Ortopedico Rizzoli in Bologna. PARTICIPANTS Patients ≤18 years with multiple osteochondromas, who provided written informed consent and had data for ≥1 12-month follow-up visit. MAIN OUTCOME(S) AND MEASUREMENT(S) Demographics, clinical features, incidence of surgeries, and disease evolution (progression or regression) were assessed. Results were summarized using descriptive statistics, annual rates of new clinical features and surgeries, and Kaplan-Meier estimates. Patient height was evaluated following Italian growth charts. RESULTS 158 patients were included in these analyses. Throughout follow-up, 80.4% of patients developed new osteochondromas, 57.6% developed new deformities, 23.4% developed new functional limitation(s). New osteochondroma(s) were developed by 28.5% patients by Month 12, 39.9% at Month 24, 50% at Month 36. Most new osteochondromas were detected in the younger population; patients aged 0-4 years underwent a significantly higher number of lesions within 12, 24 and 36 months of follow-up. The overall incidence of patients with ≥1 new deformity within 12 months was 17.7%, with incidences decreasing with increasing age (p = .023). In addition, the analyses on height highlight that 13 years is a cut off age for slow growth of the stature (p < .0005). At last follow-up visit, 46.2% of patients had disease progression, while regression (spontaneous and surgical) occurred in 7.6% (p = .007). CONCLUSIONS AND RELEVANCE This natural history study reports the main set of clinically relevant data for patients with multiple osteochondromas during skeletal development, providing insight for patient management and development of therapeutic interventions.
Collapse
Affiliation(s)
- Marina Mordenti
- Department of Medical Genetics and Rare Orthopedic Diseases and CLIBI Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | | | - Manila Boarini
- Department of Medical Genetics and Rare Orthopedic Diseases and CLIBI Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Elena Pedrini
- Department of Medical Genetics and Rare Orthopedic Diseases, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Maria Gnoli
- Department of Medical Genetics and Rare Orthopedic Diseases, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Diego Antonioli
- Ward of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Morena Tremosini
- Department of Medical Genetics and Rare Orthopedic Diseases, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Luca Sangiorgi
- Department of Medical Genetics and Rare Orthopedic Diseases and CLIBI Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| |
Collapse
|
15
|
Chaturvedi R, Lin GY, Wang W, Smitaman E. Osteochondroma of the temporal styloid process: a common disease in a rare but vulnerable location. Clin Imaging 2020; 65:5-7. [PMID: 32344289 DOI: 10.1016/j.clinimag.2020.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/23/2020] [Accepted: 04/14/2020] [Indexed: 01/12/2023]
Abstract
Osteochondromas, the most common benign bone tumor, are typically asymptomatic and discovered incidentally by imaging. Most frequently, osteochondromas occur at the metaphyses of long bones, and rarely involve the head and neck. We report the first case of a symptomatic osteochondroma of the temporal styloid process causing facial nerve paralysis.
Collapse
Affiliation(s)
- Rahul Chaturvedi
- University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA 92093, United States of America
| | - Grace Y Lin
- Department of Pathology, University of California San Diego, San Diego, CA 92103, USA
| | - Wilbur Wang
- Department of Radiology, University of California San Diego, 408 Dickinson Street, Mail code 8226, San Diego, CA 92103, USA
| | - Edward Smitaman
- Department of Radiology, University of California San Diego, 408 Dickinson Street, Mail code 8226, San Diego, CA 92103, USA.
| |
Collapse
|
16
|
Moreno-Ballesteros A, Calvo-Morón MC, García-Gómez FJ, Castro-Montaño J. Incidental finding of pelvic osteochondroma. REUMATOLOGIA CLINICA 2020; 16:183-184. [PMID: 29548897 DOI: 10.1016/j.reuma.2018.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/02/2018] [Accepted: 02/07/2018] [Indexed: 06/08/2023]
Affiliation(s)
| | - M Cinta Calvo-Morón
- Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España
| | | | - Juan Castro-Montaño
- Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España
| |
Collapse
|
17
|
Rib Exostoses Presenting as Mediastinal Masses: A Rare Presentation and Minireview of the Literature. Case Rep Med 2020; 2020:8283565. [PMID: 32089704 PMCID: PMC7021453 DOI: 10.1155/2020/8283565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 12/12/2019] [Accepted: 12/20/2019] [Indexed: 11/17/2022] Open
Abstract
Costal osteocartilaginous exostoses, also known as osteochondromas, are the most common neoplasms of the long bones but are rare tumors of the ribs. Osteochondroma is often asymptomatic and incidentally observed. Tumors typically begin to grow before puberty and continue until bone maturation is reached. Our paper presents the case of a 16-year-old young male who was admitted to the hospital with nonspecific symptoms and having a family history of exostosis. Chest X-ray and computed tomography imaging revealed multiple costosternal exostoses, manifested as mediastinal masses, with protrusion into the thoracic cavity, exerting compressive effects on the ascending aorta and pulmonary parenchyma. Surgery is required in childhood if lesions are painful. But if tumor formation occurs in adulthood, such pathological bony outgrowths should always be resected for avoiding further complications. In this patient, surgical intervention removed the tumoral masses and improved the symptoms. Subsequently, histological exam confirmed the diagnosis of osteocartilaginous exostoses and showed the lack of dysplastic changes.
Collapse
|
18
|
Jurik AG, Jørgensen PH, Mortensen MM. Whole-body MRI in assessing malignant transformation in multiple hereditary exostoses and enchondromatosis: audit results and literature review. Skeletal Radiol 2020; 49:115-124. [PMID: 31273432 DOI: 10.1007/s00256-019-03268-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/15/2019] [Accepted: 06/20/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyze the results of annual screening using whole-body magnetic resonance imaging (WBMRI) in patients with multiple hereditary exostoses (MHE) and enchondromatosis (EC), and estimate the risk for transformation to chondrosarcoma (CS) in these disorders. MATERIALS AND METHODS A total of 62 patients (57 with MHE and five with EC) screened during a mean follow-up period of 4.6 years (range, 1-10 years) using 253 WBMRIs (median four WBMRIs per patient, range, 1-10) were analyzed retrospectively. The time of WBMRIs was compared with dates for diagnosed CSs. A supplementary literature review was performed focusing on the risk of malignant transformation. RESULTS Ten patients had CS before being enrolled in the screening program, nine with MHE and one with EC. Three asymptomatic CSs were detected by screening; one in a patient with EC and two in patients with MHE, one of whom had CS previously. During the screening period, there was no occurrence of CS not detected by WBMRI in the study group. Histopathologically, the CSs were predominantly grade 1 and were, except for in two patients, located at the truncus, proximal femur, and shoulder girdle. Based on the current material and literature review, the risk of CS seems to be in the range of 2-3.7% for MHE and up to 50% for EC patients. CONCLUSIONS MRI may be used as a screening method detecting malignant transformation in MHE and EC patients, but the efficacy has to be confirmed in long-term follow-up studies including cost analysis.
Collapse
Affiliation(s)
- Anne Grethe Jurik
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd 99, 8200, Aarhus N, Denmark. .,Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Blvd 99, 8200, Aarhus N, Denmark.
| | - Peter Holmberg Jørgensen
- Department of Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Blvd 99, 8200, Aarhus N, Denmark
| | - Mikkel Meng Mortensen
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd 99, 8200, Aarhus N, Denmark
| |
Collapse
|
19
|
Shannon BA, Dixit S, McCarthy EF, Levin AS. Surgical Hip Dislocation Using the Modified Hardinge Approach for Excision of Osteocartilaginous Lesions of the Acetabulum and Femoral Neck in an Adult: A Case Report. JBJS Case Connect 2019; 9:e0026. [PMID: 31821201 DOI: 10.2106/jbjs.cc.19.00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 20-year-old woman presented with hip pain related to an osteocartilaginous lesion arising within the cotyloid fossa. She also had a lesion along the inferior femoral neck. Resection of both lesions was performed with surgical hip dislocation through a modified Hardinge approach. CONCLUSIONS This unusual location for an osteocartilaginous lesion can lead to substantial pain and disability. Surgical dislocation through a modified Hardinge approach is an excellent option to concurrently resect these benign lesions of the cotyloid fossa and femoral neck without the need for trochanteric osteotomy.
Collapse
Affiliation(s)
- Brett A Shannon
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland
| | - Sameer Dixit
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland
| | - Edward F McCarthy
- Department of Pathology, The Johns Hopkins University, Baltimore, Maryland
| | - Adam S Levin
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
20
|
DeHeer PA, Thompson N. Distal Fibular Osteochondroma Resulting in Tarsal Tunnel Syndrome: Case Report and Literature Review. J Am Podiatr Med Assoc 2019; 109:259-263. [PMID: 31268790 DOI: 10.7547/18-013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Osteochondromas are benign osseous tumors encountered most routinely by physicians responsible for diagnosing musculoskeletal disorders. Often, these osseous lesions are identified following symptoms related to their impingement on adjacent soft tissue or bone. METHODS This article presents a unique case of an asymptomatic osteochondroma of the distal fibula in a 29-year-old Caucasian woman that manifested clinically as an impingement on the tibial nerve. RESULTS After resection of the osteochondroma, the patient's tarsal tunnel syndrome symptoms resolved. CONCLUSIONS This case report demonstrates a never-before-described osteochondroma of the distal fibula traversing posterior to the ankle joint and impinging on the tibial nerve. After resection, the patient's symptoms resolved.
Collapse
|
21
|
Galanopoulos I, Stavlas P, Beltsios M. Distal Clavicle Osteochondroma Causing Supraspinatus Tendinopathy. Cureus 2019; 11:e4354. [PMID: 31192059 PMCID: PMC6550516 DOI: 10.7759/cureus.4354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Shoulder pain is a very common symptom especially in young and active population. Rotator cuff tendinopathies are believed to be the most common cause of shoulder pain up to 86%. Tumors around the shoulder area can cause pain or joint stiffness when expanding in the subacromial space. We present a rare case of a distal clavicle osteochondroma. It is a benign tumor which in this area causes supraspinatus tendinopathy and every physician should suspect this kind of diseases during the diagnostic approach of a shoulder pain. In this case, early diagnosis and appropriate treatment with excision of the lesion gave us a very good outcome with fully relief of the symptoms.
Collapse
|