Giant solitary osteochondroma arising from the fifth metatarsal bone: a case report

Solitary Osteochondromas of the Metatarsal and Cuneiform, in an Adolescent

Introduction

Solitary osteochondromas are extremely rare in the bones of the foot. In the growing skeleton, few cases affecting the metatarsals and the talus have been reported. At present, there have been no reports of osteochondromas affecting the cuneiforms.

Case Report

We report the case of a 13-year-old male patient. He presented with marked prominences in the plantar surface of his left foot and pain while participating in sporting activities. Radiological examination with X-rays, computed tomography (CT) scan, and magnetic resonance imaging revealed two solitary osteochondromas growing from the medial cuneiform and the head of the 1st metatarsal. The patient was treated surgically by excision of the osteochondromas. Histological examination confirmed the diagnosis of osteochondromas. He had an uneventful recovery and returned to his sporting activities.

Conclusion

Solitary osteochondroma can present in the cuneiform and metatarsal of a growing adolescent. CT scan is useful for the accurate diagnosis and surgical removal of the tumor.

Unusual aetiology of foot pain in the elderly: A case report & review of literature

The osteochondroma of metatarsal is a rare clinical entity. It generally occurs in the first or second decade of life. The osteochondroma should be investigated to rule out any malignant changes before embarking any surgical intervention. We report an osteochondroma of 5th metatarsal in a 65 years old female as an unusual aetiology of foot pain. We propose the scalloping effect of the osteochondroma on adjacent metatarsal as one of the mechanisms of causing pain in the foot. After ruling out the malignant transformation with the help of MRI, excision of the tumour was done with a curvilinear incision on the dorsum of the foot. There was no recurrence in 1 year follow up. This case report depicts the occurrence of osteochondroma in geriatric patient as an unusual cause of foot pain. The scalloping effect on the adjacent bone and tissues can be the aetiology of the pain.

One-stage surgical excision of a huge bilateral multiple osteochondroma of the hip: a case report

Osteochondroma or hereditary multiple exostoses is the most common benign bone tumor and is usually found in young patients. Osteochondromata of the proximal femur or hip have been reported in 30% to 90% of patients with hereditary multiple exostoses. This article presents a 25-year-old-male referred to our orthopedic clinic with a complaint of pain in both groins for the last four years which has deteriorated in the past 6 months by limitation of range of motion. Radiographic findings were consistent with huge hip osteochondroma and a histopathological report confirmed the diagnosis. This was a case of a huge bilateral osteochondroma of the hip originating from the posterior of the hips to the neck of the femur and hip joints and part of proximal of femur, that underwent one-stage surgical excision of the tumor with posterior approach and tumor resection. As we know, this case of bilateral huge hip osteochondromas has rarely been presented previously by someone who has undergone one-stage surgery treatment of a tumor this size. Bilateral hip osteochondroma is a rare condition and we showed that one-stage excision can be performed successfully.

Osteochondromas at Unusual Sites- Case Series with Review of Literature

Introduction:

Osteochondromas are benign tumours of the skeletal system. Their commonplace of occurrence is around growing ends of long bones like lower end of femur and upper end of tibia, but literature describing their incidence around flat bones of body like pelvis, scapula and small bones of hand, foot is rare.

Case Report:

We describe two cases of osteochondromas at unusual sites, one on the dorsal aspect of scapula and other at the base of first metatarsal. Patient with scapular osteochondroma had difficulty in sleeping in supine position while that with metatarsal osteochondroma had discomfort while walking.

Conclusion:

Depending on the site of occurrence, osteochondromas can give rise to different local symptoms. Possibility of osteochondroma should be kept in mind during differential diagnosis of bony swelling in flat bones as well as small bones.

Correction of a Forefoot Deformity Caused by a Large, Solitary Metatarsal Osteochondroma in an Adolescent: A Case Report

Solitary osteochondroma is the most common bone tumor, accounting for 20% to 50% of all benign bony tumors. Osteochondromas are usually found on the metaphysis of the long bones near the physis; the bones of the foot are less commonly involved. We describe a 13-year-old female with a large osteochondroma arising from the fourth metatarsal. Pressure from the tumor on the adjacent metatarsals had deformed her forefoot, creating cosmetic and functional problems. The second and third toes were deviated laterally at the metatarsophalangeal joint, and the fourth and fifth toes were deviated medially. In addition, the fourth and fifth toes were flexed at the proximal interphalangeal joint. We excised the osteochondroma and stabilized the metatarsophalangeal joints. After 3 years, the cosmetic and functional results were satisfactory. The subluxation at the metatarsophalangeal joints had resolved without treatment. Her Revised Foot Function Index score had improved from 141 preoperatively to 95 postoperatively, and her Manchester-Oxford Foot Questionnaire score had improved from 25 to 0. This case is a rare example of a large metatarsal osteochondroma in a growing child in which pressure from the tumor caused secondary forefoot deformities. The management of this case also shows the potential for the forefoot to remodel itself during adolescence, after the tumor has been resected and the joints stabilized.

Giant costal osteochondroma in a man with multiple exostoses

We report the case of a 42-year-old man who presented with kyphosis resulting from a giant symptomatic costal osteochondroma around the left fourth rib. The osteochondroma on the left side of the back was 56 cm × 47 cm × 33 cm and was painful. The size and growth of the tumor suggested a malignant transformation of a large costal osteochondroma. Multiple osteochondromas were also found on the legs. The patient's family history revealed hereditary characteristics. This patient was clinically diagnosed as a case of multiple familial osteochondromatosis. Complete removal of the tumor relieved the symptoms, and histopathologic examination confirmed malignant transformation of chondrosarcoma. There was no recurrence after 16 months of follow-up.

Malignant degeneration of a lumbar osteochondroma into a chondrosarcoma which mimicked a large retropertioneal mass

We report a case of a lumbar spinal osteochondroma that transformed into a large chondrosarcoma in a 39-year-old male who presented with an abdominal mass and back pain. This mass was also associated with a fracture of the stalk, which on cross-sectional imaging mimicked a mass of retroperitoneal origin. The diagnosis of chondrosarcoma transforming from a lumbar osteochondroma became apparent when comparison was made with previous studies.