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Jain MJ, Kapadiya SS, Mutha YM, Mehta VJ, Shah KK, Agrawal AK. Unusually Giant Solitary Osteochondroma of the Ilium: A Case Report with Review of Literature. J Orthop Case Rep 2023; 13:42-48. [PMID: 38025355 PMCID: PMC10664206 DOI: 10.13107/jocr.2023.v13.i11.4000] [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: 08/22/2023] [Revised: 09/08/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Osteochondroma is the most common benign bone tumor where a chondrogenic lesion is derived from aberrant cartilage from the perichondral ring. Although it commonly arises from the growing ends of long bones, less commonly, it may arise from the scapula, pelvis, or vertebra. Case Report We encountered a 16-year-old male patient with a painless left pelvic solid mass for 3 years, which was suggestive of osteochondroma on X-ray and magnetic resonance imaging findings. Besides cosmetic issues, the main indication for surgery was the constant discomfort in wearing pants/shorts/belts. He underwent en bloc excision followed by a biopsy of the surgical specimen by two independent histopathologists confirming the tumor to be osteochondroma. He was followed up for 2 years with no signs of post-operative complications or recurrence. This case represents one of the very few reported so affecting the iliac wing, where the excision was performed before skeletal maturation. We also performed a review of the current literature on iliac wing osteochondroma to understand the tumor better, identify gaps in current knowledge, and suggest areas for future research. Conclusion Since one of the differential diagnoses includes secondary chondrosarcoma, which could be a rare progression of osteochondroma, early recognition and comprehensive evaluation of such unusual cases needs to be dealt with a high index of suspicion to avoid misdiagnosis and to provide effective treatment.
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Affiliation(s)
- Mohit J Jain
- Department of Orthopedics, SBKS Medical Institute and Research Center at Sumandeep Vidyapeeth and Dhiraj Hospital, Waghodia, Vadodara, India
| | - Shubham S Kapadiya
- Department of Orthopedics, SBKS Medical Institute and Research Center at Sumandeep Vidyapeeth and Dhiraj Hospital, Waghodia, Vadodara, India
| | - Yash M Mutha
- Department of Orthopedics, SBKS Medical Institute and Research Center at Sumandeep Vidyapeeth and Dhiraj Hospital, Waghodia, Vadodara, India
| | - Vatsal J Mehta
- Department of Orthopedics, SBKS Medical Institute and Research Center at Sumandeep Vidyapeeth and Dhiraj Hospital, Waghodia, Vadodara, India
| | - Kshemankar K Shah
- Department of Orthopedics, SBKS Medical Institute and Research Center at Sumandeep Vidyapeeth and Dhiraj Hospital, Waghodia, Vadodara, India
| | - Aditya K Agrawal
- Department of Orthopedics, SBKS Medical Institute and Research Center at Sumandeep Vidyapeeth and Dhiraj Hospital, Waghodia, Vadodara, India
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Sun J, Wang ZP, Zhang Q, Zhou ZY, Liu F, Yao C, Zhang YF. Giant osteochondroma of ilium: a case report and literature review. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2021; 14:538-544. [PMID: 33936379 PMCID: PMC8085818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Osteochondroma is one of the most common benign bone tumors. It usually grows on the metaphysis of long bones and rarely develops in bones of scapula, feet, hands, and pelvis. The management of this disease is en-bloc excision of the tumor. We present a 45-year-old female subject, who complained of having found a mass on the right hip for more than 20 years which was diagnosed to be osteochondroma on X-ray, computed tomography (CT) and 3-dimensional (3-D) reconstruction. We performed en-bloc excision for the patient. Pathologic examination of surgical specimen confirmed the diagnosis of osteochondroma. The patient made a complete recovery and there has been no recurrence after one year of follow-up. Osteochondroma usually represents an osteo-cartilaginous aberrant overgrowth of normal epiphyseal growth plates. The disease has a slow onset and a long history. X-rays and CT scans are sufficient for diagnosis before surgery and the final diagnosis should based on pathology. Differential diagnosis includes chondrosarcoma or other neoplasms. When osteochondroma causes pain, compression of peripheral nerves, or continuous growth and other clinical symptoms, en-bloc excision of the tumor is needed. Better recognition and more comprehensive evaluation of these rare cases should be highlighted to avoid misdiagnosis during our clinical practice.
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Affiliation(s)
- Jie Sun
- Department of Orthopaedics, The Affiliated Hospital of Nantong UniversityNantong City, Jiangsu Province, PR China
| | - Zi-Ping Wang
- Department of Orthopaedics, The Affiliated Hospital of Nantong UniversityNantong City, Jiangsu Province, PR China
| | - Qing Zhang
- Department of Pathology, The Affiliated Hospital of Nantong UniversityNantong City, Jiangsu Province, PR China
| | - Zhen-Yu Zhou
- Department of Orthopaedics, The Affiliated Hospital of Nantong UniversityNantong City, Jiangsu Province, PR China
| | - Fan Liu
- Department of Orthopaedics, The Affiliated Hospital of Nantong UniversityNantong City, Jiangsu Province, PR China
| | - Chen Yao
- Department of Orthopaedics, The Affiliated Hospital of Nantong UniversityNantong City, Jiangsu Province, PR China
| | - Ya-Feng Zhang
- Department of Orthopaedics, The Affiliated Hospital of Nantong UniversityNantong City, Jiangsu Province, PR China
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Song LC, Xu Q, Li H, Li ZJ, Li Y, Qin YF, Wang BL, Zhang HF. Osteochondroma of the pubic symphysis causing hematuria: a case report and literature review. BMC Urol 2021; 21:1. [PMID: 33407372 PMCID: PMC7789616 DOI: 10.1186/s12894-020-00770-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 12/09/2020] [Indexed: 11/28/2022] Open
Abstract
Background Osteochondroma is the most common benign bone neoplasm and is sometimes referred to as osteocartilaginous exostosis. The symptoms caused by osteochondroma are rare, especially the urogenital complications. Therefore, this tumour is sometimes misdiagnosed. Case presentation This report described a 70-year-old woman with hematuria who was initially misdiagnosed with a bladder tumour in the outpatient department by a urologist. However, during cystoscopy, we found that the mass did not resemble a bladder tumor. Multidisciplinary approach with careful analysis of the imaging data suggested the diagnosis of osteochondroma. Open surgical excision of the mass was done and histology confirmed the diagnosis of benign osteochondroma. After 6 months of follow-up, the patient was still asymptomatic. Conclusions This case illustrates that hematuria is caused by not only urogenital disease but also osteochondroma. We present this case to draw the attention of clinicians to osteochondroma of the pubic symphysis.
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Affiliation(s)
- Li-Cheng Song
- Department of Orthopaedic, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China
| | - Qian Xu
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Hui Li
- Department of Orthopaedic, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China
| | - Zhi-Jun Li
- Department of Orthopaedic, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China
| | - Ya Li
- Department of the Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Ya-Fei Qin
- Department of Orthopaedic, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China
| | - Bao-Long Wang
- Department of Urology, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China.
| | - Hua-Feng Zhang
- Department of Orthopaedic, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China.
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An Unusual Case of Solitary Osteochondroma of the Iliac Wing. Case Rep Orthop 2020; 2020:8831806. [PMID: 33381339 PMCID: PMC7762652 DOI: 10.1155/2020/8831806] [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: 07/23/2020] [Accepted: 11/26/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Osteochondromas represent one of the most common bone tumors accounting for 8% of all bone tumors. While most osteochondromas arise in the metaphysis of long bones, osteochondromas have been reported in atypical locations such as the scapula, metatarsals, and the pelvic region. Osteochondromas are capable of growing large enough to cause mass effects and can undergo malignant transformation, stressing the clinical importance of recognizing these tumors. Case Presentation. In this case, we present an 18-year-old skeletally mature Caucasian male with a symptomatic osteochondroma arising from the iliac wing. The osteochondroma increased in size since he reached skeletal maturity. This resulted in a mass effect that interfered with activities of daily living, including clothing wear and symptomatic impaction on hard surfaces. Conclusion The majority of osteochondromas arise from the metaphysis of long bones, but case reports have shown that osteochondromas presenting in atypical locations such as the pelvis do occur. In the case of our patient, his asymptomatic pelvic tumor grew to the extent that it was causing interference with activities of daily living. Surgical excision of his tumor proved to be curative, and there was no recurrence at 6 months after excision. Osteochondromas in this region are capable of growing large enough to cause sexual dysfunction. Clinical suspicion must be high to properly diagnose osteochondromas in atypical locations. All providers, particularly those in primary care, should be aware of these locations as patients with symptomatic mass lesions will likely initially present here.
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Abstract
Introduction Osteochondromas are the most common benign bone tumors (accounting for 20–50% of all benign bone tumors). They are developmental malformations rather than true neoplasms and are thought to originate within the periosteum. They usually affect bones that develop by enchondral ossification and rarely originate from bones that develop by intramembranous ossification such as the scapula, pubic rami, clavicle, and ribs. Case Report We present a case of a 24-year-old male, who came with a swelling in the right side inguinal region for 2 years which was diagnosed to be osteochondroma by trocar biopsy. The site and presentation are rare. The patient had no visceral or vascular involvement though the lesion was very near many vital structures on superior pubic ramus. Conclusion Osteochondroma arising from the pelvis is an unusual presentation which should be kept in mind as a differential diagnosis when evaluating mass in pelvis.
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Affiliation(s)
- Rohan Ratra
- Department of Orthopedics, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
| | - Chetan Peshin
- Department of Orthopedics, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
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Management and retrospective analysis of pelvic ramus tumors and tumor-like lesions: Evaluation with 31 cases. Jt Dis Relat Surg 2020; 31:184-192. [PMID: 32584713 PMCID: PMC7489152 DOI: 10.5606/ehc.2020.72762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 02/05/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES This study aims to investigate the characterization, treatment approaches, and follow-up results of tumors and tumor-like lesions located in the pelvic ramus. PATIENTS AND METHODS Thirty-one patients (9 males, 22 females; mean age 48.9 years; range, 7 to 79 years) with benign and malignant tumors or tumor-like lesions in the pelvic ramus region treated and followed-up in our clinic between January 2005 and January 2019 were evaluated retrospectively. Surgical procedures were performed with anterior approach or inner-thigh approach. Twelve patients were diagnosed with malignant tumors, 12 patients with benign tumors, and seven patients with tumor-like lesions. RESULTS Seventeen patients who underwent surgical treatment were followed-up for a mean period of 61.7 months. The diameters of benign and malignant tumors were similar (p=0.425). Of all lesions, 64.5% were located in the pubis. Ischium location was significantly higher in patients with malignant lesions than tumor-like lesions. The most common complication was diffuse subcutaneous edema in the inguinal region and thigh (8.3%). CONCLUSION There are many different tumoral lesions in the pelvic ramus. Pelvic ramus tumors tend to settle more frequently in pubic ramus, whereas ramus ischium tumors are more likely to be malignant. In addition, the diagnosis of insufficiency fracture should be considered primarily in pathologic fractures of pubic ramus in females over 50 years of age. In the postoperative follow-up of pelvic ramus tumors, diffuse edema may occur even if there is no intraoperative vascular damage.
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Nayak SB, Kumar N, Sirasanagandla SR, Srinivas SP, Pamidi N, Shetty SD. Solitary osteochondroma in the body of the pubic bone: a cadaveric case report. Anat Cell Biol 2018; 51:136-138. [PMID: 29984059 PMCID: PMC6026819 DOI: 10.5115/acb.2018.51.2.136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 01/22/2018] [Accepted: 04/11/2018] [Indexed: 11/27/2022] Open
Abstract
Osteochondromas develop as cartilaginous nodules in the periosteum of bones. They are the commonest benign tumors of the skeleton, generally observed in the long bones. Rarely, they are also found in the axial skeleton, flat bones of skull and facial bones. During a regular dissection, we came across a solitary osteochondroma in posterior surface of the body of the right pubic bone. Histopathology of the bony projection confirmed the typical features of the osteochondroma. The symptomatic osteochondromas are usually evaluated during radiographic examination. Though, the observed osteochondroma is relatively smaller its unusual location is remarkable and knowledge of occurrence of such nodules is clinically important during the diagnosis and planning of treatment.
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Affiliation(s)
- Satheesha B Nayak
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India
| | - Naveen Kumar
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India
| | - Srinivasa Rao Sirasanagandla
- Department of Human and Clinical Anatomy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | | | - Narendra Pamidi
- Faculty in Anatomy, Jeffrey Cheah School of Medicine & Health Sciences, Monash University, Sunway Campus, Kuala Lumpur, Malaysia
| | - Surekha D Shetty
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India
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