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Skeletal Radiology Aug 2018Fibrodysplasia ossificans progressiva is a rare genetic disorder characterized by congenital skeletal deformities and soft tissue masses that progress to heterotopic... (Review)
Review
OBJECTIVE
Fibrodysplasia ossificans progressiva is a rare genetic disorder characterized by congenital skeletal deformities and soft tissue masses that progress to heterotopic ossification. Deformities of the great toes are distinctive, and heterotopic ossification in the soft tissues follows an expected anatomic and temporal pattern. In addition to heterotopic ossification, osteochondromata, middle ear ossification, demyelination, lymphedema, and venous thrombosis are characteristic. Awareness of this constellation of findings is important to early diagnosis and surveillance.
CONCLUSIONS
Recognition of the imaging manifestations of fibrodysplasia ossificans progressiva is imperative to early diagnosis in order to appropriately direct patient care and preclude unnecessary biopsies or surgical procedures.
Topics: Adolescent; Bone Neoplasms; Child; Child, Preschool; Early Diagnosis; Female; Humans; Infant; Myositis Ossificans; Ossification, Heterotopic; Osteochondroma
PubMed: 29445932
DOI: 10.1007/s00256-018-2889-5 -
Orthopedic Nursing
Topics: Humans; Tibia; Bone Neoplasms; Osteochondroma
PubMed: 37989162
DOI: 10.1097/NOR.0000000000000995 -
Acta Orthopaedica Et Traumatologica... Jan 2020The aim of this study was to investigate ErbB2 expression in osteochondroma and its relationship with clinicopathologic features of osteochondroma, so as to identify a...
OBJECTIVE
The aim of this study was to investigate ErbB2 expression in osteochondroma and its relationship with clinicopathologic features of osteochondroma, so as to identify a new biomarker for the malignant transformation potential of osteochondroma.
METHODS
Immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) were used to investigate the expression status of ErbB2 protein and gene in 30 osteochondroma tissues and 20 non-neoplastic bone tissues. The association of ErbB2 gene and protein expression with clinicopathological parameters of osteochondroma was analyzed by using the χ2 test and Fishers exact test.
RESULTS
ErbB2 protein was found to be over-expressed in 4 of 30 (13.3%) osteochondromas and 1 of 20 (5%) non-neoplastic bone samples, which were not statistically significant (p=0.336). However, 13 of the 30 (43.3%) osteochondromas showed ErbB2 gene amplification, which was failed to be observed in any of the non-neoplastic bone tissue. ErbB2 gene amplification in osteochondroma was significantly higher compared with that in non-neoplastic bone tissue (p=0.001). In addition, the ErbB2 gene amplification was closely associated with clinical pathological parameters of osteochondroma, including high expression of cellularity (p=0.001), presence of binucleated cells (p=0.001), nuclear pleomorphism (p=0.003), calcification (p=0.002), nodularity (p=0.002), necrosis (p=0.009) and cartilage thickness (p=0.026). The association of the gene amplification with other clinicopathological parameters of osteochondroma, including permeation of trabecular bone, cystic/mucoid changes, mitosis, radiographic appearance, cap volume and subtype of osteochondroma was not observed. The over-expression of ErbB2 protein was not found to be associated with the above stated clinical pathological parameters of osteochondroma.
CONCLUSION
ErbB2 gene amplification was associated with adverse clinicopathological status of osteochondroma and could serve as an index for malignant conversion of osteochondroma. Further research is required to verify the predictive values of ErbB2 for osteochondroma.
LEVEL OF EVIDENCE
Level IV, Diagnostic Study.
Topics: Adult; Bone Neoplasms; Cell Transformation, Neoplastic; China; Female; Gene Amplification; Gene Expression; Humans; Immunohistochemistry; Male; Osteochondroma; Receptor, ErbB-2
PubMed: 32175895
DOI: 10.5152/j.aott.2020.01.484 -
BMJ Case Reports Sep 2021Osteochondromas in hereditary multiple exostosis have increased risk of malignant transformation as compared with solitary osteochondromas. We present a case of a...
Osteochondromas in hereditary multiple exostosis have increased risk of malignant transformation as compared with solitary osteochondromas. We present a case of a 54-year-old man who presented to us with complaints of swollen mass of the left shoulder with an ulcerative lesion. Radiograph showed a sessile growth from the proximal humerus and scapula. MRI revealed a sessile osteochondroma measuring about 11×10.1×8.0 cm. The malignant nature of the disease was anticipated due to increased cap thickness and non-healing ulcer, however, biopsy showed a benign lesion without any sarcomatous change. The patient was successfully treated with extra-periosteal excision and was recurrence-free at 24 months follow-up. This case illustrates an extra-articular giant osteochondroma of the proximal humerus, with possible signs of a malignant lesion but diagnosed benign on biopsy. We conclude that a biopsy should always preclude definitive management as this can change the overall mortality and morbidity of the patient.
Topics: Bone Neoplasms; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Osteochondroma; Shoulder; Ulcer
PubMed: 34518177
DOI: 10.1136/bcr-2021-243202 -
Skeletal Radiology Jan 2018Osteochondromas are the most common benign bone tumors, and thus far, their spontaneous shrinkage is considered a rare phenomenon. This study was designed to investigate...
OBJECTIVE
Osteochondromas are the most common benign bone tumors, and thus far, their spontaneous shrinkage is considered a rare phenomenon. This study was designed to investigate the exact ratio of remission to progressive or stable cases and analyze the mechanism of tumor regression on the basis of existing theories.
MATERIALS AND METHODS
We retrospectively collected images of solitary osteochondromas in patients from 1992 to 2013, excluding cases involving short-term follow-up periods and follow-up periods that ended before growth plate closure. A total of 121 patients were diagnosed and screened for study inclusion. Tumor shrinkage was measured by assessing three points on tumor contours to determine if they had regressed or vanished. Patterns of shrinkage were further divided on the basis of mechanisms described as incorporation, absorption, and fracture.
RESULTS
Seventeen patients (mean age at initial diagnosis 13.1 years) met the study inclusion criteria. Tumor morphological classifications were pedunculated (10 cases) and sessile (7 cases). Osteochondroma shrinkage was the most common outcome (8 cases), followed by stable osteochondromas (6 cases), and osteochondromas that had progressed (3 cases). Tumors with sessile morphology were more prone to shrinkage (6 of 7 cases) compared with those of pedunculated morphology (2 of 10 cases; p = 0.015). Among pedunculated cases, tumor shrinkage was via absorption. The timing of tumor growth cessation was related to the pattern of tumor shrinkage. Absorption mostly followed tumor growth cessation, whereas incorporation mostly preceded tumor growth cessation.
CONCLUSION
The shrinkage of osteochondromas appears less rare than was originally thought.
Topics: Adolescent; Bone Neoplasms; Female; Humans; Male; Osteochondroma; Remission, Spontaneous; Retrospective Studies
PubMed: 28822998
DOI: 10.1007/s00256-017-2760-0 -
Orthopaedics & Traumatology, Surgery &... Oct 2022Spinal osteochondroma (or exostosis) is a rare benign tumour whose clinical manifestations are delayed due to their slow growth and location. Few studies have addressed... (Observational Study)
Observational Study
BACKGROUND
Spinal osteochondroma (or exostosis) is a rare benign tumour whose clinical manifestations are delayed due to their slow growth and location. Few studies have addressed the characteristics and the diagnostic and therapeutic peculiarities of spinal osteochondroma in children. The objective of this multicentre observational study was to assess the outcomes of a cohort of children after surgery for spinal osteochondroma.
HYPOTHESIS
Surgical excision of spinal osteochondroma in children is not followed by complications or recurrences.
MATERIAL AND METHODS
We included consecutive children who had surgery between 2010 and 2018 at any of eight participating centres to remove spinal osteochondromas. The cause, clinical manifestations, and location of the lesions were collected. The surgical outcomes were evaluated after at least 2 years' follow-up.
RESULTS
We identified 22 patients who had surgery to remove 26 spinal osteochondromas at a mean age of 12.8±2.6 years. Among them, 7 had a solitary osteochondroma (SO group) and 15 had hereditary multiple osteochondromas (HMO group). At diagnosis, 72% of patients had clinical signs (spinal pain, n=4; one or more lumps, n=5; and neurological manifestations, n=3). In the HMO group, the diagnosis was made during routine MRI screening for tumours involving the spinal canal. Most osteochondromas involved the cervical spine (n=13), with no difference between the two groups (p=0.9). The lamina was the most common location but 54% of the tumours were growing within the canal (92% in the HMO group). After a mean follow-up of 5.2±4.4 years, no patients had experienced any recurrences or complications related to the disease or treatment.
DISCUSSION
Surgical excision of spinal osteochondromas in children is effective, with no medium-term recurrences. Our results also confirm the low peri-operative morbidity, even when the canal is involved, and the absence of any effect at last follow-up on spinal alignment. All patients with neurological manifestations at diagnosis made a full recovery.
LEVEL OF EVIDENCE
IV, retrospective observational cohort study.
Topics: Adolescent; Cervical Vertebrae; Child; Humans; Osteochondroma; Retrospective Studies; Spinal Neoplasms; Treatment Outcome
PubMed: 35150927
DOI: 10.1016/j.otsr.2022.103239 -
Clinical Imaging Nov 2023Osteochondromas account for 20%-50% of all benign bone lesions. These tumors may present as solitary non-hereditary lesions, which are the most common presentation, or... (Review)
Review
Osteochondromas account for 20%-50% of all benign bone lesions. These tumors may present as solitary non-hereditary lesions, which are the most common presentation, or as multiple tumors associated with hereditary conditions. Plain radiography is the imaging method of choice and demonstrates the typical cortical and medullary continuity of the tumor with the underlying bone. Magnetic resonance imaging is often performed to evaluate cartilage cap thickness, which correlates with malignant transformation. Other local complications include compression of adjacent neurovascular bundles, muscles, and tendons, bursitis, tendon tears, stalk fracture, and angular or rotational long bone deformities. Although the imaging features of osteochondromas are largely known, only a few papers in the literature have focused on their main complications and image-based follow-up. This paper aimed to illustrate the main complications of osteochondromas, suggest an image-based algorithm for management and follow-up and discuss differential diagnosis.
Topics: Humans; Exostoses, Multiple Hereditary; Bone Neoplasms; Osteochondroma; Magnetic Resonance Imaging; Toes
PubMed: 37778187
DOI: 10.1016/j.clinimag.2023.109989 -
Asian Journal of Surgery Aug 2023
Topics: Humans; Fibroma, Ossifying; Radius; Upper Extremity; Osteochondroma; Soft Tissue Neoplasms
PubMed: 36878781
DOI: 10.1016/j.asjsur.2023.02.074 -
Skeletal Radiology Jun 2017We report a case of an osteochondroma in a 47-year-old woman presenting with a 2-month history of thoracic back pain that radiated down her left arm. Based on imaging... (Review)
Review
We report a case of an osteochondroma in a 47-year-old woman presenting with a 2-month history of thoracic back pain that radiated down her left arm. Based on imaging features, the osteochondroma was initially thought to represent a calcified meningioma. The unusual features of the case include the location of the tumor, patient age, the erosion of the vertebra, and the confusing neuroradiological features. We review reported cases in which a solitary costal osteochondroma impinges on the neural foramina or central spinal canal and we discuss reasons for the misdiagnosis in our case.
Topics: Back Pain; Bone Neoplasms; Diagnosis, Differential; Female; Humans; Lumbar Vertebrae; Magnetic Resonance Imaging; Meningioma; Middle Aged; Osteochondroma; Tomography, X-Ray Computed
PubMed: 28275813
DOI: 10.1007/s00256-017-2608-7 -
RoFo : Fortschritte Auf Dem Gebiete Der... Oct 2016
Topics: Chromosomes, Human, Pair 8; Diagnosis, Differential; Genetic Predisposition to Disease; Humans; Lipoblastoma; Magnetic Resonance Imaging; Male; Neoplasms, Multiple Primary; Osteochondroma; Telomere; Young Adult
PubMed: 27272687
DOI: 10.1055/s-0042-108858