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Diagnostics (Basel, Switzerland) Jun 2023Benign tumours comprise the majority of primary vertebral tumours, and these are often found incidentally on imaging. Nonetheless, accurate diagnosis of these benign... (Review)
Review
Benign tumours comprise the majority of primary vertebral tumours, and these are often found incidentally on imaging. Nonetheless, accurate diagnosis of these benign lesions is crucial, in order to avoid misdiagnosis as more ominous malignant lesions or infection. Furthermore, some of these tumours, despite their benign nature, can have localised effects on the spine including neural compromise, or can be locally aggressive, thus necessitating active management. Haemangiomas and osteomas (enostosis) are the commonest benign tumours encountered. Others include osteoid osteoma, osteoblastoma, fibrous dysplasia, osteochondroma, chondroblastoma, haemangioma, simple bone cysts, aneurysmal bone cysts, giant cell tumours, eosinophilic granuloma and notochordal rests. The majority of lesions are asymptomatic; however, locally aggressive lesions (such as aneurysmal bone cysts or giant cell tumours) can present with nonspecific symptoms, such as back pain, neurological deficits and spinal instability, which may be indistinguishable from more commonly encountered mechanical back pain or malignant lesions including metastases. Hence, imaging, including radiography, computed tomography (CT) and magnetic resonance imaging (MRI), plays a critical role in diagnosis. Generally, most incidental or asymptomatic regions are conservatively managed or may not require any follow-up, while symptomatic or locally aggressive lesions warrant active interventions, which include surgical resection or percutaneous treatment techniques. Due to advances in interventional radiology techniques in recent years, percutaneous minimally invasive techniques such as radiofrequency ablation, sclerotherapy and cryoablation have played an increasing role in the management of these tumours with favourable outcomes. The different types of primary benign vertebral tumours will be discussed in this article with an emphasis on pertinent imaging features.
PubMed: 37370901
DOI: 10.3390/diagnostics13122006 -
Insights Into Imaging Jun 2023Bizarre parosteal osteochondromatous proliferation (BPOP) is a surface-based bone lesion belonging to the group of benign chondrogenic tumors. The aim of this review is... (Review)
Review
Bizarre parosteal osteochondromatous proliferation (BPOP) is a surface-based bone lesion belonging to the group of benign chondrogenic tumors. The aim of this review is to familiarize the readers with imaging features and differential diagnosis of BPOP, also addressing pathological presentation and treatment options. The peak of incidence of BPOP is in the third and fourth decades of life, although it can occur at any age. Hands are the most common location of BPOP (55%), followed by feet (15%) and long bones (25%). On imaging, BPOP appears as a well-marginated mass of heterotopic mineralization arising from the periosteal aspect of the bone. Typical features of BPOP are contiguity with the underlying bone and lack of cortico-medullary continuity, although cortical interruption and medullary involvement have been rarely reported. Histologically, BPOP is a benign bone surface lesion characterized by osteocartilaginous proliferation with disorganized admixture of cartilage with bizarre features, bone and spindle cells. Differential diagnosis includes both benign-such as florid reactive periostitis, osteochondroma, subungual exostosis, periosteal chondroma and myositis ossificans-and malignant lesions-such as periosteal chondrosarcoma and surface-based osteosarcoma. Treatment consists of surgical resection. Local recurrences are common and treated with re-excision.Critical relevance statement Bizarre parosteal osteochondromatous proliferation is a benign mineralized mass arising from the periosteal aspect of bone cortex. Multi-modality imaging characteristics, pathology features and differential diagnosis are here highlighted to familiarize the readers with this entity and offer optimal patient care.
PubMed: 37336832
DOI: 10.1186/s13244-023-01455-0 -
Molecular Genetics & Genomic Medicine Nov 2023To analyze the clinical data and genetic characteristics of Noonan syndrome, both the effect and side effects of recombinant human growth hormone (rhGH) treatment.
OBJECTIVE
To analyze the clinical data and genetic characteristics of Noonan syndrome, both the effect and side effects of recombinant human growth hormone (rhGH) treatment.
METHODS
We collected clinical data from 8 children with Noonan syndrome diagnosed from November 2017 to June 2021. The diagnosis was clarified by exome second-generation sequencing and parental PCR-NGS validation and interpretation of the preceding evidence, and growth hormone therapy was administered. Of the cases, four males and four females were seen for slow height growth and the median age at diagnosis was 8 years 7 months (1 year 7 months to 12 years 6 months).
RESULTS
Here, 7 children were treated with rhGH. Compared to the pre-treatment period, the growth rate increased after rhGH treatment [3.7 ± 0.5 cm/year before treatment and 8.0 ± 1.0 cm/year after treatment, p < 0.01], with the maximum growth rate between 3 and 6 months of treatment and decreasing with the duration of treatment thereafter. The growth hormone treatment was discontinued and the orthopedic consultation was ordered with regular follow-up, which was considered to be related to the PTPN11 mutation.
CONCLUSION
Noonan syndrome is characterized by slow growth, short stature, mental retardation, peculiar facial features, structural heart abnormalities and abnormal bone metabolism. and osteochondroma was found after case 2 rhGH treatment. Genetic examination is mostly caused by PTPN11 mutation. It is recommended to pay attention to bone metabolism abnormalities before growth hormone treatment, especially in children with PTPN11 mutations.
Topics: Child; Male; Female; Humans; Noonan Syndrome; Human Growth Hormone; Genetic Testing; Recombinant Proteins; Mutation; Protein Tyrosine Phosphatase, Non-Receptor Type 11
PubMed: 37525886
DOI: 10.1002/mgg3.2266 -
Journal of Orthopaedic Case Reports Jul 2023Osteochondroma of the scapula constitutes only 3-5% of all osteochondromas; osteochondroma on dorsal aspect of scapula is a rare entity. Diagnosis is almost always... (Review)
Review
INTRODUCTION
Osteochondroma of the scapula constitutes only 3-5% of all osteochondromas; osteochondroma on dorsal aspect of scapula is a rare entity. Diagnosis is almost always clinicoradiologically. Additional computed tomography scan and magnetic resonance imaging may be required for osteochondroma of flat bones such as scapula. Indications for surgery include pain, deformity, dysfunction, neural or vascular compromise, failure of conservative management, or in clinical settings with the high suspicion of malignant transformation and occasionally cosmesis. Outcome of a surgery should be assessed by Patient-Reported Outcome Measures (PROMs) which appraises what "matters to the patient."
CASE REPORT
A 10-year-old boy presented to us with painless swelling over the right upper back since 3 years of age and discomfort over the area while sleeping on his back for 6 months. Diagnosis confirmed it to be a pedunculated osteochondroma arising from the dorsal scapula. Here, we report the diagnosis, treatment, and successful Patient-Reported Outcome using QuickDASH© score for an osteochondroma of dorsal scapula using CARE© case reporting guidelines.
CONCLUSION
We report a rare site of osteochondroma, review the relevant literature, and also stress upon the necessity of analyzing PROMs after surgical treatment of benign tumors of bone which would enable us to evaluate the result of surgery on symptoms, functioning, and health-related quality of life from the patient's perspective.
PubMed: 37521381
DOI: 10.13107/jocr.2023.v13.i07.3772 -
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 -
Vascular Apr 2024Although exostosis or osteochondroma is a common bone tumor, associated vascular complications are rare. Clinical and radiological diagnoses are sometimes challenging,... (Review)
Review
Although exostosis or osteochondroma is a common bone tumor, associated vascular complications are rare. Clinical and radiological diagnoses are sometimes challenging, and there is no codification for surgical management. We report two cases of popliteal arterial pseudoaneurysms due to osteochondroma of the distal femur. A review of the current literature about case series and case reports of patients affected by arterial pseudoaneurysm complicating osteochondroma was also performed.
Topics: Humans; Aneurysm, False; Popliteal Artery; Osteochondroma; Male; Treatment Outcome; Femoral Neoplasms; Female; Computed Tomography Angiography; Adult; Middle Aged
PubMed: 35420537
DOI: 10.1177/17085381221081626