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Indian Pediatrics Aug 2013
Topics: Adolescent; Bone Neoplasms; Exostoses; Humans; Male; Nail Diseases; Osteochondroma; Radiography; Toes
PubMed: 24036655
DOI: 10.1007/s13312-013-0207-9 -
Revista de La Facultad de Ciencias... Mar 2022Osteochondroma is the most frequent benign bone tumor, it can present in solitary or multiple form. Only 1 to 4% of osteochondromas are found in the spine and the most...
BACKGROUND AND OBJECTIVE
Osteochondroma is the most frequent benign bone tumor, it can present in solitary or multiple form. Only 1 to 4% of osteochondromas are found in the spine and the most frequent of these is located at the cervical level. Of all spinal osteochondromas, only 0.5% develop insidious and progressive symptoms of medullary compression, either in the form of myelopathy or radiculopathy. These tumors do not grow once the bone maturation is complete, so if the clinic appears, it does so mainly in young patients, between 20 and 30 years old.
METHODOLOGY
young male with asymptomatic one year evolution posterior cervical tumor, that begins with cervicalgia and interscapular pain, without alarm symptoms. Surgical resection of the tumor is decided.
RESULTS
the pathological result describes the tumor as an osteochondroma. Six months after the intervention, the patient did not report cervicalgia or interscapular pain with a good state of scarring and cervical mobility.
CONCLUSION
Regarding the management of these tumors, surgical treatment, by means of their resection, is indicated, if the patients present symptoms, with good functional results and a low number of complications. Its management in asymptomatic cases is controversial.
Topics: Adult; Cervical Vertebrae; Humans; Male; Neck Pain; Osteochondroma; Spinal Neoplasms; Young Adult
PubMed: 35312258
DOI: 10.31053/1853.0605.v79.n1.30804 -
Medicine Dec 2022Osteochondroma is a common benign bone tumor consisting of cartilage-covered bone confluent with the medullary canal of the epiphysis. Extraosseous osteochondroma shares... (Review)
Review
RATIONALE
Osteochondroma is a common benign bone tumor consisting of cartilage-covered bone confluent with the medullary canal of the epiphysis. Extraosseous osteochondroma shares the same appearance and histologic features as a typical osteochondroma but does not have any attachment to surrounding bone structures. Because of its low incidence, extraosseous osteochondroma is uncommon in clinical workups and thus prone to misdiagnosis. The diagnosis of extraosseous osteochondroma should be considered when there is a well-defined bony mass in the soft tissue with no direct continuity with the adjacent bone or joint. Here, we present a case of an imaging diagnosis of "calcified bursitis in the subcutaneous superficial fascial layer" and a postoperative pathological diagnosis of "extraosseous osteochondroma."
PATIENT CONCERNS
The patient was a 61-year-old man who had a right plantar heel mass for 2 years and recently visited the hospital because of discomfort in shoes.
DIAGNOSES
The patient was diagnosed with pathological examination.
INTERVENTIONS
After completing the relevant preoperative examination and preoperative preparation and excluding contraindications to surgery, surgery was performed under nerve block anesthesia.
OUTCOMES
We performed surgical resection, and the patient did not have obvious discomfort when discharged from the hospital. Auxiliary examination showed no abnormalities.
LESSONS
For foot tumors, we need to consider the possibility of extraosseous osteochondroma. After completing the auxiliary examination, we should determine the relationship between the tumor and its surrounding tissues and blood supply before surgery to avoid causing major trauma.
Topics: Male; Humans; Middle Aged; Heel; Subcutaneous Tissue; Foot Diseases; Osteochondroma; Bone Neoplasms
PubMed: 36626422
DOI: 10.1097/MD.0000000000032014 -
Journal of the American Veterinary... Feb 2018
Topics: Animals; Bone Neoplasms; Cervical Vertebrae; Diagnosis, Differential; Dog Diseases; Dogs; Fatal Outcome; Female; Magnetic Resonance Imaging; Osteochondroma; Pain; Spinal Cord Compression
PubMed: 29393733
DOI: 10.2460/javma.252.4.423 -
Current Osteoporosis Reports Jun 2017Hereditary multiple exostoses (HME) is a complex musculoskeletal pediatric disorder characterized by osteochondromas that form next to the growth plates of many skeletal... (Review)
Review
PURPOSE OF REVIEW
Hereditary multiple exostoses (HME) is a complex musculoskeletal pediatric disorder characterized by osteochondromas that form next to the growth plates of many skeletal elements, including long bones, ribs, and vertebrae. Due to its intricacies and unresolved issues, HME continues to pose major challenges to both clinicians and biomedical researchers. The purpose of this review is to describe and analyze recent advances in this field and point to possible targets and strategies for future biologically based therapeutic intervention.
RECENT FINDINGS
Most HME cases are linked to loss-of-function mutations in EXT1 or EXT2 that encode glycosyltransferases responsible for heparan sulfate (HS) synthesis, leading to HS deficiency. Recent genomic inquiries have extended those findings but have yet to provide a definitive genotype-phenotype correlation. Clinical studies emphasize that in addition to the well-known skeletal problems caused by osteochondromas, HME patients can experience, and suffer from, other symptoms and health complications such as chronic pain and nerve impingement. Laboratory work has produced novel insights into alterations in cellular and molecular mechanisms instigated by HS deficiency and subtending onset and growth of osteochondroma and how such changes could be targeted toward therapeutic ends. HME is a rare and orphan disease and, as such, is being studied only by a handful of clinical and basic investigators. Despite this limitation, significant advances have been made in the last few years, and the future bodes well for deciphering more thoroughly its pathogenesis and, in turn, identifying the most effective treatment for osteochondroma prevention.
Topics: Chronic Pain; Exostoses, Multiple Hereditary; Humans; Mutation; N-Acetylglucosaminyltransferases; Nerve Compression Syndromes
PubMed: 28466453
DOI: 10.1007/s11914-017-0355-2 -
Matrix Biology : Journal of the... Feb 2014Most elements of the vertebrate skeleton are formed by endochondral ossification. This process is initiated with mesenchymal cells that condense and differentiate into... (Review)
Review
Most elements of the vertebrate skeleton are formed by endochondral ossification. This process is initiated with mesenchymal cells that condense and differentiate into chondrocytes. These undergo several steps of differentiation from proliferating into hypertrophic chondrocytes, which are subsequently replaced by bone. Chondrocyte proliferation and differentiation are tightly controlled by a complex network of signaling molecules. During recent years, it has become increasingly clear that heparan sulfate (HS) carrying proteoglycans play a critical role in controlling the distribution and activity of these secreted factors. In this review we summarize the current understanding of the role of HS in regulating bone formation. In human, mutations in the HS synthetizing enzymes Ext1 and Ext2 induce the Multiple Osteochondroma syndrome, a skeletal disorder characterized by short stature and the formation of benign cartilage-capped tumors. We review the current insight into the origin of the disease and discuss its possible molecular basis. In addition, we summarize the existing insight into the role of HS as a regulator of signal propagation and signaling strength in the developing skeleton.
Topics: Cell Differentiation; Cell Proliferation; Chondrocytes; Chondrogenesis; Heparitin Sulfate; Humans; N-Acetylglucosaminyltransferases; Osteochondroma; Osteogenesis; Signal Transduction
PubMed: 24370655
DOI: 10.1016/j.matbio.2013.11.003 -
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 -
Spinal Cord Series and Cases May 2020Osteochondromas are benign bone tumors which occur as solitary lesions or as part of the syndrome multiple hereditary exostoses. While most osteochondromas occur in the...
INTRODUCTION
Osteochondromas are benign bone tumors which occur as solitary lesions or as part of the syndrome multiple hereditary exostoses. While most osteochondromas occur in the appendicular skeleton, they can also occur in the spine. Most lesions are asymptomatic however some may encroach on the spinal cord or the nerve roots causing neurological symptoms. While most patients with osteochondromas undergo laminectomy without fusion, laminectomy with fusion is indicated in appropriately selected cases of spinal decompression.
CASE PRESENTATION
We present a case of a 32-year-old male with history of multiple hereditary exostoses who presented with symptoms of bilateral upper extremity numbness and complaints of gait imbalance and multiple falls. He reported rapid progression of his symptoms during the 10 days before presentation. Computed tomography of the cervical spine revealed a lobulated bony tumor along the inner margin of the cervical 4 lamina. He underwent cervical 3 and 4 laminectomies, partial cervical 2 and 5 laminectomies and cervical 3-5 mass screw placement. Pathology was consistent with osteochondroma. The patient's symptoms had markedly improved at follow-up.
CONCLUSION
According to our literature review, osteochondromas most commonly occur at cervical 2 and cervical 5. We present a case of an osteochondroma at a less common level, cervical 4. While most osteochondromas are addressed with laminectomy without arthrodesis, the decision of whether arthrodesis is necessary should be considered in all patients with osteochondroma as with any cervical decompression.
Topics: Adult; Arthrodesis; Cervical Vertebrae; Clinical Decision-Making; Humans; Male; Osteochondroma; Spinal Neoplasms
PubMed: 32467563
DOI: 10.1038/s41394-020-0292-7 -
Molecular Medicine Reports Jul 2017The differences in molecular mechanisms between osteochondroma and bizarre parosteal osteochondromatous proliferation (BPOP) remain to be fully elucidated. In the...
The differences in molecular mechanisms between osteochondroma and bizarre parosteal osteochondromatous proliferation (BPOP) remain to be fully elucidated. In the present study, the differentially expressed genes between BPOP and osteochondroma were obtained from the Gene Expression Omnibus online database, and the associations among these genes were analyzed using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) online bioinformatics software. The results revealed several differentially expressed genes between human BPOP and osteochondroma. These differentially expressed genes were also enriched in different subgroups based on the analysis using DAVID online software, including 'transforming growth factor β receptor signaling pathway', 'BMP signaling pathway', 'Wnt receptor signaling pathway', 'response to chemical stimulus', 'regulation of inflammatory response', 'response to stress', 'glycosaminoglycan binding', 'polysaccharide binding', 'extracellular matrix structural constituent' and 'growth factors binding'. Taken together, these findings led to the conclusion that different gene regulatory mechanisms exist between BPOP and osteochondroma. Environmental stimulation and inflammation may contribute to BPOP or osteochondroma, and differences in extracellular matrix may contribute to differences in biological characteristics between BPOP and osteochondroma.
Topics: Bone Neoplasms; Computational Biology; Databases, Genetic; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Gene Regulatory Networks; Genetic Association Studies; Humans; Neoplasm Grading; Osteochondroma; Signal Transduction
PubMed: 28560436
DOI: 10.3892/mmr.2017.6634 -
Clinical Orthopaedics and Related... Apr 2014Subungual exostosis is a relatively common benign bone tumor that occurs in the distal phalanges of the toes and can be a source of pain and nail deformity. There is... (Review)
Review
BACKGROUND
Subungual exostosis is a relatively common benign bone tumor that occurs in the distal phalanges of the toes and can be a source of pain and nail deformity. There is controversy about the treatment of these lesions and there are few studies that have synthesized what is known and provided meaningful information on treatment.
QUESTIONS/PURPOSES
We performed a systematic review to address the following questions: (1) What is the best surgical approach for excising these lesions? (2) What is the age range, sex distribution, and presenting symptoms of subungual exostoses and which toe is most frequently affected? (3) What complications arise from treatment?
METHODS
Two authors independently searched multiple databases (Medline, 1950-May 2013; Cochrane EBM database, and EMBASE, 1980-May 2013 provided by OVID; ACP Journal Club, 2003-May 2013; CINAHL by EBSCO, 1937-May 2013; and PubMed by NLM, 1940-May 2013), and key words were chosen to achieve a broad search strategy. We included studies on the management of toe exostoses with > 10 cases and we excluded studies that reported on upper extremity exostoses or osteochondromas. Demographic and treatment data were collected from each article by two independent authors and collated. A total of 124 abstracts were screened, and 116 articles were reviewed in full, of which 13 met the inclusion criteria.
RESULTS
Complete marginal excision through a fish mouth incision protecting the nail led to a recurrence rate of 4% and satisfactory clinical results, defined as no requirement for postoperative intervention and a satisfactory clinical appearance in 73%. Most studies provided incomplete descriptions of specific surgical techniques used. Fifty-five percent of the patients were younger than 18 years of age. A history of toe trauma before diagnosis was present in approximately 30% of the cases. Delayed diagnosis occurred in approximately 10% of the cases and onychodystrophy occurred in more than 10%.
CONCLUSIONS
There is weak evidence to guide management of subungual exostosis. Adequate wound management postexcision aiming to minimize disruption to the nail bed and matrix may prevent onychodystrophy, which is a common complication of treatment.
Topics: Adolescent; Adult; Age Distribution; Bone Neoplasms; Exostoses; Female; Humans; Hypertrophy; Male; Middle Aged; Nail Diseases; Orthopedic Procedures; Osteochondroma; Patient Satisfaction; Postoperative Complications; Radiography; Recurrence; Sex Distribution; Toe Phalanges; Toes; Treatment Outcome; Young Adult
PubMed: 24146360
DOI: 10.1007/s11999-013-3345-4