Case Of Osteochondroma Research Articles

The Role of Routine Pathologic Assessment After Pediatric Osteochondroma Excision.

Osteochondromas are benign osseous lesions often excised for pain, growth abnormalities, and aesthetic concerns. While characteristic clinical and radiographic features leave little diagnostic ambiguity in most cases of osteochondroma, pathologic analysis to confirm the diagnosis and screen for malignancy is routinely performed following surgical excision. The purpose of this study was to determine the clinical and economic value of routine pathologic analysis after osteochondroma excision in a pediatric population. A retrospective review of clinical records from 2 pediatric orthopaedic hospitals (St. Louis Children's Hospital and Shriner's Hospital for Children, St. Louis) identified 426 osteochondroma lesions surgically resected from 201 patients. Patients with solitary and multiple lesions were included. Clinical, radiographic, and surgical data were recorded for each resection surgery. Pathologic reports were evaluated. Costs incurred for routine pathologic assessment was also noted. Totally, 132 patients were treated with surgical resection of a solitary osteochondroma lesion, while an additional 291 lesions were resected from 69 patients with multiple lesions. Average age at the time of surgical resection was 13.0 years (2.1 to 17.9). The most common anatomic locations of excised lesions included the distal femur (110, 25.8%), proximal tibia/fibula (95, 22.3%), and distal radius/ulna (58, 13.6%). All resected specimens were sent for pathologic analysis. The average size of the resected lesions was 19.9 mm 3 (0.02 to 385.0mm 3 ). In all cases, the histologic diagnosis confirmed benign osteochondroma. The total charges of pathologic analysis including processing and interpretation fees was ∼$755.00 for each lesion assessed, for a total cohort charge of $321,630. We propose that in most cases of pediatric osteochondroma excision procedures, postoperative histologic analysis is not strictly indicated as it rarely, if ever, alters diagnosis or management. We suggest using a "gross only" analysis in these cases. However, we do believe that with preoperative diagnostic ambiguity, or if patients present with concerning features such as rapidly expansile lesions or cortical destruction, have axial skeleton or pelvic involvement, or enlarged cartilaginous caps, full histologic evaluation of the excised lesions will continue to be prudent. Level IV-case series.

Solitary Osteochondroma of Scapula: A Common Entity at an Uncommon Location

Introduction: Introduction: Osteochondroma are benign bone tumours that often affect the metaphysical region of long bones; the scapula is rarely affected. Owing to its bulk effect, scapular osteochondroma may frequently present with symptoms. These tumours typically damage the skeleton's developing ends and stop becoming larger once the skeleton reaches maturity.Suspicion of a cancer should be raised by any increase in size. Case Report: A female patient, age 25, complained of a hard lump on her shoulder posteriorly on further imaging it was confirmed as an osteochondroma of scapula. Discussion: Osteochondromas must exhibit continuity with the underlying parent bone cortex and medullary canal. They are made up of cortical and medullary bone with an overlaying hyaline cartilage cap. They have a very minimal potential for malignancy and are often asymptomatic. Conclusion: The cases of osteochondromas in the scapula are relatively rare, it is crucial to remain vigilant and consider the possibility of malignancy if there are concerning changes in symptoms or size.

Osteochondroma of Antero Medial Maxillary Wall - A Rare Case Report.

A 17 year female came with complaints of swelling over left lateral wall of nose and left nasal block was found to have osteochondroma of maxilla on CT PNS, resected by sub labial approach with postoperative histopathological confirmation. Thus describing a rare case of osteochondroma of maxilla treated without any cosmetic and functional impairment.

A rare presentation of osteochondroma at the spinous process of the cervical spine: a case report.

Osteochondroma is a benign cartilaginous tumor that usually arises from the growth plate of the long bones. Its presentation in flat bones is uncommon. Spinal osteochondroma is a rare case, with only a 4% incidence compared to all spinal neoplasms. We report an unusual case of osteochondroma at the spinous process of the C4 spine of a 15-year-old patient with the chief complaint of neck discomfort on movement. The patient has previously been diagnosed and treated for multiple hereditary exostoses of other bones. The patient underwent surgery for the current lesion with complete excision to the base of the lesion. Histopathology revealed a benign osteochondroma with a thin layer of cartilaginous cap. The patient was healed uneventfully and had no recurrence of the lesion on the same site at the 1-year follow-up. Surgical resection remains the mainstay treatment of osteochondroma and has proved to the low recurrence. In the case of cervical osteochondroma, surgery is advisable, particularly in symptomatic patients, to prevent complications.

A case of osteochondroma arising at the articular tubercle of the temporal bone

Osteochondroma is a benign bone tumor covered by a cartilage cap, arising at the external surface of the bone. In the oral and maxillofacial regions, this lesion is known to develop in the mandibular condyle; however, involvement of the temporal bone is rare. We present a case of osteochondroma arising at the articular tubercle of the temporal bone. A 32-year-old man visited our department for evaluation of a mass in the right temporal bone. Radiographic examination revealed a pedunculated exophytic mass continuous with the articular tubercle of the right temporal bone, and the patient was clinically diagnosed with a temporal bone tumor. We performed surgical resection through a preauricular incision under general anesthesia. A histopathological evaluation revealed formation of bone covered by a cartilage cap, which confirmed the diagnosis of osteochondroma. The residual lesion showed no growth two years postoperatively.

Case Series – Osteochondromas at Rare Locations

Osteochondromas are very common. They are typically seen in long bones and rarely seen in smaller bones. Some of the rare presentations include flat bones, the body of pelvis, scapula, skull, and small bones of the hand and foot. Their presentation also varies according to the site of presentation. We have included five cases of osteochondromas occurring at rare locations with variable presentations and their management. We have included one case of metacarpal, one case of skull exostosis, two cases of scapula exostosis, and one case of fibula exostosis. Osteochondromas can rarely occur at unusual locations. It is important to thoroughly evaluate all patients presenting with swelling and pain over bony regions to accurately diagnose osteochondromas and manage accordingly.

Aberrant expression of SPAG6 and NM23 predicts poor prognosis of human osteosarcoma.

Objective: To investigate the expression and clinical significance of sperm-associated antigen 6 and NM23 proteins in human osteosarcoma. Methods: The specimens of conventional osteosarcoma with follow-up from 42 Chinese patients were analyzed in this study, and 12 cases of osteochondroma were considered controls. The expression of SPAG6 and NM23 was inspected using immunohistochemical staining, qRT-PCR, and Western blotting methods. Results: The positive expression rate of SPAG6 protein (71.43%) in 42 cases of osteosarcoma tissue was significantly higher than that (33.33%) in 12 cases of osteochondroma tissues (p < 0.05), while the positive rate of NM23 protein (35.71%) in osteosarcoma tissue was lower than that (58.33%) in osteochondroma tissue (p < 0.05). The mRNA and protein levels of SPAG6 were significantly higher than those of the adjacent normal tissues, while the expression of NM23 was lower in osteosarcoma tissues than that in the controls (p < 0.05 for all). There was a positive relationship between the expression of SPAG6 and pathological grade, metastasis, and Enneking stage (p < 0.05 for all). The overall survival rate of osteosarcoma patients with SPAG6 positive expression was significantly lower than that with SPAG6 negative expression. The relationship between the expression of NM23 and pathological grade, metastasis, and Enneking stage was negative (p < 0.05 for all). The overall survival rate of the osteosarcoma patients with NM23 positive expression was higher than that of the patients with NM23 negative expression (p < 0.05). Conclusion: Overexpression of SPAG6 and low expression of NM23 are negatively related to pathological grade, metastasis, and Enneking stage and prognosis of osteosarcoma patients. This suggested that SPAG6 and NM23 should be considered candidate prognostic biomarkers for patients with osteosarcoma.

Osteochondroma of the temporomandibular joint: Condylectomy and “Swing-back” of the mandible

Osteochondroma (OC) is a common long bone tumor, which rarely affects the cranio-maxillofacial region. They present with cartilage-capped bony protuberances that present themselves on the external bony surface, with asymmetry of face and malocclusion being their most common presentations. There is no definite protocol for its management, although treatment is directed towards the rectification of the facial asymmetry to provide pleasant esthetics and functional occlusion. It is usually managed by the surgical removal of the tumor i.e condylectomy, and second stage orthognathic surgery if required. We hereby represent two OC cases with the aim to revisit the long known concept of “swing-back” of mandible post condylectomy, which was performed along with mandibular lower border shaving, thus proving it to be an effective management option in patients not willing for later gnathic surgeries, as mandible attains near-normal position along with adequate function with such single-stage management.Osteochondroma (OC) rarely affects the cranio-maxillofacial region, with condyle and the coronoid process being the most affected facial bones. There is still uncertainity about its pathogenesis and etiology, hence a definitive diagnosis should be made after a combined clinical and radiological examination.

Intraspinal Multiple Hereditary Exostosis with Thoracic Myelopathy: A Case Report

Osteochondromas are the most common benign bone tumor and spinal involvement is not uncommon. We report a case of osteochondroma in a 14-year-old girl with underlying multiple hereditary exostosis who presented with thoracic myelopathy symptoms and signs. Magnetic resonance imaging and computed tomography scan revealed intraspinal exostosis causing significant spinal cord compression at the thoracic vertebra. Our patient was treated surgically for exostoses and showed excellent functional and neurological outcomes. The purpose of the report is to share our experience in managing intraspinal exostosis and to emphasize the importance of spinal imaging evaluation in multiple hereditary exostosis patients.

C2 intraspinal osteochondroma causing spinal cord compression in a patient with multiple hereditary exostoses

Intraspinal osteochondroma causing neurological manifestations is a rare condition and can present as either solitary osteochondroma or more commonly as a part of multiple hereditary exostoses. We report a case of osteochondroma arising from lamina of C2 in a 21-year-old patient with multiple hereditary exostoses causing spinal cord compression and cervical myelopathy. The patient presented with worsening neurological deficit and an inability to walk. Immediate laminectomy and surgical decompression were done after accurately localizing the lesion through computed tomography and magnetic resonance images. Following excision of the lesion, the patient recovered completely. The case report is followed by a review of literature highlighting the incidence of spinal osteochondroma, location preferences, clinical presentation, diagnosis, and results of decompression.

Solitary Osteochondroma of L2 Spinous Process

Osteochondroma is the most common primary benign bone tumour frequently affecting the appendicular skeleton and rarely involves the spine and even more rarely involves the lower lumbar region. The present case report was a rare case of osteochondroma arising from spinous process of L2 vertebra. A 12-year-old male was visited with his parents with complaints of progressive painless swelling in the lower back for six months. After thorough evaluation osteochondroma arising from L2 spinous process was diagnosed. Patient was operated with extraperiosteal enbloc excision of the tumour along with L2 spinous process. Enbloc excision of axial exostosis should be considered owing to the risk factor of neurological involvement and rare malignant transformation.

Incarcerated Pes anserinus around a proximal tibial osteochondroma: a rare extra-articular cause of locked knee

Background: Osteochondroma is the most common benign skeletal neoplasm and is found most often in long bones, especially in the distal femur and proximal tibia. They usually present as painless swelling near the joint and can be complicated by mechanical irritation, compression or injury of adjacent structures, fracture, malignant transformation, and post-operative recurrence. Locking of the knee refers to flexion of the knee without complete extension and passive extension is limited resulting in significant pain. Excision is a successful form of the treatment for symptomatic osteochondromas. Case Report: A case of osteochondroma of the proximal tibia illustrates extra-articular cause of locked knee secondary to the incarceration of pes anserinus tendons by the lesion. Conclusion: Surgical excision of the bilobed pedunculated posteromedial proximal tibia osteochondroma and restoration of the gracilis and semitendinosis to its normal anatomic position resulted in the complete resolution of symptoms.

Computed Tomographic Image Processing and Reconstruction in the Diagnosis of Rare Osteochondroma.

Objective We applied computed tomography (CT) to explore the imaging manifestations of rare parts of osteochondroma. Based on the medical images, deblurring using a convolutional neural network (CNN), and three-dimensional (3D) reconstruction of the images is performed in order to improve the image diagnosis. Methods Twelve cases of osteochondroma in rare locations confirmed by surgical pathology or clinical long-term dynamic observation were retrospectively analyzed using medical imaging and image reconstruction. There are 7 males and 5 females, with an average age of 43 years. CT examinations were performed in all cases. Image deblurring via the GAN model is performed followed by the 3D reconstruction of the higher quality images is implemented. A retrospective study was performed on the imaging manifestations of the above cases; the imaging characteristics were summarized. Results The imaging features are the following lesions, including 4 cases of the proximal radius, 4 cases of the scapula, 2 cases of the pelvis, and 2 cases of the proximal ribs. The cartilage caps, cortex, and sternum were typical structures of the bone surface of the studied cases. In the continuous imaging features, calcification was visible in some cases, and no significant enhancement was seen in enhanced scans; there was no obvious direction of lesion growth. The image processing techniques that we performed are useful in enhancing the quality of the medical diagnosis. Conclusions Rare site osteochondroma has certain imaging features. In most cases, we can accurately diagnose rare site osteochondroma through these features via the image processing methods that are proposed in this paper.

Dual osteochondromas arising from the coracoid process and the glenoid of scapula

Abstract Introduction: Scapular osteochondromas represent 3% to 4% of all osteochondromas. Although many cases of osteochondromas affecting the body of the scapula have been reported in the first three decades of life, case reports of osteochondroma affecting the coracoid process or the glenoid of the scapula are limited. Patient concerns: We report a case of a 56-year-old male with progressive pain and swelling of the left shoulder for six months. Diagnoses: The diagnosis was dual osteochondromas arising from the coracoid process and the glenoid of the left scapula. Interventions: Complete excision was performed. Outcomes: The patient was discharged without any complications after 10 days of postoperative wound care. His symptoms relieved at three months after surgery. At the last follow-up (two years postoperatively), the patient remained in good condition. He had full range of motion of the shoulder without any signs of recurrence. Conclusion: Dual osteochondromas arising from the glenoid and the coracoid process can cause severe dysfunction with coracoid impingement syndrome of the ipsilateral shoulder. In older individuals, it is necessary to differentiate osteochondroma from a malignant tumor.

Osteochondroma of the left condylar head- Case Report

Facial asymmetry and pain in preauricular region are rare complaints encountered in our practice and in such cases proper examination are important. Osteochondroma (OC) of temporomandibular joint (TMJ) is a rare, benign tumour of the jaw which leads to facial asymmetry, malocclusion and restricted mouth opening. Pain is not a frequent complaint but some patients can experience pain in cases of OC. Proper examination and radiographic techniques help in attaining a diagnosis. Final diagnosis is by histopatholgical examination and Treatment of choice is surgical excision. Here we are reporting a case of OC where history, clinical and radiographic examination helped in diagnosing the lesion. Keywords: Osteochondroma, Facial asymmetry, Benign tumour of TMJ.

Osteochondroma of talus and coalition of talocrural and intercuneiform joints - surgical management

&lt;p class="abstract"&gt;Osteochondroma of talus is rare benign tumour. Tarsal coalition is a condition in which two or more tarsal bones are joined by non-osseous bridges of cartilage or fibrocartilage or by osseous bridges. Association of Talus osteochondroma with coalition of tarsal bones is extremely rare and has not been reported in the literature before. We are herewith reporting a case of osteochondroma of the talus with coalition of intercuneiform and talocrural joint in an 11-year-old male patient. Patient noticed swelling around ankle and pain on strenuous activities. CT scan confirmed the diagnosis. We did complete extraperiosteal excision of the osteochondroma and resection of tarsal coalition. Histopathological examination confirmed the diagnosis of osteochondroma. At one-year follow-up there is no recurrence of the tumour and patient had full range of motion. Complete extraperiosteal excision of the osteochondroma along with resection of tarsal coalition is important for complete eradication and preventing a recurrence.&lt;/p&gt;

Midline solitary osteochondroma of C2 vertebra with myelopathy in a child: A case report with review of literature

Spinal osteochondromas with neurological deficits are rare. Only 0.5% to 1% of spinal osteochondromas present with neurological dysfunction. We hereby present a case of osteochondroma of the C2 lamina with neurological deficit and unique presentation.A 10-year-old female presented with a history of severe weakness of all four limbs after a fall. Weakness had spontaneously improved over initial three days and she presented to us with mild weakness of the right upper limb about two weeks after the fall. On examination, neck movements were full and painless with spastic quadriparesis and a motor power of grade 4/5 in all four limbs with extensor plantars.On radiology, CT scan of the cervical spine showed an osseous outgrowth from the C2 lamina in the midline projecting into the spinal canal, directed superiorly toward the dens. An MRI showed spinal-cord compression with cord deformation and signal changes.She underwent en bloc excision of the tumor mass, which was severely impinging on the spinal cord. Histopathology confirmed a diagnosis of osteochondroma. At four-year follow-up, there was complete recovery with no signs of recurrence.Spinal osteochondroma is a rare but potential cause of spinal-cord compression in a child with varied presentation.

A CASE REPORT OF FEMUR OSTEOCHONDROMA IN 22 YEARS OLD FEMALE PATIENT

Chondromais considered a nonmalignant tumor that composed of mature hyaline cartilage and commonly occur in hands and feet. Overall incidents show that females are predominant comparing to males with evenly distributed range of ages. Multiple chondromas have to be differentiated from osteochondroma and chondrosarcoma. This paper reports three different types of lesions in one patient.Osteochondroma or exostosis is the most common benign tumor of the skeleton. It is a developmental osseous anomaly, which arises from exophytic outgrowth on bone surfaces characteristically. Osteochondroma account for about 12% of bone tumors. Here, we have described a 22 years old female patient with left knee joint pain and swelling of the left distal femur with limited movements. The incisional biopsy of the left distal femur identified low-grade chondrosarcoma and chondroma after histopathology. This underwent one-stage surgical excision of the tumor with a posterior approach and tumor resection from the femur. After surgery, an unusual pain appears in the right hip joint during the post-operative period.Machine resonance imaging (MRI), and X-ray of pelvis help to diagnose thewell-differentiated chondrosarcoma and chondroma. This was a case of osteochondroma in the right proximal femur, chondroma like lesion in the left proximal femur and chondrosarcoma in the left distal femur. Ethical consideration: Written informed consent was obtained from the patient for publication of this case report and accompanying images. Conflict of interest: There is no conflict of interest.

Surgical resection of osteochondroma in the mandibular condyle associated with directional orthodontic treatment: review of literature and a case report

AbstractCharacterised by abnormal bone and/or cartilage formation on the surface of a normal bone, osteochondroma is a benign tumour manifested by poorly oriented bony protuberances, covered by hyaline cartilage and of normal histological appearance. Osteochondroma rarely occurs in the buccal and maxillofacial region, and the signs and symptoms vary according to the size and location of the tumour. In cases that involve the condyle of the mandible, the commonly recommended management is the radical resection of the tumour including the condyle, aiming to re‐establish aesthetics and function. When total condilectomy is chosen, there is a discussion in the literature about whether to perform mandibular condyle reconstruction or not. In the vast majority of cases reported, immediate reconstruction or association with other surgical procedures, such as orthognathic surgery, was chosen. This article aims to report a successful management of a case of osteochondroma in the mandibular condyle, resected surgically without immediate reconstruction, associated with directional orthodontic treatment and correlated it with the literature.

Atypical osteochondroma of the hamate that presented clinically as carpal tunnel syndrome: report of an extremely rare case and literature review

BackgroundOsteochondroma is a benign tumor that occurs mainly at the metaphysis of long bones and seldom arises from carpal bones. We describe an extremely rare case of osteochondroma of the hamate without a typical cartilaginous cap and with a spiky bony protrusion in an elderly patient.Case presentationA 78-year-old right-handed female housekeeper had a multilobed osteochondroma of the hamate, which caused carpal tunnel syndrome and irritation of the flexor tendons. Radiological examinations showed a morphological abnormality of the hamate comprising a spiky bony protrusion into the carpal tunnel and a free body proximal to the pisiform. Open carpal tunnel release and resection of the spiky bony protrusion on the hook of the hamate were performed. The flexor digitorum profundus tendons of the ring and little fingers displayed synovitis and partial laceration in the carpal tunnel. Histological examination also showed atypical findings: only a few regions of cartilaginous tissue were seen in the spiky bony protrusion, whereas the free body proximal to the pisiform contained thick cartilaginous tissue such as a cartilaginous cap typical of osteochondroma. We speculated that the bony protrusion to the carpal tunnel had been eroded by mechanical irritation caused by gliding of the flexor tendon and had resulted in the protruding spiky shape with less cartilaginous tissue. The fractured cartilaginous cap had moved into the cavity within the carpal tunnel proximal to the pisiform and had become a large free body.ConclusionsOsteochondroma of the carpal bone may take various shapes because the carpal bone is surrounded by neighboring bones and tight ligaments, which can restrict tumor growth. This type of tumor is likely to present with various symptoms because of the close proximity of important structures including nerves, tendons, and joints. The diagnosis of osteochondroma of the carpal bone may be difficult because of its rarity and atypical radiological and histological findings, such as the lack of a round cartilaginous cap. We suggest that surgeons should have a detailed understanding of this condition and should make a definitive diagnosis based on the overall findings.