Abstract Osteochondromas (OCs) are the most common benign bone tumors, but rarely arise in the lumbar spine. Due to their infrequency, understanding of their clinical presentation, management, and outcomes is limited, with most available data derived from case reports and small series. This systematic review aims to synthesize the literature on nonsyndromic lumbar spine OCs and to present an illustrative institutional case. A systematic search was conducted in PubMed, Embase, Web of Science, and Scopus from database inception to April 2024, following PRISMA 2020 guidelines. Studies reporting clinical cases or series of nonsyndromic lumbar spine OCs with sufficient details on presentation, tumor characteristics, management, and outcomes were included. The risk of bias was evaluated using the Joanna Briggs Institute tools for case reports and case series. Data extraction encompassed demographics, clinical characteristics, tumor features, operative management, and postoperative outcomes. A total of 39 studies encompassing 56 patients were included. The mean age was 42 years; 59% were male. Most lesions originated from the inferior articular process (43%) and commonly affected L4 and L5. The mean lesion size was 29.7 ± 22.2 mm, with significantly smaller lesions in patients with radiculopathy than those with low back pain or palpable mass (p = 0.00034). Radiculopathy (50%) and low back pain (25%) were the most frequent presentations (p < 0.001). The majority (80%) underwent posterior surgical excision without instrumentation, with en bloc resection performed in 78.5%. Complete symptomatic improvement was observed in 94% of patients, and recurrence was rare. Lumbar spine OCs most frequently arise from the inferior articular process and often produce radiculopathy due to intracanalicular growth. Surgical excision—especially en bloc resection—yields excellent outcomes and a low recurrence rate. Conservative treatment may be considered in selected asymptomatic patients. Early recognition and individualized management are essential for optimal outcomes.

A phase II trial (MO-Ped; NCT03442985) assessed palovarotene in pediatric patients with multiple hereditary exostosis (MHE). Patients aged ≤ 14 years with MHE were randomized 1:1:1 to placebo, palovarotene 2.5 mg, or palovarotene 5.0 mg daily. Due to concerns of premature physeal closure (PPC), a partial clinical hold was instituted, followed by trial termination. The primary efficacy endpoint was the annualized rate of new osteochondromas (OCs). Safety was assessed. Overall, 193 patients received ≥ 1 dose of palovarotene or placebo. Due to trial termination, no patients completed planned treatment. Prior to 06 December 2019 (patients notified of clinical hold and treatment stopped), 30 patients completed Month 12 efficacy imaging. No significant differences in the annualized rate of new OCs, or change from baseline in volume of OCs or OC cartilage, were observed between treatment groups. The adverse event profile was consistent with systemic retinoids. There was no evidence of an effect of palovarotene on linear growth and no cases of PPC. Overall, palovarotene showed no clear efficacy signal in MHE, resulting in a non-favorable benefit-risk profile. Interpretation of results was limited by the reduced treatment duration and smaller than expected cohort. The trial yielded important data on the natural history of MHE.Trial registration: NCT03442985 (first posted 22 February 2018)Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-22554-6.

To evaluate visible-near-infrared hyperspectral imaging (400-1000 nm) combined with a lightweight deep-learning network for differentiating low-grade chondrosarcoma (LGC) from osteochondroma (OC). Spectra were reflectance-calibrated, Savitzky-Golay smoothed, and cropped to 420-850 nm. Multi-level features-single-band reflectance, key band ratios, and PCA components from biologically informative regions were extracted. We developed ChondroSpecNet, a 1D-CNN coupling multi-scale convolutions with a residual squeeze-and-excitation block for end-to-end classification. ChondroSpecNet yielded AUC 0.92 with 87% accuracy in training, and AUC 0.83 with 86% accuracy on an independent test set. Contribution analysis identified visible-band troughs-especially 472, 467, and 501 nm-as most discriminative by absolute differences and normalized ratios. Hyperspectral microscopy plus a compact network enables accurate, efficient LGC-OC discrimination, offering real-time deployability with robust performance and practical scalability for cartilaginous-tumor diagnosis in clinical workflows.

Osteochondroma (OC) is a benign bone tumor commonly found near the ends of long bones. While spinal and hip localizations are rare, bilateral hip involvement is often associated with hereditary multiple exostoses, occurring in 30% to 90% of such cases. This report describes a unique case of bilateral hip OC developing after a spinal cord injury, in the absence of family history or hereditary multiple exostoses. A 35-year-old male presented with painful bilateral hip swelling and restricted mobility following a rural accident that caused a C6-C7 vertebral fracture with bilateral anterior dislocation of the articular facets. He also exhibited spastic tetraplegia and flexion contractures, with signs suggestive of femoral nerve compression. Initial imaging revealed myositis ossificans involving the iliopsoas and spinal muscles. A bone scan identified an immature osteoma. Histopathological examination following surgical excision confirmed the diagnosis of OC. The patient underwent spinal surgery 2 days after the trauma, followed by admission to a physical medicine rehabilitation unit. Surgical resection of the left hip lesion improved flexion, and a similar procedure on the right hip yielded temporary improvement but led to complications, including infection requiring antibiotics and drainage. Despite surgical interventions, tumor recurrence occurred within 3 months. Imaging confirmed recurrent myositis ossificans and fluid collections. One year postinjury, neurological deterioration was noted, with spastic tetraplegia progressing from the C5 to C7 level and worsening lower limb spasticity. Valium was introduced for spasm management. This case highlights a rare occurrence of bilateral hip OC following spinal cord injury and raises important questions about trauma-induced mechanisms in OC pathogenesis. It suggests the need for further investigation into the relationship between spinal trauma, heterotopic ossification, and tumor development.

Introduction and aim. Chondrosarcomas are malignant cartilage-forming tumors, with secondary cases rarely arising from osteochondromas. This report presents a case of secondary chondrosarcoma developing from an undiagnosed pelvic osteo chondroma in a young female, emphasizing the importance of early detection and timely intervention. Description of the case. A 28-year-old woman with hip and back pain underwent magnetic resonance imaging, revealing a le sion in the left iliacus muscle with sacroiliac extension. Biopsy confirmed a chondroid neoplasm, and positron emission topog raphy-computed tomography showed minimal metabolic activity. Due to the extensive soft tissue component and recurrence risk, wide local excision was performed. Histology confirmed well-differentiated secondary chondrosarcoma, WHO grade 1 arising from an undiagnosed pre-existing osteochondroma. Conclusion. The described case highlights the critical role of radiological and histopathological evaluation, timely surgical in tervention, and multidisciplinary management for optimal patient outcomes.

BackgroundOsteosarcoma (OS) is a primary bone malignancy characterized by early metastasis and generally poor prognosis. ESPN is highly expressed and plays an important role in regulating the aggressive phenotypes of several cancer cell types. However, little is known about the molecular mechanisms underlying ESPN-mediated migration and invasion in OS cells.MethodsIn this study, we first analyzed the survival of osteosarcoma patients using Kaplan-Meier analysis to assess the prognostic relevance of ESPN. To further evaluate its clinical significance, we performed immunohistochemical analysis on osteosarcoma tissue samples and benign osteochondroma (OC) tissues. The biological function of ESPN in osteosarcoma was confirmed by a series of experiments conducted both in vitro and in vivo. Additionally, we explored the underlying molecular mechanisms through Western blotting, co-immunoprecipitation, immunofluorescence, and PCR, revealing key downstream signaling pathways.ResultsIn this study, we demonstrate that ESPN, acting as an oncogene, is highly expressed in OS cell lines and tissues, promoting OS cell proliferation and metastasis. Mechanistically, ESPN promoted the phosphorylation of PI3K by direct interaction with it and active the AKT/mTOR pathway, which enhanced the expression of the transcription factor ZEB1 and initiating the epithelial-mesenchymal transition (EMT) cascade. Furthermore, we validated that mTOR-mediated activation of p70 ribosomal protein S6 kinase (p70S6K) promotes the translation of ZEB1, thereby enhancing the growth and motility of OS cells.ConclusionsOur findings reveal a previously unrecognized function of ESPN in OS, closely linked with EMT and cancer metastasis progression. Targeting ESPN may represent a potential therapeutic approach for patients with OS.

Hereditary multiple osteochondromas (HMO) is a genetic skeletal disorder caused by defects in exostosin glycosyltransferase 1 (EXT1) or 2 (EXT2) genes. It develops mainly in the growth period and causes multiple osteochondromas (OC) in the physis of the long bones, leading to discomfort and deformities. This study aimed to investigate the anatomical distribution of OC, the frequency of deformities of the lower limbs, scoliosis and surgeries performed in a cohort of patients with HMO at the time of their enrolment in a regional surveillance programme. The study population included HMO patients from the Centre of Heritable and Complex Diseases (CAKS) in the Region of Southern Denmark. Information on surgical procedures and age at the time of diagnosis was obtained from medical records, while deformities were evaluated on early-onset scoliosis (EOS) scans from time of enrolment in the CAKS. A total of 54 patients were included and 44 patients (82%) had an EOS scan. All except one (98%) HMO patient had OC in the knees at the time of their EOS scan. A total of 12 patients (27%) had leg length discrepancy, 30 (68%) had genu varum or valgum and 13 (30%) had scoliosis. The HMO patients had undergone a median of 2.0 (0-14) surgeries, where a median of four (1-23) OC were removed, mostly in the lower limb (68%). The majority of HMO patients in this cohort suffered from major anatomical burdens, leading to multiple surgeries and deformities. We suggest that a programme, such as the CAKS surveillance programme, may be beneficial to screening and follow-up of OC and deformities in patients with HMO. None. Not relevant.

This study is aimed at investigating the clinical and genetic characteristics of 244 unrelated probands diagnosed with multiple osteochondromas (MO). The diagnosis of MO typically involves identifying multiple benign bone tumors known as osteochondromas (OCs) through imaging studies and physical examinations. However, cases with both OCs and enchondromas (ECs) may indicate the more rare condition metachondromatosis (MC), which is assumed to be distinct disease. Previous cohort studies of MO found heterozygous loss-of-function (LoF) variants only in the EXT1 or EXT2 genes, with DNA diagnostic yield ranging from 78 to 95%. The PTPN11 gene, which is causative for MC, was not previously investigated as a gene candidate for MO. In this study, we detected a total of 177 unique single nucleotide and copy number variants in three genes across 220 probands, consisting of 80 previously reported and 97 novel variants. Specifically, we identified five cases with OCs and no ECs as well as four cases with MC carrying LoF variants in the PTPN11 gene and two additional cases with ECs harboring variants in the EXT1/2 genes. These findings suggest a potential overlap between the MO and MC both phenotypically and genetically. These findings highlight the importance of expanding genetic testing beyond the EXT1 and EXT2 genes in MO cases, as other genes such as PTPN11 may also be causative. This can improve the accuracy of diagnosis and treatment for individuals with MO and MC. It is essential to determine whether MO and MC represent distinct diseases or if they encompass a broader clinical spectrum.

Osteochondroma (OC) is an uncommon reason for the mandibular condyle to grow excessively. Usually unilateral, it can impact the entire mandible, the condyle and ramus, or just the condyle. It is a bony projection covered in cartilage that protrudes from the damaged bone's exterior. Condylar OC are more prevalent as a result of endochondral ossification-related development. The most notable characteristic is the gradual asymmetry of the face over time. Clinical symptoms of the patient include pain, asymmetry, malocclusion, partial or total hearing loss, trismus, and hypomobility of the TMJ. We report a case of 40-year-old male patient complaining of reduced mouth opening since last 10 years. Clinical examination revealed gross facial asymmetry, hard swelling over right TMJ, jaw deviation towards left side, restricted mouth opening of 3mm and deranged occlusion. An irregular radiopaque mass was seen over the right condylar region in OPG. A large, hyperdense mass that obliterated the sigmoid notch and extended medially to the right condyle was visible on CT scans. Using a pre-auricular Alkayat-Bramley technique, the mass was surgically removed. Occlusal corrections and jaw physiotherapy were then administered. On follow up, deviation was corrected and adequate mouth opening was achieved.

ABSTRACT To investigate the relationship between fluoride exposure and Osteochondroma (OC) prevalence, a cross-sectional study was conducted in drinking water endemic fluorosis areas of Heilongjiang Province, China. Our study first reported that the prevalence of OC was 2.3% in drinking water endemic fluorosis areas of Heilongjiang Province, China, and no difference in gender. Logistic regression analysis found that compared to 1st quartile participants, the prevalence of OC was 73% lower in the 2nd quartile participants of WF (Water fluoride), and 3.4 times higher among the 2nd quartile UF (Urinary fluoride) participants. Our study suggests that 0.259–0.420 mg/L of WF may be considered an appropriate level for reducing OC prevalence, while UF (≥0.750 mg/L) could slightly increase the prevalence of OC. In summary, the link between fluoride and OC prevalence is complicated and needs to be further investigated in a cohort population.

This study compares the accuracy and effectiveness of our novel 3D-printed titanium cutting guides with intraoperative surgical navigation for performing intraoral condylectomy in patients with mandibular condylar osteochondroma (OC). A total of 21 patients with mandibular condylar OC underwent intraoral condylectomy with either 3D-printed cutting guides (cutting guide group) or with surgical navigation (navigation group). The condylectomy accuracy in the cutting guide group and navigation group was determined by analyzing the three-dimensional (3D) discrepancies between the postoperative computed tomography (CT) images and the preoperative virtual surgical plan (VSP). Moreover, the improvement of the mandibular symmetry in both groups was determined by evaluating the chin deviation, chin rotation and mandibular asymmetry index (AI). The superimposition of the condylar osteotomy area showed that the postoperative results were very close to the VSP in both groups. The mean 3D deviation and maximum 3D deviation between the planned condylectomy and the actual result were 1.20 ± 0.60 mm and 2.36 ± 0.51 mm in the cutting guide group, and 1.33 ± 0.76 mm and 4.27 ± 1.99 mm in the navigation group. Moreover, the facial symmetry was greatly improved in both groups, indicated by significantly decreased chin deviation, chin rotation and AI. In conclusion, our results show that both 3D-printed cutting-guide-assisted and surgical-navigation-assisted methods of intraoral condylectomy have high accuracy and efficiency, while using a cutting guide can generate a relatively higher surgical accuracy. Moreover, our cutting guides exhibit user-friendly features and simplicity, which represents a promising prospect in everyday clinical practice.

Osteochondroma (OC) is one of the most common benign tumors of the long bones, but it rarely occurs in the maxillofacial skeleton. However, mandibular condylar OC often leads to severe facial deformity in affected patients, including facial asymmetry, deviation of the chin, and malocclusion. This study aimed to explore the clinical application of individualized 3D-printed templates to accurately and effectively treat condylar OC. A total of 8 patients with mandibular condylar OC were treated from July 2015 to August 2021. The enrolled patients (5 women and 3 men) had a median age of 27 years (range: 21-32 years). All patients exhibited symptoms of facial asymmetry and occlusal disorders preoperatively. The digital software used to virtually design the process consisted of three-dimensional reconstruction, 3D-cephalometry analysis, virtual surgery, individualized templates, and postoperative facial soft-tissue prediction. A set of 3D-printed templates (DOS and DOT) were used in all cases to stabilize the occlusion and guide the osteotomy. Then, pre- and post-operative complications, mouth opening, clinical signs, and the accuracy of the CT imaging analysis were all evaluated. All the measurement data were presented as means ± SD; Bonferroni and Tamhane T2 multiple comparison tests were used to examine the differences between the groups. All patients healed uneventfully. None of the patients exhibited facial nerve injury at follow-up. In comparing the condylar segments with T0p and T1, the average deviation of the condylar segments was 0.5796 mm, indicating that the post-operative reconstructed condyles showed a high degree of similarity to the reconstruction results of the virtual surgical plan. Individualized 3D-printed templates simplified surgical procedures and improved surgical accuracy, proving to be an effective method for the treatment of patients with slight asymmetric deformities secondary to condylar OC.

Background: The aim of this study was to identify a panel of candidate autoantibodies against tumor-associated antigens in the detection of osteosarcoma (OS) so as to provide a theoretical basis for constructing a non-invasive serological diagnosis method in early immunodiagnosis of OS. Methods: The serological proteome analysis (SERPA) approach was used to select candidate anti-TAA autoantibodies. Then, indirect enzyme-linked immunosorbent assay (ELISA) was used to verify the expression levels of eight candidate autoantibodies in the serum of 51 OS cases, 28 osteochondroma (OC), and 51 normal human sera (NHS). The rank-sum test was used to compare the content of eight autoantibodies in the sera of three groups. The diagnostic value of each indicator for OS was analyzed by an ROC curve. Differential autoantibodies between OS and NHS were screened. Then, a binary logistic regression model was used to establish a prediction logistical regression model. Results: Through ELISA, the expression levels of seven autoantibodies (ENO1, GAPDH, HSP27, HSP60, PDLIM1, STMN1, and TPI1) in OS patients were identified higher than those in healthy patients (p < 0.05). By establishing a binary logistic regression predictive model, the optimal panel including three anti-TAAs (ENO1, GAPDH, and TPI1) autoantibodies was screened out. The sensitivity, specificity, Youden index, accuracy, and AUC of diagnosis of OS were 70.59%, 86.27%, 0.5686, 78.43%, and 0.798, respectively. Conclusion: The results proved that through establishing a predictive model, an optimal panel of autoantibodies could help detect OS from OC or NHS at an early stage, which could be used as a promising and powerful tool in clinical practice.

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.

Osteochondroma (OC) is one of the most common benign tumors of bone but is rarely found in the mandibular condyle. The aim of this case report is to demonstrate condylectomy through endaural approach (EA) as a conservative alternative for the treatment of the OC. A 60-year-old woman having an OC of 23 millimeters length in the mandibular condyle. The patient underwent a surgical procedure for tumor resection. To generate less morbidity, a conservative approach was performed.

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.

BackgroundMandibular condylar osteochondroma (OC) could lead to facial morphologic and functional disturbances, such as facial asymmetry, malocclusion, and temporomandibular joint dysfunction. However, after condylar OC resection, the inaccurate reposition of the neocondyle still needs to be solved. The purpose of this study was to explore the feasibility of the condylar osteotomy and repositioning guide to reposition the neocondyle in the treatment of patients with severe deformity secondary to condylar OC.ResultsThree patients with severe deformity secondary to OC of the mandibular condyle were enrolled in this study. With the aid of condylar osteotomy and repositioning guide, condylar OC resection and repositioning were carried out, and the accuracy and stability of these guides were evaluated. All patients healed uneventfully, and no facial nerve injury and condylar ankylosis occurred. Compared with the computerized tomography scans in centric relation before surgery and 3 days after surgery, the results showed that the facial symmetry was greatly improved in all the patients. Also, after the superimposition of the condylar segments before surgery and 3 days after surgery, the postoperative reconstructed condyles had a high degree of similarity to the reconstruction of the virtual surgical planning. Observed from the sagittal and coronal directions, the measurements of condylar positions were very close to those of virtual surgical planning. Moreover, it also showed stable results after a 1-year follow-up.ConclusionsFor patients with severe deformity secondary to condylar OC, condylar osteotomy, and repositioning guide was expected to provide a new option for the improvement of facial symmetry and occlusal relationship.

ABSTRACT Osteosarcoma (OS) is the most common highly malignant primary solid bone tumor. Despite its relatively low incidence among cancers, it remains one of the most harmful primary malignant tumors in childhood and adolescence. It is now evident that serum autoantibodies against tumor-associated antigens (TAAs) could be used as serological cancer biomarkers in types of cancers. Serological proteome analysis (SERPA) approach was applied to profile anti-TAA autoantibody response in sera from patients with OS and normal human, as well as explore difference between this response. This approach can detect autoantibodies that could serve as clinical biomarkers and immunotherapeutic agents. Enzyme-linked immunosorbent assay (ELISA) and Western blotting were further used to validate the level of identified TAAs. ENO1 as a 47kD TAA in OS was identified and characterized by SERPA. Analysis of 172 serum samples with OS, osteochondroma (OC), and normal human sera (NHS) by ELISA showed higher frequency of anti-ENO1 autoantibodies in OS sera compared to others. Interestingly, decrease of ENO1 immunoreactivity was observed in most patients after treatments, which may imply a potential association between anti-ENO1 autoantibody titers and disease progression. Nine of twelve sera reacted strongly against purified ENO1, but three reacted weakly against purified ENO1, which indicated 75.0% sera with positive optimal density values from ELISA were consistently positive in Western blotting. The expression of ENO1 in OS tissues was evaluated by immunohistochemistry in tumor microarray. ENO1 was one of the autoantibodies that elicit autoimmune responses in OS and can be used as biomarkers in immunodiagnosis and progression of OS.

Effect of condylar osteochondroma resection through an intraoral approach on the masticatory functions: a preliminary evaluation based on occlusion and temporomandibular joint functions

Osteochondroma of the mandibular condyle: an algorithm for treatment