Bizarre parosteal osteochondromatous proliferation

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Bizarre parosteal osteochondromatous proliferation
Other namesNora lesion or Nora disease [1] [2]
Specialty Orthopedics
Symptoms Painless lump in finger or toe [1]
Risk factors Possibly trauma in a minority [1]
Diagnostic method Medical imaging [1]
Differential diagnosis Mainly subungal exostosis [1]
TreatmentSurgical excision. [1]
Prognosis Up to 50% recur after surgery [1]
FrequencyRare, [2] <5% of cartilage tumors, [3] M=F [1]

Bizarre parosteal osteochondromatous proliferation (BPOP), also known as Nora's lesion, [4] is a type of non-cancerous bone tumor belonging to the group of cartilage tumors. [1] [2] [5] It is generally seen in the tubular bones of the hands and feet, [6] where it presents with a rapidly enlarging painless lump in a finger or toe. [1]

Contents

It is composed of bone, cartilage and spindle cells. [1] Some people report previous trauma. [1]

Diagnosis is by medical imaging. [1] Treatment is by surgical excision. [1] Up to 50% recur after surgery. [1]

It is rare, [2] and occurs more often in the 20s and 30s. [1] Combined with subungal exostosis, it accounts for less than 5% of cartilage tumors. [3] Males and females are affected equally. [1] The condition was first described by Frederick E. Nora in 1983. [6] [7]

Signs and symptoms

BPOP generally presents with a 1–3 cm painless lump in a finger or more frequently a toe. [1] Growth can be rapid. [2]

Mechanism

It is composed of bone, cartilage and spindle cells. [1] A small number of people have reported previous trauma. [1]

Diagnosis

Medical imaging usually shows a well-defined wide-based bony growth on the surface of bone. [6]

Differential diagnosis

BPOP is distinct from subungal exostosis. [1] [6] Conditions that may appear similar to BPOP include: myositis ossficans, ostechondroma, surface osteosarcoma and granulomatous infection. [2]

Treatment

Treatment is by surgical excision. [1]

Outcomes

Up to 50% recur after surgery. [1] [2]

Epidemiology

BPOP is rare. [2] It is most often seen in people in their 20s and 30s. [1] Combined with subungal exostosis, it accounts for less than 5% of cartilage tumors. [3] Males and females are affected equally. [1] [6]

History

Bizarre parosteal osteochondromatous proliferation was first described by Frederick E. Nora in 1983. [6] [7] Generally in the US, it has been thought of as a mouthful and hence it is sometimes referred to as Nora's lesion. [4]

Other animals

In 1998 a report of a similar lesion to BPOP was reported in a wallaby. [8]

Related Research Articles

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References

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  2. 1 2 3 4 5 6 7 8 Bocklage, Therese J.; Quinn, Robert; Verschraegen, Claire; Schmit, Berndt (2014). "16. Cartilaginous tumours of bones and joints". Bone and Soft Tissue Tumors: A Multidisciplinary Review with Case Presentations. London: JP Medical Ltd. p. 379. ISBN   978-1-907816-22-2.
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  8. Rungsipipat, A.; Yamaguchi, R.; Naganobu, K.; Iwamoto, K.; Uchida, K.; Tateyama, S.; Kurogi, T.; Katayama, N. (1998). "A bone tumour resembling bizarre parosteal osteochondromatous proliferation in a wallaby". Australian Veterinary Journal. 76 (8): 561–564. doi:10.1111/j.1751-0813.1998.tb10218.x. ISSN   1751-0813. PMID   9741726.