A bizarre parosteal osteochondromatous proliferation (Nora's lesion) of metatarsus, a histopathological and etiological puzzlement


Doganavsargil B., ARGIN M., SEZAK M., Kececi B., Pehlivanoglu B., Oztop F.

JOINT BONE SPINE, cilt.81, sa.6, ss.537-540, 2014 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 81 Sayı: 6
  • Basım Tarihi: 2014
  • Doi Numarası: 10.1016/j.jbspin.2014.07.008
  • Dergi Adı: JOINT BONE SPINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.537-540
  • Anahtar Kelimeler: Bizarre parosteal osteochondromatous proliferation, Foot, Radiographs, Pathogenesis
  • Dokuz Eylül Üniversitesi Adresli: Hayır

Özet

Nora's lesion (bizarre parosteal osteochondromatous proliferation) is a rare, benign lesion that is composed of differing amounts of cartilage, bone, and spindle cells and an unusual form of calcified cartilage so-called "blue bone". Whether it represents a reactive proliferation or a neoplastic lesion still remains controversial. We present a 24-year-old woman having a 4.5 cm two lobulated mass attached to second metatarsus of her left foot. The lesion was hyperintense on magnetic resonance imaging and accompanied by an extensive soft tissue and bone marrow edema. In resection specimen, smaller lobule appeared stuck-on the cortex while the larger one had a broader base and a 0.4 cm cartilaginous cap-like formation. The histological picture was best fit to Nora's lesion however showed less fibroblastic tissue and cartilaginous pleomorphism. The lesion also showed areas with cortical invasion and a small focus of fracture callus accompanied by adjacent medullary edema and fat necrosis. The case is presented with the comparative radiologic, macroscopic and microscopic findings for its diagnostic difficulties and etiopathogenetic considerations in favour of a maturation phenomenon in parosteal ostecartilaginous lesions irrespective of the cause. (C) 2014 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.