Bizarre Parosteal Osteochondromatous Proliferation in the First Metatarsal Bone: A Case Report

Woo-Sung Kim; Yu-Hun Jung; Sang-Hun Oh; Eun-Mee Han

doi:10.5292/jkbjts.2014.20.2.104

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Kim, Jung, Oh, and Han: Bizarre Parosteal Osteochondromatous Proliferation in the First Metatarsal Bone: A Case Report

Case Report

J Korean Bone Joint Tumor Soc 2014;20(2):104-108.

Published online: 10 January 2014

DOI: https://doi.org/10.5292/jkbjts.2014.20.2.104

Bizarre Parosteal Osteochondromatous Proliferation in the First Metatarsal Bone: A Case Report

Woo-Sung Kim, Yu-Hun Jung, Sang-Hun Oh, Eun-Mee Han^*

^*Pathology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea

Departments of Orthopedic Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea

Correspondence to: Yu-Hun Jung Department of Orthopaedic Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, 255-2, Seohyun-dong, Bundang-gu, Seongnam 463-774, Korea TEL: +82-31-779-0175 FAX: +82-31-779-0176 E-mail: osjungyh@naver.com

Received 30 October 2014 Revised 27 November 2014 Accepted 29 November 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bizarre parosteal osteochondromatous proliferation (Nora's lesion) is a rare benign tumor and known to be primarily occur in the small tubular bone of the hands and feet. However, it is very unusual to be reported that it occurs in metatarsal bone in Korea. Thus, we report this tumor of metatarsal bone including the literature review because we have experienced this example.

Keywords: tumor of metatarsal bone, bizarre parosteal osteochondromatous proliferation, Nora's lesion

References

1. Nora FE, Dahlin DC, Beabout JW. Bizarre parosteal osteochondromatous proliferations of the hands and feet. Am J Surg Pathol. 1983; 7:245–50.

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3. Torreggiani WC, Munk PL, Al-Ismail K, et al. MR imaging features of bizarre parosteal osteochondromatous proliferation of bone (Nora's lesion). Eur J Radiol. 2001; 40:224–31.

4. Kim BH, Park YK, Kim YW, Yang MH. Bizarre Parosteal Osteochondromatous Proliferation: A report of five cases. Korean J Pathol. 1996; 30:733–8.

5. van der Walt JD, Ryan JF. Parosteal osteogenic sarcoma of the hand. Histopathology. 1990; 16:75–8.

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Figure 1.

Arrow at plain radiograph shows a bony mass in the both 1^st metatarsal head dorsal area.

Figure 2.

The MRI shows that the tumor is homogenous appearance and there is no bony deconstruction, medulla abnormality, continuity to bone marrow, that suggests bizarre parosteal osteochondromatous proliferation. (A) T1 enhanced image (B) T2 enhanced image (C) Enhancement of soft tissue and bursa around the tumor in the MRI with intravenous gadolinium contrast suggests inflammation of soft tissue due to irritation from tumor.

Figure 3.

Gross specimen photo shows the 6.8×4.8×2.5 cm sized bony mass with cartilaginous cap.

Figure 4.

The specimen was examined histologically, the lesion is composed of a cartilaginous cap, calcified cartilage matrix, cancellous bone, spindle cell that compose fibrous tissue. (A) H&E, ×12.5, (B) H&E, ×100.

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