scholarly journals Nora’s lesion of the distal ulna: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110643
Author(s):  
Cheng Han Lin ◽  
Karl Wu
Keyword(s):  
Benign Lesion ◽  
Excisional Biopsy ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Distal Ulna ◽  
Nora’S Lesion ◽  
Calcified Lesion ◽  
Bone Cortex ◽  
Painless Mass ◽  
Hands And Feet

Nora’s lesion, also known as bizarre parosteal osteochondromatous proliferation (BPOP), is a very rare benign lesion with few published cases. BPOP is more common in adults during the second to third decades of life, and usually occurs on the hands and feet. Radiologically, it appears as a calcified mass attached to the bone cortex that grows rapidly and that recurs easily following resection. Aggressive features on imaging and confusing histopathological findings usually result in misdiagnosis or mistreatment. Herein, we present a case of a rare bony tumour involving the distal ulna presenting as a painless growing mass. An excisional biopsy with clear margins was performed without disturbing the ulnar nerve and arteries. There was no recurrent mass or calcified lesion 1 year after surgery. Based on its rarity and difficult diagnosis, BPOP should be considered in the differential diagnosis of a painless mass in the distal ulnar region. Careful follow-up after surgery is essential, even without lesion recurrence.

Subungual Exostosis of the Great Toe

2011 ◽  
Vol 4 (6) ◽  
pp. 376-378 ◽  
Author(s):  
Roop Singh ◽  
Mantu Jain ◽  
Rakesh Goel ◽  
Ramchander Siwach ◽  
Rajneesh Kalra ◽  
...  
Keyword(s):  
Benign Lesion ◽  
Plain Radiograph ◽  
Excisional Biopsy ◽  
Great Toe ◽  
Therapeutic Level ◽  
Level Of Evidence ◽  
The Past ◽  
Calcified Lesion ◽  
Nail Removal

Subungual exostosis is an acquired, benign, and solitary bone tumor of the distal phalanx occurring beneath or adjacent to nail. A 18-year-old man presented with a lump, ulceration, and pain on his right big toe. This complaint was present for the past 2 years. Initially, lump and pain were present, and since the past 6 months ulceration and superadded infection occurred. Plain radiograph showed a calcified lesion that was continuous with the phalangeal cortical surface in the distal dorsal aspect of the big toe. Excisional biopsy with complete nail removal and reconstruction of the tip of the toe were done. Histopathology confirmed the diagnosis of subungual exostosis. Clinical or radiological recurrence was not observed after 26 months of follow-up. The case is reported to present the tumor overview and to highlight that the diagnosis of this benign lesion should not be missed. Clinical and radiological features allow early diagnosis and treatment thus preventing the lesion to progress to the stage of onycholysis. Level of Evidence: Therapeutic, Level IV

Bizarre Parosteal Osteochondromatous Proliferation (Nora's Lesion) in the Medial Sesamoid of the First Toe

2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Onur Tetik ◽  
Lercan Aslan ◽  
Kadir Buyukdogan ◽  
Mehmet Chodza ◽  
Onder Kilicoglu
Keyword(s):  
Young Adults ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
En Bloc ◽  
Nora’S Lesion ◽  
Bony Lesion ◽  
En Bloc Excision ◽  
Small Bones ◽  
Bloc Excision ◽  
Hands And Feet

Bizarre parosteal osteochondromatous proliferation, or Nora's lesion, is a unique bony lesion that generally originates from the small bones of the hands and feet in young adults. We report a case of a bizarre parosteal osteochondromatous proliferation originating from the medial sesamoid of the first toe that was managed surgically by en bloc excision. At 5-year follow-up, there was no evidence of recurrence.

Nora's Lesion: Bizarre Parosteal Osteochondromatous Proliferation Causing Splay Foot Deformity: A Case Report

2019 ◽  
Vol 109 (6) ◽  
pp. 463-466 ◽  
Author(s):  
Anthony J. Mollica ◽  
Benjamin Getz ◽  
Chinenye Ezike ◽  
Blake Brannick ◽  
Albert J. Mollica
Keyword(s):  
Benign Lesion ◽  
Foot Deformity ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Nora’S Lesion ◽  
Spindle Cells ◽  
Common Diagnosis ◽  
Hands And Feet ◽  
Splay Foot ◽  
Tubular Bones

Nora's lesion, or bizarre parosteal osteochondromatous proliferation (BPOP), is a rare benign lesion that is made up of varying degrees of cartilage, bone, and spindle cells. Most notably, calcification of the cartilage or “blue bone,” is a feature of the disorder. The condition principally affects long tubular bones of the hands and feet, and is generally seen in patients in their second and third decades of life. We present a case of BPOP occurring in the second interspace with symptoms that would be consistent with a more common diagnosis of predislocation syndrome, or a second interspace neuroma. This case study may help the clinician in considering a more subtle cause of a splay deformity in the second interspace, and walk through the diagnostic and treatment course for BPOP.

scholarly journals Nora’s lesion: bizarre parosteal osteochondromatous proliferation in right foot: a case report

2021 ◽  
Vol 7 (5) ◽  
pp. 1043
Author(s):  
Shikhar Yadav ◽  
Divya G. ◽  
Jithin Mohan ◽  
Joice Varghese
Keyword(s):  
Benign Lesion ◽  
Plain Radiograph ◽  
Excision Biopsy ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Nora’S Lesion ◽  
First Metatarsal ◽  
Benign Pathology ◽  
One Year ◽  
The Right ◽  
Hands And Feet

<p class="abstract"><span lang="EN-US">Nora’s lesion is a benign lesion involving mainly the proximal phalanges, metatarsals or metacarpals in the hands and feet. It may be easily confused with a malignant entity and was first identified and reported by Nora et al. in 1983. We present a case of a 12 years old female with complains of a swelling over the right foot noticed 4 months ago. Plain radiograph revealed heterotrophic calcification over the dorso-lateral aspect of the head of the first metatarsal. MRI scan of the foot was suggestive of a benign pathology with a differential of bizarre parosteal osteochondromatous proliferation (BPOP) or an osteochondroma. The patient was managed with excision biopsy and lesion was excised along with the pseudo-capsule and adjoining periosteum. Cortex appeared normal and wound was washed with hydrogen peroxide and incision closed. Histopathology report was suggestive of Nora’s lesion. One year follow up of the patient showed no recurrence. BPOP proliferation is a benign lesion however differentials need to be kept in mind and treatment with excision of the lesion along with the pseudo-capsule and periosteal tissue beneath the lesion has low rates of recurrence. </span></p>

A case of primary breast diffuse large B cell lymphoma

2021 ◽  
Vol 148 (12) ◽  
pp. 102-107
Author(s):  
Trinh Le Huy ◽  
Tran Dinh Anh
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Painless Mass ◽  
Large B Cell

Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare non-Hodgkin’s lymphoma with limited data. We here report a case of primary breast diffuse large B-cell lymphoma mimicking breast cancer. A 52-year-old woman had a painless mass in her right breast. Fine needle aspiration cytology and core biopsy were performed which suggested malignant features but could not confirm the specific subtype. Excisional biopsy then was conducted revealing non-Hodgkin lymphoma, which was subsequently confirmed with histopathology and diagnosed as diffuse large B-cell lymphoma (DLBCL). A chest computed tomography scan revealed a 3.5 cm sized breast mass with skin thickening and modest lymphadenopathy in the ipsilateral axilla. The patient received six courses of R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone plus rituximab) chemotherapy, then whole breast radiation (30Gy in 15 fractions). At 12 months of follow-up, the patient survives with no evidence of disease. No morbidities occurred in this patient during the follow-up period. We briefly review the current practice pattern in patients with primary breast diffuse large B-cell lymphoma.

scholarly journals Central giant cell granuloma of the maxilla: a case re-port

2017 ◽  
Vol 5 (2) ◽  
pp. 145
Author(s):  
Najwa Alchalabi ◽  
Hayder Salih ◽  
Ahmed Merza
Keyword(s):  
Giant Cell ◽  
Unusual Case ◽  
Clinical Presentation ◽  
Benign Lesion ◽  
Giant Cell Granuloma ◽  
Case Presentation ◽  
Central Giant Cell Granuloma ◽  
First Choice ◽  
Bone Cortex

Introduction: Central giant-cell is a benign lesion that predominantly involves the bone of the mandible and maxilla with a wide variation of its behavior. Surgery usually is the first choice in treatment of central giant cell granuloma.Case Report: In this case report we present a 29 years-old female with well define swelling on left maxilla. Diagnosis through incisional biopsy showed a central giant cell granuloma. Surgery with curettage was our treatment option with a follow up( 2 years ), No recurrence was reported.Discussion: Information on the maxillary central giant cell granuloma in published studies is insufficient. So here we present our case as unusual case presentation. Differential diagnosis of this case included osteosarcoma (parosteal type) since the tumor clinical presentation in periosteous tissue adjacent to the bone cortex and showed rapid growth. We chose the conventional surgical treatment by simple surgical curettage by mid-face degloving approach to avoid any facial scaring.

scholarly journals Bizarre Parosteal Osteochondromatous Proliferation (Nora Lesion) in Upper and Lower Limbs: A Report of Three Cases and Review of Literature

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maryada Venkateshwar Reddy ◽  
Anjaneyulu Kandukuri ◽  
Vidyasagar Chandankere ◽  
Vinay Mathew Joseph ◽  
Annappareddy Venkata Gurava Reddy
Keyword(s):  
Benign Lesion ◽  
Plain Radiograph ◽  
Lower Limbs ◽  
Radiological Evaluation ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Diagnostic Dilemma ◽  
Small Bones ◽  
The Right ◽  
High Index Of Suspicion

Introduction: Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare bone pathology affecting small bones of hand and feet. This benign lesion needs to be distinguished from many malignant bone tumors as it poses a diagnostic dilemma due to its clinical, radiological, and histological picture. We report three cases of BPOP affecting the hand and foot. Case 1: A 21-year-old gentleman presented with painful swelling in the long finger of the right hand. A plain radiograph showed a radio dense mass which was later excised and diagnosis confirmed in histopathology. There was no recurrence in 2 years of follow-up. Case 2: A 5-year-old boy presented with painful swelling over the right ankle with no history of antecedent trauma. Following radiological evaluation, the patient was successfully treated with excision. Case 3: A 35-year-old lady presented with a painful swelling on the dorsal aspect of her hand which was gradually increasing in size. After radiological evaluation, the patient was successfully treated with excision and lesion confirmed to be BPOP on histological examination. She was symptom free without recurrence in up to 2 years of follow-up. Conclusion: Nora’s lesion is a rare pathology requiring high index of suspicion. Excision is the recommended mode of treatment. All our cases responded well with excision with immediate pain relief following surgery and no recurrence in up to 2 years of follow-up. Keywords: Nora, bizarre parosteal osteochondromatous proliferation, neoplasm, tumor, benign.

Bizarre Parosteal Osteochondromatous Proliferation of the Little Toe

2006 ◽  
Vol 96 (2) ◽  
pp. 158-161 ◽  
Author(s):  
Baransel Saygi ◽  
Evrim Karadag-Saygi ◽  
Can Erzik ◽  
Murat Erkan ◽  
Yakup Yildirim
Keyword(s):  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Excisional Biopsy ◽  
Lateral Side ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Initial Examination ◽  
Histologic Diagnosis ◽  
Nora’S Lesion ◽  
Fifth Toe

A 19-year-old woman presented with pain at the lateral side of the fifth toe of her left foot, which was separated from the adjacent toe. Initial examination suggested dislocation of the fifth metatarsophalangeal joint due to a past fracture. Radiographs showed a mass arising from the proximal phalanx of the little toe, with no medullary and cortical continuity. Excisional biopsy of the mass was performed, and a histologic diagnosis of bizarre parosteal osteochondromatous proliferation of bone (Nora’s lesion) was made. (J Am Podiatr Med Assoc 96(2): 158–161, 2006)

scholarly journals An Unusual Clinical Presentation of Merkel Cell Carcinoma: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Deba P. Sarma ◽  
Dawn E. Heagley ◽  
Julianne Chalupa ◽  
Meredith Cox ◽  
James M. Shehan
Keyword(s):  
Elderly Patients ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Clinical Presentation ◽  
Benign Lesion ◽  
Excisional Biopsy ◽  
The Sun ◽  
Merkel Cell ◽  
Exposed Skin

Introduction. Merkel cell carcinoma is a rare, aggressive neuroendocrine cell carcinoma arising in the sun-exposed skin of elderly patients. Most of these tumors are located in the dermis. An unusual clinical presentation of such a tumor in the subcutis, if not biopsied, may be easily mistaken as a benign lesion.Case Presentation. An 83-year-old white woman presented with a several-month history of a painless 7 mm subcutaneous mass that was initially thought to be a lipoma. A conservative follow-up was planned. At the insistence of the patient, an excisional biopsy of the mass was performed revealing a subcutaneous Merkel cell carcinoma. The tumor cells stained positively for CK 20, chromogranin, and synaptophysin. No other primary or metastatic tumors found after a thorough work-up. The patient was treated with local irradiation. She remains disease free at her six-month follow-up visit.Conclusion. When a new growth is encountered in the sun-exposed skin of elderly patients, a biopsy is warranted even if the lesion clinically appears benign.

scholarly journals Bizarre Parosteal Osteochondromatous Proliferation (Nora Lesion)

2017 ◽  
Vol 3 ◽  
pp. 2513826X1775109
Author(s):  
Zach Zhang ◽  
Bibianna Purgina ◽  
Jing Zhang
Keyword(s):  
Growth Pattern ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
High Rate ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Local Growth ◽  
En Bloc ◽  
Immediate Reconstruction ◽  
Hands And Feet

Bizarre parosteal osteochondromatous proliferation, also known as Nora lesion, is a rare benign surface lesion of the bone commonly affecting the hands and feet. It has an aggressive local growth pattern and high rate of recurrence post-excision. The authors report a case of recurred Nora lesion involving thumb metacarpal neck. En bloc resection with immediate reconstruction using distal radius bone graft was provided as a treatment with no clinical or radiological recurrence at 2-year follow-up.

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