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Objective: Rare disease Background: Osteochondroma is the most common bone tumor and is a surface bone lesion that includes cortical and medullary bone with a hyaline cartilage cap. Benign osteochondroma is a common tumor in children that may be asymptomatic but can cause pain and limit joint movement when arising in a joint. This report describes the presentation, diagnosis, and management of an intra-articular osteochondroma of the right elbow joint in an 8-year-old boy. Case Report: An 8-year-old boy experienced persistent right elbow pain and limited motion, which were unresponsive to conservative measures. Examination revealed a firm swelling in the right cubital fossa. Radiographic and advanced imaging confirmed an osteochondroma originating from the capitellum and trochlea. Surgical exploration via a lateral approach and capsulotomy excised a lobulated intra-articular mass (5×2×1.5 cm). Histopathology showed a hyaline cartilage cap with typical chondrocytes and endochondral ossification, and normal fatty marrow and hematopoietic elements in the stroma. The procedure restored normal elbow function. This case is the first documented instance of an elbow joint intra-articular osteochondroma. Conclusions: This report has highlighted the importance of surgical removal and histopathology in the diagnosis of this common bone lesion to exclude the differential diagnoses of intra-articular masses that include a foreign body, enchondroma, chondroblastoma, periosteal chondroma, chondromyxoid fibroma, or malignant chondrosarcoma. [ABSTRACT FROM AUTHOR]

Background: Multiple cartilaginous exostoses (MCE) are a rare genetic disorder characterized by multiple osteochondromas in the metaphysis of long bones. Case Presentation. We report a 15-year-old male patient, his father, and his brother, all presenting varied severity of the same symptom. The patient exhibited symptoms since infancy, with osteochondromas affecting mobility and causing joint deformities. Whole exome sequencing identified a pathogenic NM_000127.3(EXT1):c.1056 + 2 T > G and a likely pathogenic NM_000127.3(EXT1):c.1047G > T variant in the EXT1 gene, both novel. Conclusions: Despite three decades since the discovery of the EXT1 gene, MCE diagnosis may be delayed until adolescence or adulthood. This report contributes to clinical understanding, emphasizing the importance of early diagnosis, genetic analysis, and potential treatment approaches, to mitigate long-term deformities and complications in MCE patients. [ABSTRACT FROM AUTHOR]

Osteochondroma of the craniofacial region is rare. However, the most common site of osteochondroma in the craniofacial region is the mandibular coronoid process and mandibular condyle. Here, we report a case of a 32‐year‐old woman treated by condylectomy and secondary reconstruction with a temporomandibular joint prosthesis. [ABSTRACT FROM AUTHOR]

Background: Radial head dislocation in patients with multiple hereditary exostoses (MHE) is associated with loss of function and cosmetic problems. The treatment of the deformity with radial head dislocation is difficult and the timing of surgical intervention is important. The aim of this study was to evaluate the factors predictive of radial head dislocation in patients with MHE. Methods: Patients diagnosed with forearm deformity due to MHE between 1995 and 2021 were retrospectively evaluated. Radiographic parameters including radial bow (RB), ulnar bow (UB), total radial bow (TRB), total ulnar bow (TUB), percent ulnar length (PUL), ulnar shortening (US), radial articular angle (RAA), modified Masada classification and irregularity of proximal radioulnar joint (PRUJ) of the dislocated group (group D), that is subluxation or dislocation of the radial head, and the located group (group L) were compared. Results: A total of 18 patients and 25 limbs (5 girls and 13 boys) with a mean age of 10.5 years were included. There were significant differences in TUB (22.8° ± 5.6° vs. 10.7° ± 6.5°), PUL (97.5% ± 5.5% vs. 108.2% ± 7.7%) between group D and group L (p < 0.05). Moreover, irregularity of PRUJ on radiographs was more in group D (p < 0.05). Conclusions: It is possible that appropriate radiographic assessment in relation to radial head dislocation may prevent delayed surgical treatment of forearm deformities in MHE. Level of Evidence: Level IV (Diagnostic) [ABSTRACT FROM AUTHOR]

Langebaanweg is a Mio‐Pliocene locality located on the West Coast of South Africa. It is renowned for its rich diversity of both terrestrial and marine vertebrate fossils. Several carnivorans have been identified from this site, amongst which is the recently described jackal‐like canid, Eucyon khoikhoi. One of the skeletons assigned to E. khoikhoi exhibits anatomical deformities on several bones of the skeleton. Here, we use multiple methodologies (anatomical descriptions, CT scanning and histology) to investigate the bony overgrowths or exostoses evident in the radius, and we compare these findings with those of a radius from a healthy individual of the same species from Langebaanweg. Our results show that anatomical observations are important for first level observation of the pathology, but that micro‐CT scanning permits a more precise assessment of how the pathology affected the internal organization of the bone, both periosteally and endosteally. This methodology permitted us to diagnose the tumors as benign rather than cancerous. Our observations of calcified cartilage in the histological thin sections in the region of the exostosis allowed us to further diagnose the exostosis as an osteochondroma. This study has demonstrated the usefulness of applying multiple techniques to characterize and diagnose pathological bony growths in a fossil canivoran. We have also demonstrated the usefulness of histological studies in permitting a more refined diagnosis of the exostosis as an osteochondroma. [ABSTRACT FROM AUTHOR]

This article aims to understand the impact of a condition causing multiple benign neoplasms on a historical individual, and increase understanding of disease processes using a paleopathological case. We present the case of an adult male from the Balizhuang site in Weifang City, Changle County, Shandong Province, China, dated by the burial artifacts to the Qing period (1644–1911 CE). The individual has multiple bony growths found on both long and flat bones, which were also observed radiographically. Imaging revealed that the lesions show continuity with the medullary cavity of the host bone. The individual also exhibited short stature, upper limb length asymmetry, and hip and ankle deformities. Conditions included in a differential diagnosis are myositis ossificans, parosteal osteosarcoma, and osteochondroma, with multiple osteochondromas (MO) being the most likely diagnosis. We also present historical texts suggesting the presence of osteochondromas in China. This may be the first case of adult MO reported in Chinese bioarcheology, helping to expand paleopathological data on benign tumors. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Osteochondroma on the ventral scapula is clinically rare and can incur pseudo‐winged scapula and snapping syndrome if not treated. In this regard, surgical excision is suggested, if possible, with a minimally invasive approach to accelerate physical recovery. Osteochondroma is a common benign bone tumor, characterized by a cartilage‐capped osseous protuberance with cortical and medullary continuity with the underlying native bone. Osteochondroma is commonly found in the long bones, such as the proximal humerus, distal femur, and proximal tibia, but rarely seen in flat bones. We report a case of pedunculated osteochondroma on the ventral surface of left scapula in a young adult woman. She presented with a slight pseudo‐winged scapula, occasional pain, and snapping sound with motion of the left shoulder. The tumor was surgically resected using a minimally invasive approach, and an excellent outcome was obtained. [ABSTRACT FROM AUTHOR]

Abstract Background Multiple cartilaginous exostoses (MCE) are a rare genetic disorder characterized by multiple osteochondromas in the metaphysis of long bones. Case Presentation. We report a 15-year-old male patient, his father, and his brother, all presenting varied severity of the same symptom. The patient exhibited symptoms since infancy, with osteochondromas affecting mobility and causing joint deformities. Whole exome sequencing identified a pathogenic NM_000127.3(EXT1):c.1056 + 2 T > G and a likely pathogenic NM_000127.3(EXT1):c.1047G > T variant in the EXT1 gene, both novel. Conclusions Despite three decades since the discovery of the EXT1 gene, MCE diagnosis may be delayed until adolescence or adulthood. This report contributes to clinical understanding, emphasizing the importance of early diagnosis, genetic analysis, and potential treatment approaches, to mitigate long-term deformities and complications in MCE patients.

Osteochondromas, the most frequent type of bone tumor, develop from the metaphysis region of bones. Osteochondroma often occurs in bones, however, it is rare when it comes to rib tumors. It is often asymptomatic and observed incidentally.We present a case of a 14-year-old male patient who had been experiencing cough and mild fever for approximately a week. We requested a CXR PA and LAT. It showed a pulmonary nodule measuring 1.5 cm in diameter in the upper segment of the left lower lobe.Taking into account the unclear nature of the diagnosis, we requested CT scan with contrast of the chest to obtain a better view. It showed:The nodule visualized on the CXR corresponded to a posteriorly directed, well-defined lesion arising from the costal cartilage of the third left rib, measuring 1.2 × 1.3 × 1.1 cm, likely representing an osteochondroma.The case we discussed highlights a rib osteochondroma that initially seemed like a pulmonary nodule on an X-ray, pointing out the importance of using CT scans for accurate diagnosis in such cases, and reminding us to consider osteochondroma when we see similar symptoms and to regularly check the tumor with medical imaging after it's been confirmed by a pathological test.

Introduction: Osteochondroma is a benign tumor of bone. Malignant transformation of Osteochondroma is the most devastating complication one can encounter. Osteochondroma can transform into any malignancy like Osteosarcoma, Chondrosarcoma and Ewing sarcoma. Malignant transformation is more common in patients with multiple exostosis. Recognition of this malignant transformation is needed to predict the patient's outcome. Case presentation: A 26-year-old male patient came with complaints of a mass in the left knee region for the past 7 years. X-ray of the knee showed multiple pedunculated exostosis on either side of the distal end of the femur, tibia and fibula. Histopathological examination revealed a bony lesion with a cartilaginous cap of increased thickness and cellularity. The cartilaginous cap possesses plump chondrocytes showing binucleation-forming nodules with mild atypia. The cartilaginous cap undergoes endochondral ossification, suggesting the possibility of a secondary peripheral atypical cartilaginous tumor from osteochondroma of the tibia. Discussion: Chondrosarcoma is a heterogeneous type of primary bone cartilaginous malignancy with variable clinical outcomes. Malignant transformation of osteochondroma in the appendicular skeleton was named atypical cartilaginous tumor; in the axial skeleton, it is named Grade 1 Chondrosarcoma. Conclusion: Differentiation between osteochondroma and its malignant transformation can be possible if made in a multidisciplinary setting such as clinical history, radiological findings along with histology to confirm the diagnosis.

Exostosis, or osteochondroma, represents the most prevalent primary benign bone tumor, often viewed as a developmental anomaly rather than a true neoplasm. This article presents 2 cases illustrating complications associated with tibial osteochondroma. The first case involves a 25-year-old patient with recurrent medial knee pain attributed to pes anserine bursitis secondary to tibial osteochondroma, managed successfully with surgical excision. The second case features a 15-year-old with similar symptoms and unsuccessful conservative management, highlighting the diagnostic challenges and therapeutic options for this condition. Discussion encompasses the clinical presentation, diagnostic modalities including MRI and ultrasound, and management strategies such as conservative measures, corticosteroid injections, and surgical excision. Recognizing and promptly managing complications like pes anserine bursitis in tibial osteochondroma is crucial to prevent chronic pain and functional impairment, emphasizing the importance of a multidisciplinary approach involving orthopedic surgeons, radiologists, and physical therapists.

BACKGROUND: Osteochondroma (osteochondral exostosis) is the most common benign neoplasm of bone tissue, accounting for up to 9% of all bone tumors. Possible manifestations of a single osteochondral exostosis are pain, a limited range of motion, compression of vascular or neural structures, and crepitus. The literature describes several clinical cases of the treatment of patients with osteochondral exostosis of the proximal radius. A distinguishing feature of the proximal radius’s anatomy is the close location of such anatomical structures as the posterior interosseous nerve, the enthesis of the distal biceps tendon, and the proximal radioulnar joint. CLINICAL CASE DESCRIPTION: This clinical case for the first time describes osteochondroma of the radial neck, which causes supination deficiency. CONCLUSION: The surgical treatment allowed us to achieve excellent treatment results with the complete restoration of the function and range of motion in the elbow joint. The key aspect is the knowledge of this segment’s anatomy.

Abstract Background Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare benign bone tumor, it is also called “Nora’s lesion”. The lesion is characterized by heterotopic ossification of the normal bone cortex or parosteal bone. The etiology of BPOP is unclear and may be related to trauma. In most BPOPs, the lesion is not connected to the medullary cavity. Here we report an atypical case, characterized by reversed features compared to the typical BPOP, which demonstrated continuity of the lesion with the cavity. Case presentation An 11-year-old female child had a slow-growing mass on her right wrist for 8 months with forearm rotation dysfunction. Plain X-rays showed an irregular calcified mass on the right distal ulna, and computed tomography (CT) showed a pedunculated mass resembling a mushroom protruding into the soft tissue at the distal ulna. The medulla of this lesion is continuous with the medulla of the ulna. A surgical resection of the lesion, together with a portion of the ulnar bone cortex below the tumor was performed, and the final pathology confirmed BPOP. After the surgery, the child’s forearm rotation function improved significantly, and there was no sign of a recurrence at 1-year follow-up. Conclusion It is scarce for BPOP lesions to communicate with the medullary cavity. However, under-recognition of these rare cases may result in misdiagnosis or inappropriate treatment thereby increasing the risk of recurrence. Therefore, special cases where BPOP lesions are continuous with the medulla are even more important to be studied to understand better and master these lesions. Although BPOP is a benign tumor with no evidence of malignant transformation, the recurrence rate of surgical resection is high. We considered the possibility of this particular disease prior to surgery and performed a surgical resection with adequate safety margins. Regular postoperative follow-up is of utmost importance, without a doubt.

Abstract Background This study aimed to demonstrate the occurrence of lower extremity deformities and their risk factors in patients with solitary osteochondromas. Methods We retrospectively reviewed consecutive patients with solitary osteochondromas around the knee. The laterality (left or right), involved bone (femur or tibia), tumor type (pedunculated or sessile), and direction (medial or lateral) were examined. The whole limb length (WLL), mechanical lateral distal femoral angle (mLDFA), and medial proximal tibial angle (MPTA) were measured using teleroentgenogram. Lower limb deformity was defined as a difference of more than 5° in mLDFA or MPTA in both lower extremities or a difference in WLL of more than 1 cm. Patients were divided into two groups, with deformity and without deformity. Results Lower extremity deformities were observed in 8 of 83 patients. Significant difference in the type of osteochondroma (p = 0.004) between the groups was observed. Differences in sex, age, laterality, involved bone, direction, and distance from the physis to the osteochondroma between groups were not statistically significant. The sessile type of osteochondroma was a risk factor for lower limb deformity with an odds ratio of 24.0 according to Firth’s logistic regression analysis. Conclusion In our cohort with solitary osteochondroma, lower limb deformities were observed in 8 (9.6%) out of the 83 patients and these were significantly associated with sessile-type tumors. Therefore, patients with sessile-type solitary osteochondroma around the knee require careful surveillance of lower limb alignment with whole leg teleroentgenogram.

Tibial exostosis, also known as osteochondroma, is a common benign bone tumor found predominantly in adolescents and young adults. Vascular complications associated with this tumor, such as arterial occlusion and pseudoaneurysm formation, are rare but can lead to significant morbidity if not promptly diagnosed and managed. We present a case of a 25-year-old patient who presented with thrombosis of the left popliteal vein and a painless swelling in the popliteal fossa. Radiographic and CT angiography revealed an exostosis on the proximal tibia causing arterial occlusion and venous compression. Surgical resection of the exostosis via a posterior knee approach resulted in successful resolution of symptoms and a favorable outcome at a 12-month follow-up. Histopathological examination confirmed the benign nature of the tumor with no evidence of malignant transformation. This case highlights the importance of prompt recognition and surgical intervention in managing vascular complications associated with tibial exostosis. A multidisciplinary approach involving orthopedic and vascular specialists is crucial for achieving optimal outcomes in such cases.

Background: Primary bone tumors are relatively uncommon and constitute only 0.2-0.5% of all tumors in all ages in most series reported worldwide. Benign bone tumors are more common than the malignant bone tumors. Not many studies on benign bone tumors in the North Eastern Indian population are published in the available literature. Aims and Objectives: The current study was done with the aim to find out the epidemiological data on benign bone tumors in patients of the North-East Indian population who were admitted to the orthopedic department of a teaching institute. Materials and Methods: A hospital-based retrospective study with prospective effect was conducted on benign bone tumors in patients admitted to the Department of Orthopedics at our teaching institute from 2016 to 2020. Patients of all ages and both sexes with suspicion of bone tumors based on history and clinical examination were subjected to roentgenographic evaluation, including computed tomography (CT) scan and/or magnetic resonance imaging. Pre-operative core needle biopsy under C-arm/CT guidance or incisional biopsy was done for histological diagnosis, followed by appropriate intervention. Soft-tissue tumors and malignant bone tumors were excluded. Patients were followed up for recurrence, complications, and functional recovery. Results: Forty patients of bone tumors were treated out of 2288 patients admitted to the department (incidence of 1.75%). 29 were benign bone tumors with an incidence of 1.27%. Of 10-20 years age group was most commonly affected. Male preponderance with M: F=6.25:1. Femur (n=16) was the most commonly affected bone. Presenting features were swelling (n=18), pain (n=11), and pathological fracture (n=5). osteochondroma (n=15) was most common followed by giant cell tumor of bone (n=6). Treatment ranged from intralesional steroid to wide marginal excision based on histopathological diagnosis, the extent of tumor, anatomical location, and presenting symptoms. All patients were rehabilitated to activities of daily living at the final follow-up. No recurrence or any long-term complications were reported. Conclusion: This study gives epidemiological data on benign bone tumors, which can be used for setting up or upgrading dedicated oncological or oncosurgery institutes. A multicentric study on a large population in the future is suggested to obtain a larger data bank. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Bizarre parosteal osteochondromatous proliferations (BPOPs) are distinct clinical–pathological entities that demonstrate combinations of atypical-appearing osseous and chondromatous tissues. These lesions are usually reactive in nature. Histopathologically, 'bizarre' cartilage is a characteristic feature of this lesion. BPOPs usually represent slow-growing painless bony hard protuberances that arise from the surface of affected bone cortices, typically the metacarpals, metatarsals, and phalanges. The occurrence of these lesions in the skull and jaws is sporadic. This case report highlights the clinical presentation, histopathological characteristics, and management of BPOP arising from the supraorbital rim in a 61-year-old female patient. [ABSTRACT FROM AUTHOR]

Background: Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare benign bone tumor, it is also called "Nora's lesion". The lesion is characterized by heterotopic ossification of the normal bone cortex or parosteal bone. The etiology of BPOP is unclear and may be related to trauma. In most BPOPs, the lesion is not connected to the medullary cavity. Here we report an atypical case, characterized by reversed features compared to the typical BPOP, which demonstrated continuity of the lesion with the cavity. Case presentation: An 11-year-old female child had a slow-growing mass on her right wrist for 8 months with forearm rotation dysfunction. Plain X-rays showed an irregular calcified mass on the right distal ulna, and computed tomography (CT) showed a pedunculated mass resembling a mushroom protruding into the soft tissue at the distal ulna. The medulla of this lesion is continuous with the medulla of the ulna. A surgical resection of the lesion, together with a portion of the ulnar bone cortex below the tumor was performed, and the final pathology confirmed BPOP. After the surgery, the child's forearm rotation function improved significantly, and there was no sign of a recurrence at 1-year follow-up. Conclusion: It is scarce for BPOP lesions to communicate with the medullary cavity. However, under-recognition of these rare cases may result in misdiagnosis or inappropriate treatment thereby increasing the risk of recurrence. Therefore, special cases where BPOP lesions are continuous with the medulla are even more important to be studied to understand better and master these lesions. Although BPOP is a benign tumor with no evidence of malignant transformation, the recurrence rate of surgical resection is high. We considered the possibility of this particular disease prior to surgery and performed a surgical resection with adequate safety margins. Regular postoperative follow-up is of utmost importance, without a doubt. [ABSTRACT FROM AUTHOR]

Background: This study aimed to demonstrate the occurrence of lower extremity deformities and their risk factors in patients with solitary osteochondromas. Methods: We retrospectively reviewed consecutive patients with solitary osteochondromas around the knee. The laterality (left or right), involved bone (femur or tibia), tumor type (pedunculated or sessile), and direction (medial or lateral) were examined. The whole limb length (WLL), mechanical lateral distal femoral angle (mLDFA), and medial proximal tibial angle (MPTA) were measured using teleroentgenogram. Lower limb deformity was defined as a difference of more than 5° in mLDFA or MPTA in both lower extremities or a difference in WLL of more than 1 cm. Patients were divided into two groups, with deformity and without deformity. Results: Lower extremity deformities were observed in 8 of 83 patients. Significant difference in the type of osteochondroma (p = 0.004) between the groups was observed. Differences in sex, age, laterality, involved bone, direction, and distance from the physis to the osteochondroma between groups were not statistically significant. The sessile type of osteochondroma was a risk factor for lower limb deformity with an odds ratio of 24.0 according to Firth's logistic regression analysis. Conclusion: In our cohort with solitary osteochondroma, lower limb deformities were observed in 8 (9.6%) out of the 83 patients and these were significantly associated with sessile-type tumors. Therefore, patients with sessile-type solitary osteochondroma around the knee require careful surveillance of lower limb alignment with whole leg teleroentgenogram. [ABSTRACT FROM AUTHOR]

Background: To our knowledge, there have been no studies examining peroneal nerve decompression and proximal fibular osteochondroma excision exclusively in patients with multiple hereditary exostoses (MHE). The purpose of this study was to evaluate the indications, complications, and recurrence associated with nerve decompression and proximal fibular osteochondroma excision in patients with MHE. Methods: The records on patients with MHE undergoing peroneal nerve decompression from 2009 to 2023 were retrospectively reviewed. Indications, clinical status, surgical technique, recurrence, and complications were recorded and were analyzed using the Fisher exact test, logistic regression, and the Kaplan-Meier method. Results: There were 126 limbs identified in patients with MHE who underwent peroneal nerve decompression. The most common indications were pain over the proximal fibula, tibialis anterior and/or extensor hallucis longus weakness, and dysesthesias and/or neuropathic pain. Seven cases experienced postoperative foot drop as a complication of the decompression and osteochondroma excision. Logistic regression found significant relationships between complications and excision of anterior osteochondromas (odds ratio [OR], 5.21; p = 0.0062), proximal fibular excision (OR, 14.73; p = 0.0051), and previous decompression (OR, 5.77; p = 0.0124). The recurrence rate was 13.8%, and all recurrences occurred in patients who were skeletally immature at the index procedure. The probability of skeletally immature patients not experiencing recurrence was 88% at 3 years postoperatively and 73% at 6 years postoperatively. Conclusions: Indications for peroneal nerve decompression included neurologic symptoms and pain. The odds of a complication increased with excision of anterior osteochondromas and previous decompression. Recurrence of symptoms following decompression and osteochondroma excision was found exclusively in skeletally immature patients. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

The actions of the retinoic acid nuclear receptor gamma (RARγ) agonist, palovarotene, on pre-existing osteochondromas were investigated using a mouse multiple osteochondroma model. This approach was based on the knowledge that patients often present to the clinic after realizing the existence of osteochondroma masses, and the findings from preclinical investigations are the effects of drugs on the initial formation of osteochondromas. Systemic administration of palovarotene, with increased doses (from 1.76 to 4.0 mg/kg) over time, fully inhibited tumor growth, keeping the tumor size (0.31 ± 0.049 mm3) similar to the initial size (0.27 ± 0.031 mm3, p = 0.66) while the control group tumor grew (1.03 ± 0.23 mm3, p = 0.023 to the drug-treated group). Nanoparticle (NP)-based local delivery of the RARγ agonist also inhibited the growth of osteochondromas at an early stage (Control: 0.52 ± 0.11 mm3; NP: 0.26 ± 0.10, p = 0.008). Transcriptome analysis revealed that the osteoarthritis pathway was activated in cultured chondrocytes treated with palovarotene (Z-score = 2.29), with the upregulation of matrix catabolic genes and the downregulation of matrix anabolic genes, consistent with the histology of palovarotene-treated osteochondromas. A reporter assay performed in cultured chondrocytes demonstrated that the Stat3 pathway, but not the Stat1/2 pathway, was stimulated by RARγ agonists. The activation of Stat3 by palovarotene was confirmed using immunoblotting and immunohistochemistry. These findings suggest that palovarotene treatment is effective against pre-existing osteochondromas and that the Stat3 pathway is involved in the antitumor actions of palovarotene. [ABSTRACT FROM AUTHOR]

Case: We report a unique case of dynamic scapular winging due to compression of the long thoracic nerve by a ventral scapular osteochondroma, representing a combination of mechanical and neural causes. Arthroscopic resection of the lesion was performed, which led to complete resolution of the symptoms. Conclusion: By reporting this case, we aimed to increase awareness of the importance of a correct etiological diagnosis of dynamic scapular winging, so that targeted treatment can be addressed. Arthroscopic resection seems ideal for this indication because it reduces the risk of complications and patient recovery time. [ABSTRACT FROM AUTHOR]

Osteochondroma rarely occurs in the ribs; therefore, the treatment is not standardized. There are few studies of resection via complete thoracoscopic surgery (CTS), although video‐assisted thoracoscopic surgery with mini‐thoracotomy has been reported. Herein, we report a case of costal osteochondroma managed with CTS. A 23‐year‐old woman presented to our hospital due to left chest pain. Chest computed tomography revealed a bone‐like structure protruding into the thoracic cavity from the left fourth rib. Thus, surgery was performed to obtain a definitive diagnosis and provide appropriate treatment. The tumor was resected from the base at the border of the normal bone via CTS using three 5.5‐mm ports. A pathological diagnosis of costal osteochondroma was made. The patient had an uneventful clinical course and did not present with a recurrence 1 year after surgery. Therefore, CTS can be a good approach for cases with slim and stalked costal osteochondroma. [ABSTRACT FROM AUTHOR]

Introduction: Hereditary multiple exostosis or hereditary multiple osteochondromas is a very rare clinical condition. Usually, these lesions tend to occur in the pediatric population, remaining silent until adulthood. Moreover, current studies show a small prevalence in the male population. The osteochondromas usually occur at sites with great bone activity and turnover, such as the diaphysis or metaphyseal plates (especially in children) of long bones. Their appearance in short bones (such as vertebrae) is very rare. Case presentation: We present a case of familial HME in a 53-year-old female patient with a very uncommon clinical description of the disease. The patient presented at our hospital with Frankel D-type paraparesis, with multiple osteochondromas (located at the right humerus, bilateral femurs, right tibia, and hip joints, besides the numerous ones over the spinal column) and urinary incontinence. She was suffering from bilateral coxarthrosis and gonarthrosis, which limited severely the range of her movements. An early menopause status was brought into consideration by the patient, being installed circa 15 years before, at 38 years old. She was currently in treatment with bisphosphonates for her concomitant osteoporosis. Conclusions: Despite the relatively rare nature of the disease, it may be an important concern for the patient's quality of life. Intraspinal processes may trigger paraparesis or other neurological statuses, which may require a surgical treatment. The nature of the lesions is usually benign and do not require further radio- or chemotherapy. [ABSTRACT FROM AUTHOR]

The diagnosis of an osteochondroma in the short bones of the extremities is atypical and the presentation in infancy is unusual. A 3-month-old female presented for evaluation of radial deviation of the right index finger present since birth. Radiographs showed a broad-based osseous outgrowth with the usual features of an osteochondroma arising from the base of middle phalanx. Initial corrective surgery at 22 months was followed by recurrence of the lesion. Another resection at 4 years confirmed a final diagnosis of BPOP (bizarre parosteal osteochondromatous proliferation). The subsequent pathologic diagnosis of BPOP appears to support the hypotheses concerning the etiology of BPOP as possibly arising from repeated trauma to the metaphysis. [ABSTRACT FROM AUTHOR]

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 3 mm 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 FROM AUTHOR]

Key Clinical Message Osteochondroma on the ventral scapula is clinically rare and can incur pseudo‐winged scapula and snapping syndrome if not treated. In this regard, surgical excision is suggested, if possible, with a minimally invasive approach to accelerate physical recovery. Abstract Osteochondroma is a common benign bone tumor, characterized by a cartilage‐capped osseous protuberance with cortical and medullary continuity with the underlying native bone. Osteochondroma is commonly found in the long bones, such as the proximal humerus, distal femur, and proximal tibia, but rarely seen in flat bones. We report a case of pedunculated osteochondroma on the ventral surface of left scapula in a young adult woman. She presented with a slight pseudo‐winged scapula, occasional pain, and snapping sound with motion of the left shoulder. The tumor was surgically resected using a minimally invasive approach, and an excellent outcome was obtained.

Background: Outcome of total hip arthroplasty (THA) in a patient with a giant solitary acetabular osteochondroma and a 30-year-old neglected fracture neck femur with a high-riding dislocated hip has never been described. Case report: A 60-year-old female with a 30-year-old untreated fracture neck femur with resorbed femur head and a giant intra-articular acetabular osteochondroma was managed by tumor excision and THA surgery. At a follow up of 1 year, function improved significantly, with a limb length discrepancy of 1cm, and no evidence of tumor recurrence. Conclusion: Despite the complexity of the surgical technique, tumor excision with concomitant THA surgery achieved excellent results in the short-term.

Osteochondromas are the most common benign bone tumors, usually developing in the distal femur, proximal tibia, and proximal humerus. Solitary osteochodromas around the wrist joint are extremely rare. Slowly growing lesions could cause pain, swelling, loss of hand grip, radiocarpal motion restriction, and median nerve neuropathy. Here we present a rare case of solitary osteochondroma which originated from the distal ulna and settled in the distal radioulnar joint. The lesion restricted the forearm rotation while compressing on the median nerve at the carpal tunnel. Surgical removal of the lesion resulted in symptom relief, restoration of the forearm rotation, and median nerve decompression. Precise physical examination of the wrist beside accurate paraclinical evaluations are mandatory in patients with secondary carpal tunnel symptoms.

Background: Osteochondroma, the most common benign bone tumor, typically occurs in long bones but rarely in the carpus. When found in the carpus it poses diagnostic challenges, warranting differential diagnosis to distinguish it from other conditions like intercarpal joint degeneration, ligament lesions, nerve compression, or traumatic injuries. Case report: We present case of a 55-year-old male patient with 6 months of right wrist pain. The patient had no relevant history of trauma or prodromal symptoms. Hand examinations revealed a tenderness to palpation in the region of the scaphoid tubercle and scapho-trapezoidal joint. Sensory examination was normal. Surgery was performed to repair the torn FCR tendon and excise the lesion simultaneously. Histology revealed benign neoplasm composed of trabeculae of mature bone covered with an outer sheath of hyaline cartilage. Histomorphology was suggestive of osteochondroma. Post-operatively there was immediate pain relief. No recurrence was noted on follow-up visits. Conclusion: This case report contributes to the expanding body of knowledge on the clinical presentation, diagnosis, and management of scaphoid osteochondromas, highlighting the need for a nuanced approach to wrist pain, even in the absence of trauma or prodromal symptoms. Level of evidence: Level IV.

Osteochondromas are common asymptomatic lesions. The development of chondroid malignancies from cartilage caps has rarely been described. Costal osteochondromas are relatively rare lesions. The incidence of osteochondromas in flat bones is approximately less than 5% of all osteochondromas. Osteochondroma originating from two adjacent ribs and forming a joint with each other is a phenomenon described for the first time in the literature. [ABSTRACT FROM AUTHOR]

We report a case of tibial osteochondroma in a 25-year-old female who presented with a palpable calf mass. This mass was associated with a thick cartilaginous cap on cross-sectional imaging, suggesting chondrosarcoma. A CT-guided biopsy was performed, and histology, however, was consistent with osteochondroma. Orthopedic oncology recommended surgical excision due to the potential high sampling error with chondroid lesions. The patient underwent surgical resection, resulting in a final diagnosis of osteochondroma. No post-surgical complications occurred, and a 12-month follow-up showed no evidence of local recurrence. This case highlights the atypical imaging feature of a thick cartilaginous cap in a benign etiology without malignant transformation.

Osteochondromas are benign osteocartilaginous tumours, which are developmental abnormalities rather than actual neoplasms. The lesser trochanter is an extremely rare location for a solitary osteochondroma, and depending on the tumour's size, the patient can exhibit various symptoms, including a limited range of motion. This case study describes a rare instance of a benign solitary osteochondroma of the lesser trochanter identified and managed using an excisional biopsy following Ludloff's approach. With intraoperative fluoroscopy, we could accurately outline and remove the entire tumour mass without endangering the nearby essential tissues.

Tibial fibular synostosis is a rare congenital or acquired abnormality with most cases identified coincidentally upon clinical presentation. Distal tibio-fibular synostosis are reported to be secondary to traumatic events; and whereas Unilateral distal Tibial fibular synostosis have been widely documented, bilateral occurrences are rare among persons of black ethnicity. The objective of this report is to elaborate a rare occurrence of bilateral distal tibial fibular synostosis incidentally found during a bone preparation procedure in a gross anatomy laboratory. This was a distally located bone fusion with exostoses, involving the anterior, medial and posterior surfaces of the tibial-fibular bones. The causative factor of this deformity in our case couldn't be ascertained since this was a cadaveric incidental finding with no life or clinical history to relate to. However with distal fusions and visible exostoses, we probably infer that this was synostosis of osteochondromatic origin. Permission to access the case specimens and present this report was sought and granted by the University Research and Ethics committee of Equator University of science and technology. [ABSTRACT FROM AUTHOR]

In this case report, we aimed to share the clinical and histopathological examination and treatment process of a 6-month-old hybrid cat brought with the complaint of swelling in the medial part of the right auricle. In clinical examination, it was determined that the mass had a hard and irregular surface structure. As a result of the clinical examination, it was decided to completely extirpate the mass and send it to the pathology department. The mass was widely separated from the surrounding tissues and extirpated with the help of cautery. Microscopic examination of the mass revealed that there were chondrocytes among the dense bone cell accumulations and that they formed islands in some areas. As a result of histopathological examinations, it was determined that the suspicious mass was osteochondroma. During the postoperative examinations, it was determined that there was no recurrence or complication in the patient. As a result, it was concluded that this presentation will contribute to the literature since osteochondroma masses are rare in the ear region. [ABSTRACT FROM AUTHOR]

Background: Osteochondromas of the mandibular condyle show facial asymmetry and malocclusion. Because condylar osteochondromas are generally resected in a preauricular approach with risks of facial nerve injury and visible scar, the authors report endoscopically assisted intraoral resection of osteochondroma of the mandibular condyle with a piezoelectric surgical device.Case presentation: A 38-year-old woman presented with malocclusion and facial asymmetry caused by deviation of the chin to the left. Computed tomography showed a hyperdense, well-circumscribed mass arising from the medial aspect of the right mandibular condyle with resorption of the skull base. The patient underwent an endoscopically-assisted intraoral condylectomy with a piezoelectric surgical device. The postoperative course was uneventful without trismus, malocclusion, or facial asymmetry, and there was no recurrence 4 years after surgery.Conclusion:Endoscopically assisted intraoral resection of osteochondroma of the mandibular condyle with a piezoelectric surgical device is a minimally invasive and safe surgery. [ABSTRACT FROM AUTHOR]

Chondrosarcoma is an aggressive bone tumor typically affecting older adults in the 6th and 7th decade. These tumors often present as painful masses in the pelvis, ribs, and long bones and have certain characteristic features on the imaging leading to the diagnosis. The occurrence of these tumors in the young adult population is a rare condition that is not well described. Often, they may be confused with benign counterparts, enchondroma or osteochondroma, which does not require any treatment and are very common. The aim of this case series was to analyze the patient presentation and radiographic image findings as well as surgical treatment and outcomes of ten young adults with chondrosarcoma over a three-year period. Overall, imaging of these tumors in young adults did not necessarily demonstrate all typical features of chondrosarcomas such as endosteal scalloping, calcifications, lobular growth, and high uptake on whole-body bone scans. One patient in the case series passed away from complications from dedifferentiated chondrosarcoma, and nine patients have recovered with no local recurrence. [ABSTRACT FROM AUTHOR]