Florid reactive periostitis and bizarre parosteal osteochondromatous proliferation: pre-biopsy imaging evolution, treatment and outcome

Sundaram, Murali; Wang, LihuanLisa; Rotman, Mitchell B.; Howard, Richard F.; Saboeiro, Alesia P.

doi:10.1007/s002560100343

Cited by 70 publications

(57 citation statements)

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“…In contrast to this, Dhondt et al [4] and Sundaram et al [22] claim to have identified lesions that have progressed from FRP to BPOP radiographically, thus supporting the unitary hypothesis [25]. Histologic confirmation of the progression from FRP to BPOP is not present in either of these reports [4,22], and so we maintain BPOP does represent a distinct clinicopathologic entity. However, we are not able to prove or disprove this, as all patients presented and underwent excision biopsy as part of their investigation/treatment at the BPOP stage.…”

Section: Resultscontrasting

confidence: 45%

Bizarre Parosteal Osteochondromatous Proliferation: A Locally Aggressive Benign Tumor

Joseph

Ritchie

MacDuff

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Bizarre parosteal osteochondromatous proliferation (BPOP) is a benign lesion of bone, and numerous questions remain unresolved regarding its etiology, diagnosis, and treatment. Questions/purposes We present the Scottish Bone Tumour Registry experience of this rare lesion. Patients and MethodsWe performed a retrospective analysis of the Scottish Bone Tumour Registry records. Histologic specimens were reexamined by a musculoskeletal pathologist. Radiographs were reevaluated by a musculoskeletal radiologist.Results From 1983 to 2009, 13 cases (13 patients; six male, seven female) were identified. Their ages ranged from 13 to 65 years. All patients presented with localized swelling. Pain was present in five. Antecedent trauma was present in two. Nine lesions affected the hand, three the foot, and one the tibial tuberosity. Twelve lesions were excised and one was curetted. There were seven recurrences of which six were excised. One lesion recurred a second time and was excised. There were no metastases. Radiographs showed densely mineralized lesions contiguous with an uninvolved cortex. Cortical breakthrough was present in one case and scalloping in another. Histologic analysis characteristically showed hypercellular cartilage with pleomorphism and calcification/ossification without atypia, bone undergoing maturation, and a spindle cell stroma. Conclusions BPOP is a rare benign lesion that probably is neoplastic, with no gender predilection, and affecting patients over a wide age range. Previously trauma was considered an etiologic factor, but this no longer seems to be the case. The rate of recurrence was 50%, which may indicate a more extensive resection is required for this locally aggressive lesion. No metastases were reported.

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Section: Resultscontrasting

confidence: 45%

Bizarre Parosteal Osteochondromatous Proliferation: A Locally Aggressive Benign Tumor

Joseph

Ritchie

MacDuff

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…BPOP lesions often are excised early and, as a result, their natural history is not entirely clear [6]. The few that have been observed with time exhibit evolution from a less organized periosteal soft tissue swelling with few calcifications toward a more mineralized lesion and eventually to a completely ossified mass [6,14,24]. This maturation process has been hypothesized to represent a reparative etiology in the response to trauma [11,24,27], despite that the majority of patients described in case reports lack a traumatic history.…”

Section: Discussion and Treatmentmentioning

confidence: 99%

“…The few that have been observed with time exhibit evolution from a less organized periosteal soft tissue swelling with few calcifications toward a more mineralized lesion and eventually to a completely ossified mass [6,14,24]. This maturation process has been hypothesized to represent a reparative etiology in the response to trauma [11,24,27], despite that the majority of patients described in case reports lack a traumatic history. More recently, some reports have suggested BPOP is a neoplastic process instead of a reparative one [7,12,17,22,26,28].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

Asymptomatic Upper Arm Mass in a 37-year-old Woman

Rothenberg¹,

Zhang²,

Rosenberg³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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A 37-year-old woman presented with a painless left upper extremity mass that she first noticed after a long strenuous workout 2 weeks before presentation. The patient denies any medical history, significant family history, and history of recent or remote trauma.On physical examination, there was a firm, fixed 3 cm 9 2 cm nontender mass palpable in the upper anterior aspect of the humerus. There were no overlying skin changes and she had full painless ROM of her shoulder and elbow.Plain radiographs (Fig. 1) and MRI ( Fig. 2) of the humerus were obtained.

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“…Florid reactive periostitis, Nora's lesion, and turret exostosis are clearly different pathologies; however, several authors hypothesize that they are simply different evolutionary stages of the maturation and organization of a subperiosteal hematoma secondary to a minor trauma [7,11]. Florid reactive periostitis corresponds to the first stage, which histologically seems to be a recent fracture callus, presenting an undefined mass emerging from the cortical bone surface.…”

Section: Discussionmentioning

confidence: 99%

“…It can be clearly differentiated from Nora's lesion and solitary osteochondroma through radiographic analysis and histological study. There is typically an aggressive periosteal reaction in radiographic study accompanied by extensive edema [4,10,11].…”

Section: Discussionmentioning

confidence: 99%