Nora's Lesion: Bizarre Parosteal Osteochondromatous Proliferation of the Tibia

Kershen, L. Michael; Schucany, William G.; Gilbert, Nathan F.

doi:10.1080/08998280.2012.11928880

Cited by 10 publications

(5 citation statements)

References 10 publications

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“…Here, we demonstrate similar involvement of VSMC phenotype switch, VEGF and TGFß signaling and change in histomorphology in PAA as compared to AAA (Figures 1, 2A and S1B). Additionally, based on a singular case with possible isolated osseous strain on the popliteal artery, so-called Nora's lesion, we demonstrate a preserved VSMC phenotype and expression profile in this patient (Figure S1) [10,11,39]. Generally, a modest inflammatory component is described for PAA samples.…”

Section: Discussionmentioning

confidence: 60%

Apolipoprotein E (ApoE) Rescues the Contractile Smooth Muscle Cell Phenotype in Popliteal Artery Aneurysm Disease

et al. 2023

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Popliteal artery aneurysm (PAA) is the most frequent peripheral aneurysm, primarily seen in male smokers with a prevalence below 1%. This exploratory study aims to shed light on cellular mechanisms involved in PAA progression. Sixteen human PAA and eight non-aneurysmatic popliteal artery samples, partially from the same patients, were analyzed by immunohistochemistry, fluorescence imaging, Affymetrix mRNA expression profiling, qPCR and OLink proteomics, and compared to atherosclerotic (n = 6) and abdominal aortic aneurysm (AAA) tissue (n = 19). Additionally, primary cell culture of PAA-derived vascular smooth muscle cells (VSMC) was established for modulation and growth analysis. Compared to non-aneurysmatic popliteal arteries, VSMCs lose the contractile phenotype and the cell proliferation rate increases significantly in PAA. Array analysis identified APOE higher expressed in PAA samples, co-localizing with VSMCs. APOE stimulation of primary human PAA VSMCs significantly reduced cell proliferation. Accordingly, contractile VSMC markers were significantly upregulated. A single case of osseous mechanically induced PAA with a non-diseased VSMC profile emphasizes these findings. Carefully concluded, PAA pathogenesis shows similar features to AAA, yet the mechanisms involved might differ. APOE is specifically higher expressed in PAA tissue and could be involved in VSMC phenotype rescue.

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Section: Discussionmentioning

confidence: 60%

Apolipoprotein E (ApoE) Rescues the Contractile Smooth Muscle Cell Phenotype in Popliteal Artery Aneurysm Disease

et al. 2023

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“…Treatment method is resection with wide margins in aggressive benign and malignant tumors, while marginal excision is performed in benign tumors [14,15]. No malignancy was found in our recent literature review and in the 4 patients in the current study [2][3][4][5][6][7][8][9][10][11][12][13][16][17][18].…”

Section: Discussionmentioning

confidence: 93%

“…Also known as Nora's lesion or periostitis ossificans, bizarre parosteal osteochondromatous proliferation (BPOP) is a rare lesion which was described for the first time by Nora et al in 1983 [1][2][3]. Although so far BPOP has been reported in the literature many times as case reports, there are less than 10 case series in the literature on this issue [4][5][6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Management of Nora’s Lesion: Case Series

Öztürk¹,

Arıkan²,

Beltir³

et al. 2018

Acta Oncol Tur.

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Nora'nın lezyonu olarak da bilinen bizarre parosteal osteokondromatöz proliferasyon, kemikten egzofitik büyüme ile kendini gösteren, benign bir lezyondur. Bu çalışmada, 2010-2018 yılları arasında tedavi edilen Nora lezyonuna sahip dört hastanın değerlendirilmesi ve kısa bir literatür taraması yapılarak güncel bilgilerin incelenmesi amaçlandı. YÖNTEM ve GEREÇLER: Ortalama yaşları 32+24 std (26-37 yaş arası) olan iki erkek ve iki kadın toplam 4 hasta çalışmaya dahil edildi. Hastaların tanıya kadar geçen süre ve semptomları, klinik bulguları, kitle boyutu, MRI bulguları, cerrahi tedavileri, tedavi sonuçları ve komplikasyonlar incelendi. BULGULAR: Tüm hastalara marginal eksizyon yapıldı. En sık kitle lokalizasyonu ön kolun uzun kemikleri idi. Bir vakada post-operatif 24. ayda rekürrens görüldü, nüks rezeksiyonu yapıldı. Diğer üç hastada takiplerinde nüks ya da komplikasyon görülmedi. TARTIŞMA ve SONUÇ: Bizarre parosteal osteokondromatöz proliferasyon, vücudun birçok farklı lokalizasyonunda yerleşebilen, benign karaktere sahip ancak sık rekürrens ile karşımıza çıkabilen, nadir bir kemik lezyonudur. İyi bir preoperatif planlama ile yapılan dikkatli bir marginal eksizyon, nüksün önlenmesinde en önemli anahtardır.

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“…A posteromedial painful right leg mass in a young female was noted without a history of any antecedent injury. [38] Tender, firm, and non-mobile mass was seen clinically, and the radiograph showed more than a 3 cm area of amorphous calcification without bony communication. MRI revealed an aggressive and expansile lesion, the incisional biopsy of which revealed BPOP.…”

Section: Lower Extremitymentioning

confidence: 96%

Bizarre parosteal osteochondromatous proliferation or Nora’s lesion affecting the extremities: A concise update

Dharmshaktu

Agarwal

et al. 2022

JMSR

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The bizarre parosteal osteochondromatous proliferation or Nora’s lesion is an unusual clinical entity that presents with localized swelling and pain. The characteristic radiological appearance includes a cluster of variably calcified lesions adjacent to a particular bone. However, it does not necessarily have direct continuity with its medullary region. The etiopathogenesis of this disorder is not yet fully understood. Various other lesions require careful exclusion and the use of advanced imaging modalities to supplement the diagnosis. The final diagnosis of the lesion, however, is based on the histopathological basis. However, these lesions are reported as sporadic reports or small series in the literature and are also discovered in areas other than the common locations in hands and feet. The recent research aims to throw more advanced knowledge into their causation, including genetic etiology. The symptomatic lesions may require excision for clinical relief, but recurrence is not uncommon. The future research, and preferably multi-center collaboration, is required for more insight into their comprehensive nature and clinical spectrum. A brief and crisp update of the articles published in the past 10 years describing bizarre parosteal oseochondromatous proliferation in the extremities is presented here for educational purposes for orthopedists and generalists alike.

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Nora's Lesion: Bizarre Parosteal Osteochondromatous Proliferation of the Tibia

Cited by 10 publications

References 10 publications

Apolipoprotein E (ApoE) Rescues the Contractile Smooth Muscle Cell Phenotype in Popliteal Artery Aneurysm Disease

Apolipoprotein E (ApoE) Rescues the Contractile Smooth Muscle Cell Phenotype in Popliteal Artery Aneurysm Disease

Management of Nora’s Lesion: Case Series

Bizarre parosteal osteochondromatous proliferation or Nora’s lesion affecting the extremities: A concise update

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