Some Reactive Lesions of Bone Are Probably Neoplasms

Memon, Raima A.; Wei, Shi; Siegal, Gene P.

doi:10.5858/arpa.2020-0817-ra

Cited by 2 publications

(13 citation statements)

References 75 publications

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“…The "maturation" of the periosteal reaction can occur very rapidly due to the reactive proliferative characteristics of FRP, leading to rapid hardening of the mass within a few weeks. [1,9] The clinical symptoms of the case reported by Byun BH et al differed from previous FRPs in long bones, which typically present with pain or swelling in the affected limb. [8] Our comprehensive analysis indicates that FRP in long tubular bones shares similarities with FRP in short tubular bones, such as a period of acute response followed by regression of some lesions after the peak phase.…”

Section: Discussionmentioning

confidence: 69%

Florid reactive periostitis of the clavicle: A case report and literature review

Tang,

Wang,

Liu

et al. 2023

Medicine

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Rationale: Florid reactive periostitis (FRP), a rare reactive bone lesion, typically presents in the short tubular bones of the extremities, with infrequent occurrences in the long tubular bones. This report discusses a unique case of FRP in the clavicle, managed through comprehensive lesion debridement and bone grafting, yielding positive results over a 3-year duration. Patient concern: A 25-year-old male presented with a discernible mass at the left sternal end of the clavicle, discovered incidentally 2 weeks prior. The patient exhibited no clinical signs of inflammation, pain, sinus tract, or suppuration. Diagnosis: Initial pathological examination of the local excision suggested benign lesions, although malignancy could not be ruled out. A definitive diagnosis of clavicular FRP was reached post complete lesion resection, with supporting evidence from postoperative pathology, imaging, and clinical symptoms. Intervention: The left clavicle was reconstructed through an open surgical procedure involving total mass removal and ipsilateral extraction of an iliac bone of suitable dimensions. This was implanted into the clavicular bone defect and internally fixed with a plate. Outcomes: Three years of consecutive follow-up revealed no recurrence of hyperplasia, absence of mass or tenderness at the left sternal end of the clavicle, and unimpaired function of adjacent joints. Lessons: The primary clinical challenge with FRP is its diagnosis. While pathological diagnosis remains crucial, it is also important to incorporate imaging and clinical symptoms for a comprehensive assessment. Complete mass excision may offer specific benefits in distinguishing FRP from its malignant counterparts.

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Section: Discussionmentioning

confidence: 69%

Florid reactive periostitis of the clavicle: A case report and literature review

Tang,

Wang,

Liu

et al. 2023

Medicine

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“…Particularly, BPOP has been viewed by some authors as the intermediate stage of a spectrum of reactive lesions, which also encompasses florid reactive periostitis (early stage) and acquired osteochondroma or turret exostosis (late stage) [ 4 ]. More recently, other authors have proposed that BPOP may represent a neoplastic rather than reactive lesion [ 5 ]. This notion is supported by the identification of recurrent cytogenetic abnormalities associated with BPOP [ 6 ].…”

Section: Epidemiology and Clinical Presentationmentioning

confidence: 99%

“…However, according to the 2020 World Health Organization classification of bone tumors, BPOP is considered as a separate entity and possible neoplastic etiology is suggested [ 2 ]. Like BPOP, florid reactive periostitis occurs most commonly in the phalanges of the hands and feet and, less frequently, in metacarpals, metatarsals and long bones [ 5 ]. It is mostly seen in young adults ranging in age from 20 to 40 years [ 5 ], similar as BPOP.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Like BPOP, florid reactive periostitis occurs most commonly in the phalanges of the hands and feet and, less frequently, in metacarpals, metatarsals and long bones [ 5 ]. It is mostly seen in young adults ranging in age from 20 to 40 years [ 5 ], similar as BPOP. On imaging, a soft-tissue swelling with heterotopic ossification is seen in contiguity with an intact bone cortex [ 17 , 18 ], although cortical destruction has been occasionally reported [ 18 ].…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Over weeks to months, periosteal reaction maturation can occur and result in a soft-tissue calcified shadow, which is also known as florid reactive periostitis ossificans (Fig. 6 ) [ 5 ].

Fig.…”

Section: Differential Diagnosismentioning

confidence: 99%

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Bizarre parosteal osteochondromatous proliferation: an educational review

et al. 2023

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Bizarre parosteal osteochondromatous proliferation (BPOP) is a surface-based bone lesion belonging to the group of benign chondrogenic tumors. The aim of this review is to familiarize the readers with imaging features and differential diagnosis of BPOP, also addressing pathological presentation and treatment options. The peak of incidence of BPOP is in the third and fourth decades of life, although it can occur at any age. Hands are the most common location of BPOP (55%), followed by feet (15%) and long bones (25%). On imaging, BPOP appears as a well-marginated mass of heterotopic mineralization arising from the periosteal aspect of the bone. Typical features of BPOP are contiguity with the underlying bone and lack of cortico-medullary continuity, although cortical interruption and medullary involvement have been rarely reported. Histologically, BPOP is a benign bone surface lesion characterized by osteocartilaginous proliferation with disorganized admixture of cartilage with bizarre features, bone and spindle cells. Differential diagnosis includes both benign—such as florid reactive periostitis, osteochondroma, subungual exostosis, periosteal chondroma and myositis ossificans—and malignant lesions—such as periosteal chondrosarcoma and surface-based osteosarcoma. Treatment consists of surgical resection. Local recurrences are common and treated with re-excision.Critical relevance statement Bizarre parosteal osteochondromatous proliferation is a benign mineralized mass arising from the periosteal aspect of bone cortex. Multi-modality imaging characteristics, pathology features and differential diagnosis are here highlighted to familiarize the readers with this entity and offer optimal patient care.

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Some Reactive Lesions of Bone Are Probably Neoplasms

Cited by 2 publications

References 75 publications

Florid reactive periostitis of the clavicle: A case report and literature review

Florid reactive periostitis of the clavicle: A case report and literature review

Bizarre parosteal osteochondromatous proliferation: an educational review

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