Zur Myositis ossificans circumscripta

Jenny, P.; Spescha, H.; Fliegel, C P

doi:10.1055/s-2008-1059908

Cited by 1 publication

(2 citation statements)

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“…In midline incisions, injury to the xiphoid process or pubis may liberate bone-forming cells 2. As in this reported case, the initial clinical picture is often confused with that of osteomyelitis or soft tissue abscess 3. A case of myositis ossificans was also reported in the platysma following radical neck dissection 4.…”

Section: Discussionmentioning

confidence: 81%

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Mature bone metaplasia in abdominal wall scar

Daoud

Watkins

Brown

et al. 1999

Postgraduate Medical Journal

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SummaryA 58-year-old man who had had three laparotomies for gastric surgery, developed a painful mass in the abdominal wall scar. Radiology confirmed bone formation in the scar. The bone was excised and the wound repaired. Histology confirmed metaplastic mature bone formation. This case draws the attention to the clinical condition of bone formation in midline scars. Clinically, it should be diVerentiated from scar recurrence following surgery for abdominal malignancy.Keywords: myositis ossificans; heterotopic ossification A 58-year-man presented with a 9-month history of a painful swelling in a left paramedian scar. In 1966, he had a Polya gastrectomy, for peptic ulcer disease. In 1993, he presented with severe biliary reflux oesophagitis. Upper endoscopy confirmed the diagnosis. He was treated with omeprazole and cisapride with little improvement. He was referred for surgical opinion and in 1996, he had a 'Roux en y' reconstruction. This was followed 8 weeks later by laparotomy for division of omental adhesions causing jejunal obstruction. On this third laparotomy, ectopic calcifications were noted in the scar. Postoperatively, he developed a wound infection followed by a small bowel fistula, which closed spontaneously.In 1997, he presented with a tender mass under the laparotomy scar. Initially, ultrasound and magnetic resonance imaging (MRI) confirmed a soft tissue mass. The pain in the scar increased gradually over the next few months, and surgical exploration of the mass was indicated. A pre-operative plain X-ray showed abdominal wall calcifications.At operation, a 140 × 45 mm piece of mature bone was found underneath the scar, between the posterior rectus sheath and the peritoneum. This was dissected and was found to merge with the xiphoid cartilage. The bone was divided just below the lower end of the sternum using a bone-cutting forceps. HistologyMacroscopically, the specimen was a hard spindle-shaped piece of tissue 140 × 45 × 20 mm, which required sawing and blocks were decalcified. Microscopically, the lesion consisted of mature lamellar bone within which bone marrow showing trilineage haematopoiesis was present, together with cartilage and fibro-fatty connective tissue. The histological features were unlike those of myositis ossificans, and the appearance was most in keeping with osteocartilaginous metaplasia. There was no cellular atypia or evidence of malignancy.

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Section: Discussionmentioning

confidence: 81%

“…Surgical removal of the calcified swelling is often indicated due to increasing pain and disability 3. In case of athletes, a large mass of mature lamellar bone is also associated with muscle weakness and significant loss of joint motion 6.…”

Section: Discussionmentioning

confidence: 99%