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      Nora’s lesion of the second toe

      case-report

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          Abstract

          Bizarre parosteal osteochondromatous proliferation, otherwise known as Nora’s lesion, is surface tumor of bone with high probability of local recurrence. The author reports a case of Nora’s lesion of the proximal phalanx of the second toe, successfully managed by en bloc excision of the swelling. At four-year follow-up there was no evidence of recurrence.

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          Bizarre parosteal osteochondromatous proliferation of bone (Nora's lesion).

          R Swee, M Meneses, Vivek K. Unni (1993)
          Bizarre parosteal osteochondromatous proliferation was first described in 1983, when Nora et al. reported 35 examples of a proliferative lesion involving the small bones of the hands and, less often, the feet. No examples involving the large bones were reported. We present 65 cases of this condition, five from the Mayo Clinic files and 60 from our consultation files, including 34 females and 31 males; patients' ages ranged from 8 to 73 years (average, 33.9 years). Thirty-six lesions involved the hands, 10 the feet, 17 the long bones, one the skull, and one an unknown site. The long bones involved were the radius (three lesions), ulna (six), fibula (two), femur (three), tibia (two), and humerus (one lesion). Roentgenograms typically showed a heavily calcific mass attached to the underlying cortex and having a broad base. Histologically, a large amount of hypercellular cartilage showed maturation to trabecular bone, which frequently contained spindle cells in the intertrabecular spaces, an appearance that could lead to a mistaken diagnosis of parosteal osteosarcoma. A helpful feature was the distinct blue tinctorial characteristic of the bone in the lesion. Follow-up information was available for 40 patients; approximately 55% had a recurrence. No metastasis had been reported in any of the 65 cases. Bizarre parosteal osteochondromatous proliferations are a form of heterotopic ossification and should not be mistaken for chondrosarcoma or osteosarcoma.
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            Bizarre parosteal osteochondromatous proliferation (Nora's lesion) of the forefoot.

            Nabile Bousselmame, Mostapha Boussouga, Khalid Lazrak … (2008)
            Nora's tumour is an uncommon benign tumour, involving mostly tubular bones of hands and feet, and characterized by a proliferation of chondroid, bony and fibrous tissues. Main differential diagnoses are osteochondroma, chondrosarcoma, and osteosarcoma. The authors report a case involving the left foot. The diagnosis was suspected by imaging characteristic features and was confirmed by histological examination. Treatment was surgical, with complete excision. There are no clinical or radiological signs of recurrence on further review one year postoperatively.
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              A case of Bizarre Parosteal Osteochondromatous Proliferation of the hand.

              L Teoh, Francis Sim, O Löw … (2002)
              We report a case of Bizarre Parosteal Osteochondromatous Proliferation (BPOP) of the hand that was initially misdiagnosed as an osteochondroma. BPOP, although a benign lesion, behaves aggressively with rapid growth and high risk of local recurrence after local resection. The distinguishing features of BPOP as opposed to an osteochondroma are discussed.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Indian J Orthop
                Journal ID (publisher-id): IJO
                Title: Indian Journal of Orthopaedics
                Publisher: Medknow Publications (India )
                ISSN (Print): 0019-5413
                ISSN (Electronic): 1998-3727
                Publication date (Print): Jul-Sep 2010
                Volume: 44
                Issue: 3
                Pages: 342-344
                Affiliations
                Department of Orthopedics, IBRI Regional Referral Hospital, PO Box 46, IBRI 516, Sultanate of Oman
                Author notes
                Address for correspondence: Dr.S.S. Suresh, PO Box 396, IBRI 516, Sultanate of Oman. E-mail: dr.s.s.suresh@ 123456gmail.com
                Article
                Publisher ID: IJOrtho-44-342
                DOI: 10.4103/0019-5413.65150
                PMC ID: 2911939
                PubMed ID: 20697492
                SO-VID: c05b1341-e8a4-4a2c-a703-9272ac4c40bf
                Copyright © © Indian Journal of Orthopaedics
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Orthopedics
                Keywords: tumor phalanx of foot,bizarre parosteal osteochondromatous proliferation,nora’s lesion
                Data availability:
                ScienceOpen disciplines: Orthopedics
                Keywords: tumor phalanx of foot, bizarre parosteal osteochondromatous proliferation, nora’s lesion

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