Nora's Lesion: Bizarre Parosteal Osteochondromatous Proliferation Causing Splay Foot Deformity: A Case Report

2019 ◽  
Vol 109 (6) ◽  
pp. 463-466 ◽  
Author(s):  
Anthony J. Mollica ◽  
Benjamin Getz ◽  
Chinenye Ezike ◽  
Blake Brannick ◽  
Albert J. Mollica
Keyword(s):  
Benign Lesion ◽  
Foot Deformity ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Nora’S Lesion ◽  
Spindle Cells ◽  
Common Diagnosis ◽  
Hands And Feet ◽  
Splay Foot ◽  
Tubular Bones

Nora's lesion, or bizarre parosteal osteochondromatous proliferation (BPOP), is a rare benign lesion that is made up of varying degrees of cartilage, bone, and spindle cells. Most notably, calcification of the cartilage or “blue bone,” is a feature of the disorder. The condition principally affects long tubular bones of the hands and feet, and is generally seen in patients in their second and third decades of life. We present a case of BPOP occurring in the second interspace with symptoms that would be consistent with a more common diagnosis of predislocation syndrome, or a second interspace neuroma. This case study may help the clinician in considering a more subtle cause of a splay deformity in the second interspace, and walk through the diagnostic and treatment course for BPOP.

scholarly journals Nora’s lesion of the distal ulna: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110643
Author(s):  
Cheng Han Lin ◽  
Karl Wu
Keyword(s):  
Benign Lesion ◽  
Excisional Biopsy ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Distal Ulna ◽  
Nora’S Lesion ◽  
Calcified Lesion ◽  
Bone Cortex ◽  
Painless Mass ◽  
Hands And Feet

Nora’s lesion, also known as bizarre parosteal osteochondromatous proliferation (BPOP), is a very rare benign lesion with few published cases. BPOP is more common in adults during the second to third decades of life, and usually occurs on the hands and feet. Radiologically, it appears as a calcified mass attached to the bone cortex that grows rapidly and that recurs easily following resection. Aggressive features on imaging and confusing histopathological findings usually result in misdiagnosis or mistreatment. Herein, we present a case of a rare bony tumour involving the distal ulna presenting as a painless growing mass. An excisional biopsy with clear margins was performed without disturbing the ulnar nerve and arteries. There was no recurrent mass or calcified lesion 1 year after surgery. Based on its rarity and difficult diagnosis, BPOP should be considered in the differential diagnosis of a painless mass in the distal ulnar region. Careful follow-up after surgery is essential, even without lesion recurrence.

scholarly journals Nora’s lesion: bizarre parosteal osteochondromatous proliferation in right foot: a case report

2021 ◽  
Vol 7 (5) ◽  
pp. 1043
Author(s):  
Shikhar Yadav ◽  
Divya G. ◽  
Jithin Mohan ◽  
Joice Varghese
Keyword(s):  
Benign Lesion ◽  
Plain Radiograph ◽  
Excision Biopsy ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Nora’S Lesion ◽  
First Metatarsal ◽  
Benign Pathology ◽  
One Year ◽  
The Right ◽  
Hands And Feet

<p class="abstract"><span lang="EN-US">Nora’s lesion is a benign lesion involving mainly the proximal phalanges, metatarsals or metacarpals in the hands and feet. It may be easily confused with a malignant entity and was first identified and reported by Nora et al. in 1983. We present a case of a 12 years old female with complains of a swelling over the right foot noticed 4 months ago. Plain radiograph revealed heterotrophic calcification over the dorso-lateral aspect of the head of the first metatarsal. MRI scan of the foot was suggestive of a benign pathology with a differential of bizarre parosteal osteochondromatous proliferation (BPOP) or an osteochondroma. The patient was managed with excision biopsy and lesion was excised along with the pseudo-capsule and adjoining periosteum. Cortex appeared normal and wound was washed with hydrogen peroxide and incision closed. Histopathology report was suggestive of Nora’s lesion. One year follow up of the patient showed no recurrence. BPOP proliferation is a benign lesion however differentials need to be kept in mind and treatment with excision of the lesion along with the pseudo-capsule and periosteal tissue beneath the lesion has low rates of recurrence. </span></p>

scholarly journals Lesion with blue bone-a case report

2018 ◽  
Vol 8 (1) ◽  
pp. 1323-1325
Author(s):  
Laila Mohamed Ilias ◽  
Babitha Alingal Mohammed ◽  
Roshini PS ◽  
Anupama Ponniah ◽  
Poornima Vijayan
Keyword(s):  
Histopathological Examination ◽  
Fibrous Tissue ◽  
Bone Lesion ◽  
Metacarpal Bone ◽  
Cortical Surface ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
X Ray ◽  
Spindle Cells ◽  
Small Bones ◽  
Hands And Feet

Bizzare parosteal osteochondromatous proliferation, or Nora‘s lesion is a unique bone lesion that most often arises in the small bones of hands and feet.  It is characterised by proliferation of chondroid, bony and fibrous tissue, and is occasionally misdiagnosed as a malignant process.  Our case was a 31 yr old lady, who presented with a painless swelling near the 5th metacarpal bone of right hand.  X-ray showed well marginated mineralised mass arising from the cortical surface of the metacarpal bone.  Histopathological examination revealed bizarre parosteal osteochondromatous proliferation composed of varying amounts of cartilage, bone and spindle cells. Cartilage was hypercellular and chondrocytes were enlarged. Ossification was irregular and had a peculiar blue tinctorial quality. 

Bizarre Parosteal Osteochondromatous Proliferation (Nora's Lesion) in the Medial Sesamoid of the First Toe

2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Onur Tetik ◽  
Lercan Aslan ◽  
Kadir Buyukdogan ◽  
Mehmet Chodza ◽  
Onder Kilicoglu
Keyword(s):  
Young Adults ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
En Bloc ◽  
Nora’S Lesion ◽  
Bony Lesion ◽  
En Bloc Excision ◽  
Small Bones ◽  
Bloc Excision ◽  
Hands And Feet

Bizarre parosteal osteochondromatous proliferation, or Nora's lesion, is a unique bony lesion that generally originates from the small bones of the hands and feet in young adults. We report a case of a bizarre parosteal osteochondromatous proliferation originating from the medial sesamoid of the first toe that was managed surgically by en bloc excision. At 5-year follow-up, there was no evidence of recurrence.

Bizarre Parosteal Osteochondromatous Proliferation (Nora's Lesion) of the Sesamoid: a Case Report

2000 ◽  
Vol 21 (5) ◽  
pp. 408-412 ◽  
Author(s):  
J.A. Harty ◽  
P. Kelly ◽  
D. Niall ◽  
J.C. O'Keane ◽  
M.M. Stephens
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Metatarsophalangeal Joint ◽  
Magnetic Resonance Images ◽  
Parosteal Osteosarcoma ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
First Metatarsophalangeal Joint ◽  
Histological Features ◽  
Nora’S Lesion ◽  
Plantar Aspect

We report the a case of Nora's lesion (Bizarre Parosteal Osteochondromatous Proliferation) of the sesamoid. A 32-year-old woman presented with a painless, enlarging mass of two years duration on the plantar aspect of the first metatarsophalangeal joint of the left foot. Radiographs, Computerized Tomographs and Magnetic Resonance images, initially suggested a parosteal osteosarcoma arising from the tibial sesamoid. The mass was excised, and a histological diagnosis of Bizarre Parosteal Osteochondromatous Proliferation of bone (Nora's lesion) was made. The aggressive growth of this lesion may suggest a neoplasm clinically. Histological features, however, are those of a reactive lesion.

Hereditary symphalangism with associated tarsal synostosis and hypophalangism

1993 ◽  
Vol 83 (1) ◽  
pp. 1-9 ◽  
Author(s):  
JE Castle ◽  
S Bass ◽  
IO Kanat
Keyword(s):  
Family Members ◽  
Rare Condition ◽  
Mendelian Inheritance ◽  
Interphalangeal Joint ◽  
Genetic Condition ◽  
Joint Fusion ◽  
Hands And Feet

Symphalangism is a rare genetic condition that may represent the earliest documentation of mendelian inheritance in man. The disorder results in interphalangeal joint fusion in the hands and feet. The authors review this rare condition and present a case study consisting of four generations with 15 affected family members. The association of multiple tarsal synostosis and the previously unreported associated occurrence of pedal hypophalangism in this pedigree is presented.

scholarly journals Bizarre Parosteal Osteochondromatous Proliferation (Nora’s Lesion) of the Mandible. A Rare Bony Lesion

2011 ◽  
Vol 6 (2) ◽  
pp. 264-269 ◽  
Author(s):  
H. M. Dashti ◽  
J. D. Reith ◽  
B. J. Schlott ◽  
E. L. Lewis ◽  
D. M. Cohen ◽  
...  
Keyword(s):  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Nora’S Lesion ◽  
Bony Lesion

scholarly journals Multidigit Camptodactyly of the Hands and Feet: A Case Study

Hand ◽  
2013 ◽  
Vol 8 (3) ◽  
pp. 324-329 ◽  
Author(s):  
Kristy L. Hamilton ◽  
David T. Netscher
Keyword(s):  
Hands And Feet

Nora’s Lesion

1997 ◽  
Vol 22 (4) ◽  
pp. 469-471 ◽  
Author(s):  
C.S. MUDGAL ◽  
J.B. JUPITER
Keyword(s):  
Benign Tumour ◽  
Case Review ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Nora’S Lesion ◽  
Bony Lesions

Isolated primary bony lesions of the digits are infrequent. A phalangeal lesion in the hand is most likely to be benign. Rarely, however, primary benign tumour-like conditions affecting the handmay radiologically mimic an osteochondroma and histologically mimic a malignancy. We describe a case of bizarre parosteal osteochondromatous proliferation (Nora’s lesion, BPOP), which may do both and mislead the unsuspecting surgeon. The aim of this paper is to present our experience with this case, review existing literature and promote awareness among hand surgeons of a condition that can often be misdiagnosed.

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