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.

scholarly journals Endoscopic ampullectomy

2012 ◽  
Vol 03 (S 05) ◽  
pp. 065-067 ◽  
Author(s):  
Michael Bourke
Keyword(s):  
Treatment Decision ◽  
Ampulla Of Vater ◽  
En Bloc ◽  
Non Invasive ◽  
Relative Safety ◽  
Invasive Method ◽  
En Bloc Excision ◽  
Bloc Excision ◽  
Careful Assessment

AbstractEndoscopic ampullectomy offers a minimally invasive method of effectively treating non-invasive neoplasms of the ampulla of Vater and surrounding peri-ampullary region with high success and relative safety. These lesions would otherwise require surgical intervention, including pancreatico-duodenectomy. However, major complications may occur and a careful assessment of the patients comorbidities and their ability to tolerate adverse events needs to be factored into the treatment decision. Careful staging, often multi-modality is required, particularly for extensive lesions. Complete en-bloc excision of the entire neoplasm should be the goal with conventional papillary adenomas. Large lesions with extra-papillary extension currently require extended piecemeal excision, however with meticulous technique, recurrence is uncommon in longterm follow up.

scholarly journals Solitary Osteochondroma Arising from the Dorsal Vertebral Spinous Process

2014 ◽  
Vol 2 (1) ◽  
pp. 25
Author(s):  
Ruban Raj Joshi ◽  
Gabriel David Sundararaj
Keyword(s):  
Spinous Process ◽  
Benign Tumors ◽  
Excision Biopsy ◽  
En Bloc ◽  
X Ray ◽  
Lower Back ◽  
Solitary Osteochondroma ◽  
En Bloc Excision ◽  
Bloc Excision

Introduction: Osteochondroma are benign tumors which arise from aberrant cartilage nodules within the periosteum. They can be either pedunculated or sessile and are more common in the extremities and rarely seen in spine. En-bloc excision is the preferred treatment. Case Report: We present a case of 20 year female, who came with a swelling and pain in lower back for two years which was diagnosed to be thoracic vertebra(D11) osteochondroma on x-ray and computed tomography. Excision biopsy was done and confirmed it to be osteochondroma. There has been no recurrence even after 16 months of follow up. Conclusion: Although rare, osteochondroma of the vertebra should be kept in mind as a differential diagnosis when evaluating mass in spine. En bloc excision should be performed.

scholarly journals Bizarre Parosteal Osteochondromatous Proliferation (Nora Lesion)

2017 ◽  
Vol 3 ◽  
pp. 2513826X1775109
Author(s):  
Zach Zhang ◽  
Bibianna Purgina ◽  
Jing Zhang
Keyword(s):  
Growth Pattern ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
High Rate ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Local Growth ◽  
En Bloc ◽  
Immediate Reconstruction ◽  
Hands And Feet

Bizarre parosteal osteochondromatous proliferation, also known as Nora lesion, is a rare benign surface lesion of the bone commonly affecting the hands and feet. It has an aggressive local growth pattern and high rate of recurrence post-excision. The authors report a case of recurred Nora lesion involving thumb metacarpal neck. En bloc resection with immediate reconstruction using distal radius bone graft was provided as a treatment with no clinical or radiological recurrence at 2-year follow-up.

scholarly journals Cold en bloc excision (CEBE) of bladder tumours using Zedd excision scissors: a prospective, pilot, safety and feasibility study

2020 ◽  
Vol 12 ◽  
pp. 175628722097223
Author(s):  
Hameed BMZ ◽  
Padmaraj Hegde ◽  
Milap Shah ◽  
Bhavan Prasad Rai ◽  
Joseph Thomas ◽  
...  
Keyword(s):  
Bladder Tumour ◽  
Posterior Wall ◽  
Bladder Perforation ◽  
Detrusor Muscle ◽  
En Bloc ◽  
En Bloc Excision ◽  
The Mean ◽  
Bloc Excision ◽  
Bladder Tumours

Background: Transurethral resection of bladder tumour (TURBT) is the traditional technique of choice for endoscopically suspected bladder tumours. Cold En Bloc Excision (CEBE) using novel Zedd scissors is proposed for endoscopic treatment of patients with non-muscle invasive bladder cancer (NMIBC). The aim of this study was to evaluate feasibility and safety of CEBE of bladder tumours using Zedd scissors. Methods: A pilot prospective study of patients who underwent a CEBE of suspicious bladder tumours using Zedd scissors was conducted. A total of 23 patients underwent CEBE for suspected bladder tumours using Zedd scissors. New and recurrent tumours <3 cm were included in the study. The outcome measures were the presence of detrusor muscle (DM) and obturator nerve reflex (ONR), bladder perforation rates, specimen cautery artefacts, recurrence rates and complication rates. The mean age was 64 years ± 10.41 (range: 49–83 years). The median follow up was 4 months (range 1–9 months). The mean tumour size was 1.8 cm ± 0.40 (range: 0.8–2.6 cm). Tumours were located in the lateral wall ( n = 11), dome ( n = 2), posterior wall ( n = 6), trigone ( n = 2), anterior wall ( n = 4) and the junction of lateral and posterior wall ( n = 4). Results: There was no ONR or bladder perforation and none of the patients had any complications. DM was present in 21 patients (91%). There was no tumour identified at the circumferential margins. There was no cautery artefact reported in any case. No patients had a recurrence at first follow up cystoscopy and two patients had out of field recurrence at subsequent cystoscopies. Conclusion: CEBE with Zedd scissors is a promising en bloc excision technique for bladder tumour. It is a safe and feasible for excision of tumours less than 3 cm. The early oncological outcomes are comparable with existing en bloc resection techniques (ERBT) for NMIBC.

scholarly journals Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Mathew Yamoah Kyei ◽  
Robert Djagbletey ◽  
Afua Darkwa Abrahams ◽  
James Edward Mensah
Keyword(s):  
Rare Condition ◽  
Surgical Excision ◽  
Scrotal Skin ◽  
En Bloc ◽  
Uninvolved Skin ◽  
Normal Configuration ◽  
Skin Nodules ◽  
En Bloc Excision ◽  
Bloc Excision

Idiopathic scrotal calcinosis is a rare condition, characterized by the idiopathic deposition of calcium in the scrotal dermis leading to the formation of a single nodule or multiple nodules of different sizes. Surgical excision of the nodules reduces symptoms and improves cosmesis. We present a case of idiopathic scrotal calcinosis that had an en bloc excision of scrotal skin nodules and primary closure of the scrotal skin. Handling each hemiscrotum as a separate entity and preserving the median raphe with its uninvolved skin improved the cosmesis. Reported outcomes of surgery were satisfactory with no postoperative complications. At 30 months of follow-up, the residual scrotal skin had regained its laxity and the scrotum its normal configuration. There is the risk of recurrence of the calcific nodules post excision, but these may be smaller in size and with regained scrotal configuration that could be amenable to excision with further preservation of the native scrotal skin.

Bizarre Parosteal Osteochondromatous Proliferation

2015 ◽  
Vol 105 (1) ◽  
pp. 80-84 ◽  
Author(s):  
Crystal Holmes ◽  
Palak Choksi ◽  
James S. Wrobel
Keyword(s):  
Young Adults ◽  
Case Report ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Management Options ◽  
Current Case ◽  
Recurrent Lesion ◽  
Microscopic Features ◽  
Small Bones ◽  
Hands And Feet

Bizarre parosteal osteochondromatous proliferation (BPOP) is an uncommon reactive mesenchymal lesion mainly affecting the small bones of the hands and feet. They frequently occur in young adults. It is important to understand and differentiate BPOP from other lesions, especially because of its atypical microscopic features and tendency to recur. We present a case of a recurrent lesion involving the toe and discuss management options. To our knowledge, our current case report is the first in the literature to report a recurring BPOP lesion of the toe.

scholarly journals A CASE REPORT OF GIANT GENITAL WARTS

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
L. Grimaldi ◽  
R. Cuomo ◽  
R. Bilenchi ◽  
F. Roviello ◽  
G. Nisi ◽  
...  
Keyword(s):  
Transmitted Disease ◽  
Genital Warts ◽  
Rare Form ◽  
En Bloc ◽  
Immediate Reconstruction ◽  
Sexually Transmitted ◽  
En Bloc Excision ◽  
Bloc Excision ◽  
Sporadic Tumour

Giant genital warts (GGW) represent a rare form of sexually transmitted disease caused by the human papillomavirus, arising more frequently in the vulvar and perianal regions as large exophytic cauliflower-like mass. Estimated rate of recurrence is 60 to 66%, while malignant transformation is possible and it has been reported in 30 to 56% of cases. A 45- years-old woman was admitted to our Structure of Plastic and Reconstructive Surgery, Siena, Italy with an extensive cauliflower- like masses diffused on vulvar and perianal region. The patient was treated in general anaesthesia, with a wide en bloc excision up to free clinical edges and immediate reconstruction of the vulvar continuity. Buschke Lowenstein tumour or giant genital warts is a sporadic tumour with an elevate local recurrence rate. In some cases, surgery can be very difficult and it must be associated to other strategies. An accurate follow-up is always necessary

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 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. 

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