Bizarre parosteal osteochondromatous proliferation (BPOP), also known as Nora's lesion,[4] is a type of non-cancerous bone tumor belonging to the group of cartilage tumors.[1][2][5] It is generally seen in the tubular bones of the hands and feet,[6] where it presents with a rapidly enlarging painless lump in a finger or toe.[1]
| Bizarre parosteal osteochondromatous proliferation | |
|---|---|
| Other names | Nora lesion or Nora disease[1][2] |
| Specialty | Orthopedics |
| Symptoms | Painless lump in finger or toe[1] |
| Risk factors | Possibly trauma in a minority[1] |
| Diagnostic method | Medical imaging[1] |
| Differential diagnosis | Mainly subungal exostosis[1] |
| Treatment | Surgical excision.[1] |
| Prognosis | Up to 50% recur after surgery[1] |
| Frequency | Rare,[2] <5% of cartilage tumors,[3] M=F[1] |
It is composed of bone, cartilage and spindle cells.[1] Some people report previous trauma.[1]
Diagnosis is by medical imaging.[1] Treatment is by surgical excision.[1] Up to 50% recur after surgery.[1]
It is rare,[2] and occurs more often in the 20s and 30s.[1] Combined with subungal exostosis, it accounts for less than 5% of cartilage tumors.[3] Males and females are affected equally.[1] The condition was first described by Frederick E. Nora in 1983.[6][7]
Signs and symptoms
editBPOP generally presents with a 1–3 cm painless lump in a finger or more frequently a toe.[1] Growth can be rapid.[2]
Mechanism
editIt is composed of bone, cartilage and spindle cells.[1] A small number of people have reported previous trauma.[1]
Diagnosis
editMedical imaging usually shows a well-defined wide-based bony growth on the surface of bone.[6]
Differential diagnosis
editBPOP is distinct from subungal exostosis.[1][6] Conditions that may appear similar to BPOP include: myositis ossficans, ostechondroma, surface osteosarcoma and granulomatous infection.[2]
Treatment
editTreatment is by surgical excision.[1]
Outcomes
editEpidemiology
editBPOP is rare.[2] It is most often seen in people in their 20s and 30s.[1] Combined with subungal exostosis, it accounts for less than 5% of cartilage tumors.[3] Males and females are affected equally.[1][6]
History
editBizarre parosteal osteochondromatous proliferation was first described by Frederick E. Nora in 1983.[6][7] Generally in the US, it has been thought of as a mouthful and hence it is sometimes referred to as Nora's lesion.[4]
Other animals
editIn 1998 a report of a similar lesion to BPOP was reported in a wallaby.[8]
References
edit- ^ a b c d e f g h i j k l m n o p q r s t u v w x y WHO Classification of Tumours Editorial Board, ed. (2020). "Bizarre parosteal osteochondromatous proliferation". Soft Tissue and Bone Tumours: WHO Classification of Tumours. Vol. 3 (5th ed.). Lyon (France): International Agency for Research on Cancer. pp. 348–350. ISBN 978-92-832-4503-2.348-350&rft.edition=5th&rft.pub=International Agency for Research on Cancer&rft.date=2020&rft.isbn=978-92-832-4503-2&rft_id=https://books.google.com/books?id=kaR9zQEACAAJ&rfr_id=info:sid/en.wikipedia.org:Bizarre parosteal osteochondromatous proliferation" class="Z3988">
- ^ a b c d e f g h Bocklage, Therese J.; Quinn, Robert; Verschraegen, Claire; Schmit, Berndt (2014). "16. Cartilaginous tumours of bones and joints". Bone and Soft Tissue Tumors: A Multidisciplinary Review with Case Presentations. London: JP Medical Ltd. p. 379. ISBN 978-1-907816-22-2.
- ^ a b c Engel, Hannes; Herget, Georg W.; Füllgraf, Hannah; Sutter, Reto; Benndorf, Matthias; Bamberg, Fabian; Jungmann, Pia M. (March 2021). "Chondrogenic Bone Tumors: The Importance of Imaging Characteristics". RöFo: Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin. 193 (3): 262–275. doi:10.1055/a-1288-1209. ISSN 1438-9010. PMID 33152784.262-275&rft.date=2021-03&rft.issn=1438-9010&rft_id=info:pmid/33152784&rft_id=info:doi/10.1055/a-1288-1209&rft.aulast=Engel&rft.aufirst=Hannes&rft.au=Herget, Georg W.&rft.au=Füllgraf, Hannah&rft.au=Sutter, Reto&rft.au=Benndorf, Matthias&rft.au=Bamberg, Fabian&rft.au=Jungmann, Pia M.&rft_id=https://doi.org/10.1055%2Fa-1288-1209&rfr_id=info:sid/en.wikipedia.org:Bizarre parosteal osteochondromatous proliferation" class="Z3988">
- ^ a b Davies, A. Mark; Sundaram, Murali; James, Steven J. (2009). Imaging of Bone Tumors and Tumor-Like Lesions: Techniques and Applications. Springer Science & Business Media. p. 684. ISBN 978-3-540-77982-7.
- ^ "ICD-11 - ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Retrieved 6 July 2021.
- ^ a b c d e f Mahajan, Sumit; Chandra, Rajesh; Mohan Lal, Yash (December 2012). ""Nora lesion" – Bizarre parosteal osteochondromatous proliferation". Journal of Clinical Orthopaedics and Trauma. 3 (2): 119–121. doi:10.1016/j.jcot.2012.07.001. ISSN 0976-5662. PMC 3872810. PMID 26403451.119-121&rft.date=2012-12&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872810#id-name=PMC&rft.issn=0976-5662&rft_id=info:pmid/26403451&rft_id=info:doi/10.1016/j.jcot.2012.07.001&rft.aulast=Mahajan&rft.aufirst=Sumit&rft.au=Chandra, Rajesh&rft.au=Mohan Lal, Yash&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872810&rfr_id=info:sid/en.wikipedia.org:Bizarre parosteal osteochondromatous proliferation" class="Z3988">
- ^ a b Nora, F. E.; Dahlin, D. C.; Beabout, J. W. (April 1983). "Bizarre parosteal osteochondromatous proliferations of the hands and feet". The American Journal of Surgical Pathology. 7 (3): 245–250. doi:10.1097/00000478-198304000-00003. ISSN 0147-5185. PMID 6837834. S2CID 36384395.245-250&rft.date=1983-04&rft.issn=0147-5185&rft_id=https://api.semanticscholar.org/CorpusID:36384395#id-name=S2CID&rft_id=info:pmid/6837834&rft_id=info:doi/10.1097/00000478-198304000-00003&rft.aulast=Nora&rft.aufirst=F. E.&rft.au=Dahlin, D. C.&rft.au=Beabout, J. W.&rft_id=https://pubmed.ncbi.nlm.nih.gov/6837834/&rfr_id=info:sid/en.wikipedia.org:Bizarre parosteal osteochondromatous proliferation" class="Z3988">
- ^ Rungsipipat, A.; Yamaguchi, R.; Naganobu, K.; Iwamoto, K.; Uchida, K.; Tateyama, S.; Kurogi, T.; Katayama, N. (1998). "A bone tumour resembling bizarre parosteal osteochondromatous proliferation in a wallaby". Australian Veterinary Journal. 76 (8): 561–564. doi:10.1111/j.1751-0813.1998.tb10218.x. ISSN 1751-0813. PMID 9741726.561-564&rft.date=1998&rft.issn=1751-0813&rft_id=info:pmid/9741726&rft_id=info:doi/10.1111/j.1751-0813.1998.tb10218.x&rft.aulast=Rungsipipat&rft.aufirst=A.&rft.au=Yamaguchi, R.&rft.au=Naganobu, K.&rft.au=Iwamoto, K.&rft.au=Uchida, K.&rft.au=Tateyama, S.&rft.au=Kurogi, T.&rft.au=Katayama, N.&rft_id=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1751-0813.1998.tb10218.x?sid=nlm%3Apubmed&rfr_id=info:sid/en.wikipedia.org:Bizarre parosteal osteochondromatous proliferation" class="Z3988">