Nora's lesion, also known as bizarre parosteal osteochondromatous proliferation (B.P.O.P.), involves mostly the small tubular bones of the hands and feet. Histologically, it is characterized by a proliferation of chondroid, bony and fibrous tissues, sometimes with high cellular density, bizarre chondrocytes but is devoid of cellular atypia and necrosis. Distinct blue color is noted at the interface of bone and cartilage. The most important lesions that present differential diagnostic problems are chondrosarcoma, parosteal osteosarcoma and florid reactive periostitis. The lesion is benign but may recur locally in as many as 55%. The clinical and pathological findings of four cases of Nora's lesion are presented.
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J Am Acad Orthop Surg
November 2024
From the Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY (Albanese, Lynch, and Damron), and the Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA (Eswaran).
Beyond enchondromas, the most common bone tumors of the hand, there are numerous less common benign bone tumors and mimickers with which orthopaedic and hand surgeons should be familiar. These include other benign cartilage tumors, cystic lesions, osteogenic tumors, giant cell tumor, and fibrous dysplasia. Particularly unique lesions include bizarre parosteal osteochondromatous proliferation (Nora lesion), florid reactive periostitis, turret exostosis (acquired osteochondroma), giant cell reparative granuloma (solid aneurysmal bone cyst), and epidermoid cyst.
View Article and Find Full Text PDFA patient with a benign bizarre parosteal osteochondromatous proliferation (BPOP) located in the anterior knee was treated with resection in preparation for total knee arthroplasty (TKA). The BPOP reoccurred and was treated with re-resection at the time of TKA. The BPOP reoccurred a second time and underwent malignant transformation to a fungating high-grade pleomorphic sarcoma with metastatic lesions.
View Article and Find Full Text PDFBMC Musculoskelet Disord
July 2024
Department of Orthopedics, The Second Xiangya Hospital, Central South University, No 139 Renmin Road, Changsha, Hunan, 410011, China.
Background: Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare benign bone tumor, it is also called "Nora's lesion". The lesion is characterized by heterotopic ossification of the normal bone cortex or parosteal bone. The etiology of BPOP is unclear and may be related to trauma.
View Article and Find Full Text PDFJ Int Med Res
June 2024
Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Bizarre parosteal osteochondromatous proliferation (BPOP), also termed Nora lesion, is a rare, benign tumor most often located in the hands and feet. We herein present the second reported case of BPOP affecting the spine, an uncommon location. One year after surgical excision, the patient was pain-free and showed no evidence of recurrence.
View Article and Find Full Text PDFSAGE Open Med Case Rep
April 2024
Department of Orthopedic Surgery, Shaare Zedek Medical Center, The Hebrew University School of Medicine, Jerusalem, Israel.
Bizarre parosteal osteochondromatous proliferations, also known as Nora's lesions, are rare benign tumors with a high recurrence rate. They are often difficult to identify because of their similar appearance to other tumors. We describe a 25-year-old healthy female patient with bizarre parosteal osteochondromatous proliferations in an uncommon location on the pelvic ilium, presenting with unique clinical findings of abdominal pain and femoral paresthesia and showing atypical radiographic findings.
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