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Benign Bone Tumors of the Hand: Beyond Enchondromas.

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.

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Introduction: Benign bone tumors like osteochondroma are common during skeletal maturity occurring usually at the ends of long bones, such as the distal femur, proximal humerus, and proximal tibia. The tumor can occur in sessile or pedunculated forms. Mass lesions occurring around the ankle can lead to chronic pain, pathological fractures, progressive erosion, and scalloping of adjacent bone.

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A 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.

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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.

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Case: Bizarre parosteal osteocartilaginous proliferation (BPOP) is rare, especially in the foot. To the best of our knowledge, multifocal BPOP has yet to be reported. We are reporting a case of a 40-year-old woman who presented with 4 bumps over her midfoot and toes.

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