Solitary thoracic osteochondroma causing spinal compression: Case report

Spinal osteochondromas are very rare, and they present with nonspecific localized pain owing to bone involvement. Diagnosis is made based on direct X-ray and computed tomography (CT) imaging of the exophytic bone lesion with pedunculated or sessile structure. Although asymptomatic patients can be observed, surgical excision is the main treatment modality. We present the case of a 34-year-old man with solitary thoracic osteochondroma. The patient presented with complaints of pain in the legs, numbness, and inability to walk. The diagnosis was confirmed with CT imaging showing calcified heterogeneous bone lesion originating from the left side of T1-2 facet joint. After total excision, histopathological examination revealed the diagnosis of osteochondroma. No new clinical or radiological findings were detected in the 10-month follow-up.     

Treatment of spinal cord compression caused by C2 osteochondroma with reconstruction and fusion after total resection: Case report and literature review

Context: Osteochondroma is the most common benign tumor of the bone, but spinal osteochondroma is rare. We report a case of cervical osteochondroma in multiple exostoses arising from the lamina of the C2 vertebra, presenting with features of compressive myelopathy in a 22-year-old male. Total resection of the tumor and atlantoaxial fixation and fusion after reconstruction of the C1 posterior arch were performed.Findings: The patient recovered significantly. He was asymptomatic and no sign of recurrence was observed after one-year follow-up.Conclusions: Osteochondroma should be considered as a rare cause of spinal cord compression. Entire removal of the tumor will result in complete decompression and can reduce the risk of recurrence. We provide a new approach to reconstruct after resection.     

Osteochondroma and secondary synovial osteochondromatosis

Secondary synovial osteochondromatosis (SOC) is a rare disorder caused by a variety of joint disorders. Two unusual cases of secondary SOC are presented. The first patient is a 43-year-old man with extensive SOC developing within a bursa surrounding an osteochondroma of the pubic bone. The second patient is a 23-year-old man who developed florid and progressive SOC of his hip joint following excision of a femoral neck osteochondroma. SOC recurred despite three excisions over a 15-month period. Imaging was useful in pre-operative diagnosis of bursal SOC in the first patient and in detecting multiple recurrences in the second patient. Both cases illustrate prominent SOC developing secondary to osteochondroma. The different hypotheses regarding bursal and secondary SOC are reviewed. Received: 8 October 1998 Revision requested: 28 October 1998 Revision received: 13 November 1998 Accepted: 16 November 1998     

Digital cutting guide and endoscopically-assisted vertical ramus osteotomy to treat condylar osteochondroma: a long-term study

We have introduced an effective treatment for mandibular condylar osteochondroma with a digital cutting guide and endoscopically-assisted vertical ramus osteotomy (VRO). Eleven patients with unilateral condylar osteochondroma, who did not require orthognathic surgery or had less than 3 mm deviation of the chin and a stable occlusion, were treated during the period April 2013–January 2017 with a digital cutting guide and endoscopically-assisted VRO. Clinical data collected included the occlusion, facial contour, and maximum mouth opening (MMO). Computed tomographic (CT) scans were taken before and after operation. Two patients also had additional shaping of the mandibular contour. The pathological diagnosis was confirmed to be osteochondroma in all cases. A mean (range) 19 (12–40) months of follow-up for all 11 cases showed stable postoperative occlusion and facial aesthetics. There were no functional disturbances, recurrence, or condylar absorption. VRO is an alternative to orthognathic surgery for patients with osteochondroma who do not have severe malocclusions. The digital cutting guide and endoscopically-assisted VRO make it possible to achieve precise resection of the tumour and maintain the occlusion with minimal invasion.     

Osteocondroma de la columna cervical provocando tortícolis y hemiparesia

Osteochondromas are slow-growing benign bone tumors that are located frequently in the long bones. Approximately 1-4% of them occur in the spine. Solitary spinal osteochondromas may produce a wide variety of symptoms depending on their location and relationship to associated structures.We report a case of a 74-year old woman who was admitted to our hospital with complaints of progressive left hemibody weakness and cervicalgia. Neurological examination disclosed mild left-sided hemiparesis and left torticollis. Computed tomography and magnetic resonance imaging of the cervical spine revealed an expansive lesion affecting the left C3-C4 facet joint. The patient underwent a posterior C3 and C4 hemilaminectomy, complete excision of the lesion and instrumented posterior cervical fixation. Histological examination confirmed the diagnosis of osteochondroma. After surgery her symptoms improved progressively with no neurological sequels.     

Osteochondroma of the mandibular condyle: Indications for different surgical methods: A case series of 7 patients

The aim of this study was to evaluate and discuss the long-term outcomes of patients with condylar osteochondroma managed through 3 different surgical techniques.Seven patients with condylar osteochondroma treated in the author's department from May 2012 to January 2019 were included in this retrospective study. Clinical evaluations (visual analogue scale for TMJ pain, jaw function, symmetry, and quality of life), maximum interincisal opening (MIO) and radiological findings were collected pre- and postoperatively. Other parameters assessed included tumour size and location; complications and follow-up. Radical condylectomy with immediate total joint alloplastic reconstruction was performed in 4 patients, local excision in 2 patients and low condylectomy with concomitant orthognathic surgery in 1 patient. During an average follow-up period of 40,8 months no clinical or radiographic signs of recurrence were found. Average MIO increased from 25,5mm to 39,5mm at the longest follow up, and all clinical evaluations were greatly improved.In conclusion, the described surgical techniques appear valuable in the treatment of condylar osteochondroma. Local excision is indicated in tumor involving less than half the surface of the condylar head; radical condylectomy with immediate alloplastic total joint reconstruction is indicated in gigantic lesion compromising the anatomical components and function of the joint. Orthognathic surgery procedures should be combined with tumor resection when correction of associated dentofacial deformities is indicated.     

Spontaneous healing of an osteochondroma fracture

Osteochondroma is the most common benign tumor of bone, usually asymptomatic. Fracture of an osteochondroma is a rare complication and has been recognized as a cause of pain. Treatment of this fracture is controversial and some authors suggest fracture as an indication for surgical excision. We present a case of fractured osteochondroma that healed without complication.     

L4椎管内骨软骨瘤致神经根受压1例报告

患者，男，62岁。2002年3月初开始，无明显外伤史，逐渐出现腰痛伴一侧腿痛4年余，时轻时重，经对症治疗有好转而没有引起重视。近半年腰腿痛症状加重，伴典型间歇性跛行，站立和行走时症状加重，而下蹲或坐下休息和卧床时减轻，疼痛从左侧臀部放射至同侧小腿外侧与足背。门诊以腰椎管狭窄收入院。检查：腰部无畸形，L4棘突与棘突左侧压痛，腰部过伸试验阳性。     

快速对比增强MRI诊断良恶性软骨肿瘤的价值研究

目的:探讨利用快速对比增强MRI鉴别良恶性软骨肿瘤。方法:37例患者中,有8例内生软骨瘤,11例骨软骨瘤,18例软骨肉瘤。对其进行快速对比增强MRI扫描,按开始出现强化的时间不同分为:早期增强—动脉强化后10s内开始强化;进展期增强—动脉强化后10s～2min之间;延迟期增强—动脉强化5min后。结果显示与27例外科手术标本、3例刮除物标本和7例活检标本,结合长期随访结果和组织病例诊断相互关联。结果:强化的开端同良恶性肿瘤存在显著相关性(P<0.001)。早期增强可出现在软骨肉瘤病例中,亦出现在骺板未融合的骨软骨瘤病例中,但不出现在内生型软骨瘤中。诊断恶性软骨肿瘤的敏感度为89%,特异性为84%,阳性预测值为84%,阴性预测值为89%。结论:快速对比增强MRI成像有助于鉴别成人的良恶性软骨肿瘤。