Mithilesh Anil Nikam¹*, Nitin S Patil² and Priyambada Kumar¹

¹ Senior Resident, Department of Orthopaedics, Krishna Institute of Medical Sciences, Karad, India
²Professor, Department of Orthopaedics, Krishna Institute of Medical Sciences, Karad, India

*Corresponding Author: Mithilesh Anil Nikam, Senior Resident, Department of Orthopaedics, Krishna Institute of Medical Sciences, Karad, India.

Received: June 22, 2022; Published:

Abstract

Introduction: Osteochondromas are the most common type of benign bone tumours, which usually present as a solitary nonhereditary lesion along the shaft of long bones. Osteochondromas are generally asymptomatic and at most times, the only significant complain is of a painless slow-growing mass over the involved bone. The scalloping effect and increased localised pressure due to the tumour are hypothesised to be the main aetiology of the pain. These tumours should be evaluated to rule out any malignant changes prior to surgical management. Complete surgical excision is the treatment of choice, so as to relieve pain caused by expanding nature of the tumour and prevent a pathological fracture through affected region.

Case Report: We present a case of an Osteochondroma of the 4th metatarsal in a 16-year-old male, presenting with pain and swelling over the affected foot as the chief complaint. On physical examination, a solitary bony hard swelling was palpated in 4th web space of the foot MRI was done to rule out any malignant changes prior to surgical excision of the tumour. scan of the foot showed a cartilage capped bony outgrowth, arising from the distal 4th metatarsal along plantar as well as dorsal aspect and extending into the 4th webspace. The mass was excised en bloc.

Conclusion: The osteochondroma in the metatarsal is rare but should be kept in mind as an unusual aetiology of a painful foot even at the young age group.

Keywords: Osteochondroma; Exophytic Mass; Benign Tumour; Surgical Excision

References

1. Saglik Y., et al. “Manifestations and management of osteochondromas: a retrospective analysis of 382 patients”. Acta Orthopaedica Belgica 72 (2006): 748-755.
2. Porter DE and Simpson AHRW. “The neoplastic pathogenesis of solitary and multiple osteochondromas”. The Journal of Pathology 188 (1999): 119-125.
3. Khurana J., et al. “Osteochondroma. In: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. Fletcher CDM, Unni KK and Mertens F (eds.). Lyon, France: IARC (2002): 234-236.
4. Bovée JVMG and Hogendoorn PCW. “Multiple Osteochondromas. In: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. Fletcher CDM, Unni KK and Mertens F (eds.). Lyon, France, IARC (2002): 360-362.
5. Canella P., et al. “Exostosis: development, evolution and relationship to malignant degeneration”. Italian Journal of Orthopaedics and Traumatology 7 (1981): 293-298.
6. Garrison RS., et al. “Chondrosarcoma arising in osteochondroma”. Cancer 49 (1982): 1890-1897.
7. Peterson HA. “Multiple hereditary osteochondromata”. Clinical Orthopaedics 239 (1989): 222-230.
8. Seibert JJ., et al. “A primary rib tumor in a newborn”. Journal of Pediatric Surgery 11 (1976): 1031-1032.
9. Sharipo F., et al. “Hereditary multiple exostoses. Anthropometric, roentgenographic, and clinical aspects”. The Journal of Bone and Joint Surgery 61 (1979): 815-824.
10. Volpi N., et al. “Familial multiple exostoses syndrome: a phacomatosis of bone tissue”. Acta Neurologica Scandinavica 8 (1986): 516-527.
11. Wood VE., et al. “The treatment of hereditary multiple exostosis of the upper extremity”. Journal of Hand Surgery 10 (1985): 505513.
12. Morton KS. “On the question of recurrence of osteochondroma”. The Journal of Bone and Joint Surgery 46 (1964): 723-725.
13. Hennekam RCM. “Hereditary multiple exostoses”. Journal of Medical Genetics 28 (1991): 262-266.
14. Nawata K., et al. “Knee deformities in multiple hereditary exostoses: A longitudinal radiographic study”. Clinical Orthopaedics 313 (1995): 194-199.
15. Solomon L. “Hereditary multiple exostosis”. The Journal of Bone and Joint Surgery 45 (1963): 292-304.
16. Chrisman OD and Goldenberg RR. “Untreated solitary osteochondroma. Report of two cases”. The Journal of Bone and Joint Surgery America 50 (1968): 508-512.
17. Van Oost J., et al. “Compartment syndrome associated with an osteocartilaginous exostosis”. Acta Orthopaedica Belgica 62 (1996): 233-235.
18. Cardelia JM., et al. “Proximal fibular osteochondroma with associated peroneal nerve palsy: a review of six cases”. Journal of Pediatric Orthopaedics 15 (1995): 574-577.
19. Vallance R., et al. “Vascular complications of osteochondroma”. Clinical Radiology 36 (1985): 639-642.
20. Quirini GE., et al. “Osteochondroma of the thoracic spine: an unusual cause of spinal cord compression”. American Journal of Neuroradiology 17 (1996): 961-964.
21. Pandya NK., et al. “Spinal cord compression in a patient with multiple hereditary exostoses caused by breast adenocarcinoma metastatic to osteochondromas of the spine: case report”. Spine 31 (2006): 920-924.
22. Koga M., et al. “Osteochondroma in the mandibular condyle that caused facial asymmetry: a case report”. Cranio 24 (2006): 67-70.
23. Koehl GL and Tilson HB. “Osteochondromas associated with facial asymmetry and masticatory dysfunction: report of two cases”. Journal of Oral Surgery 35 (1977): 934-939.
24. Huang HR., et al. “Costal exostosis presenting with hemothorax: report of one case”. European Journal of Pediatrics 165 (2006): 342343.
25. Castells L., et al. “Case report: haemothorax in hereditary multiple exostosis”. The British Journal of Radiology 66 (1993): 269-270.
26. Markove RC and Huvos AG. “Cartilaginous tumors of the ribs”. Cancer 27 (1971): 794-801.
27. Smithuis TH. “Exostosis bursata”. The Journal of Bone and Joint Surgery (British Volume) 3 (1964): 544-545.
28. Jadhav PU., et al. “Osteochondromas at unusual sites-case series with review of literature”. Journal of Orthopaedic Case Reports 1 (2016): 52.
29. Chioros PG., et al. “Unusual osteochondroma of the foot and ankle”. The Journal of foot surgery 5 (1987): 407e411.
30. Molitor PJ and Myint S. “An unusual solitary osteochondroma arising from the first metatarsal bone”. Foot1 (1997): 37-e39.
31. Mohabey V and Ankush. “Synostosing osteochondroma of foot: a rare case report”. Journal of Medical Science and Clinical Research (2017).
32.  

Citation

Citation: Mithilesh Anil Nikam., et al. “Osteochondroma at an Unusual Site - A Case Report". Acta Scientific Orthopaedics 5.5 (2022): 00-00.

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Copyright: © 2022 Mithilesh Anil Nikam., et al.This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.