J Korean Orthop Assoc.  2018 Jun;53(3):271-276. 10.4055/jkoa.2018.53.3.271.

Parosteal Lipoma Associated with Underlying Recurrent Bizarre Parosteal Osteochondromatous Proliferation (Nora's Lesion) of the Hand

• Kang S
• Chung PH
• Kim JP
• Kim YS
• Lee HM
• Cho KS

• KMID: 2429176
• DOI: http://doi.org/10.4055/jkoa.2018.53.3.271

Abstract

Parosteal lipoma is a benign tumor of the mature adipose tissue that contacts the periosteum of the underlying bone directly. The tumor commonly arises in the long bones, such as the femur, radius or tibia, and often exhibits underlying osseous changes, such as a cortical hyperostosis or erosion. Parosteal lipoma arising in a finger is rare. Furthermore, there are no reports of parosteal lipoma associated with underlying bizarre parosteal osteochondromatous proliferation. The authors present a rare case of parosteal lipoma of the proximal phalanx of the little finger accompanied by recurrent bizarre paroteal osteochondromatous proliferation in a 64-year-old male patient who had previously undergone an excisional biopsy at the same location 8 years earlier.

Keyword

hand; phalanx; parosteal lipoma; bizarre parosteal osteochondromatous proliferation

MeSH Terms

Adipose Tissue
Biopsy
Femur
Fingers
Hand*
Humans
Hyperostosis
Lipoma*
Male
Middle Aged
Periosteum
Radius
Tibia

Figure

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  Figure 1 Anteroposterior radiograph (A) and coronal (B) and axial (C) computered tomography scans showing an osseous projection surrounded by a radiolucent soft tissue mass at the ulnar aspect of the proximal phalanx of the right little finger in a 64-year-old man taken 8 years prior to this presentation.

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  Figure 2 Anteroposterior radiograph taken at this presentation showing a soft tissue mass with radiolucency and an irregularly shaped osseous projection attached to the underlying cortex arising from the lateral aspect of the midshaft of the proximal phalanx of the finger.

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  Figure 3 Coronal (A) and axial (B) T1-weighted magnetic resonance imaging (MRI) showing a normal, bony signal intensity mass surrounded by a lobulated homogenous soft tissue mass of high signal intensity, coronal (C) and axial (D) T2 weighted MRI showing hypointensity of the soft tissue mass arising from the volar-ulnar aspect of the proximal phalanx shaft.

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  Figure 4 Gross specimen of the excised mass, 3.5×2.5×1.0 cm in size, was well-circumscribed encapsulated fat tissue accompanied by a hard bony mass.

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  Figure 5 Histopathologically, the superficial area of the mass showed mature lobulated adipose tissue without cellular atypia (A) and the basal area was composed of fibrocartilagenous tissue with immature bony trabeculae (B) (A, B: H&E, ×200).

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