Conservative condylectomy for management of osteochondroma of the mandibular condyle

Osteochondroma is one of the most common benign tumors of the skeleton. This tumor is rare in the craniofacial region, with the most common sites of occurrence being the coronoid process of the mandible and the mandibular condyle. Traditionally, the treatments of these lesions include total condylectomy or local resection of the lesion. Conservative condylectomy procedure with reshaping of the remaining condylar neck and repositioning of the articular disk has been suggested. This article aimed to describe a 35-year-old woman with osteochondroma in the left mandibular condyle who was treated by conservative condylectomy. The patient has been free of recurrence for 2 years, showing good aesthetic and functional stability. Copyright © 2013 by Mutaz B. Habal, MD.

Using Conservative Condylectomy for Management of a Large Osteochondroma of the Mandibular Condyle With 6-Year Follow- up

Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure.

Treatment of severe facial asymmetry secondary to osteochondroma of the mandibular condyle: case report

Osteochondroma (OC) is the most common benign tumor of long bones. However it is rarely found in the facial skeleton, being the coronoid process and mandibular condyle the most affected sites in this region. It basically consists in bone growth covered by cartilage. The etiology is still controversial: neoplastic, developmental, reparative and traumatic origins have been discussed in literature. The treatments of these lesions include total condylectomy or local resection of the lesion. This paper aims to report a case of a patient with history of trauma and possible fracture of the mandibular condyle in childhood, which in youth developed dentofacial deformity with severe facial asymmetry. The treatment consisted of resection of lesion both with maxillary and mandibular osteotomies associated with graft from the iliac crest bone. Actually, the patient is with a favorable aesthetic, without functional deficit and absence of lesion’s recurrence.

Osteosarcoma arising from osteochondroma of the tibia: case report and cytogenetic findings

Osteochondroma is a cartilage capped benign tumor developing mainly at the juxta-epiphyseal region of long bones. The rate of malignant transformation, mainly into chondrosarcoma, is estimated to be less than 1-3%. Transformation into osteosarcoma is very rare and has been reported only thirteen times. There is little information on treatment and outcome. We report the case of a secondary osteosarcoma arising in the left tibia of a 23-year-old male, 10 years after the initial diagnosis of osteochondroma and after two partial resections. Malignant transformation occurred at the stalk and not at the cartilage cap, as would normally be expected. Chromosome banding analysis revealed the karyotype: 46,XY, t(3;13)(q21;q34) [2]/46,XY [18]. Records from additional cases will help determine the parameters that define these rare secondary bone lesions.

Haematuria in two geldings caused by osteochondroma of the os pubis: Case reports and anatomic study of the os pubis in 41 cadaveric pelvises

Exostosis of the os pubis causing haematuria, and potentially cystorrhexis, in horses has not been described in the literature. In this study, 2 geldings that suffered from exercise-induced haematuria caused by an osteochondroma of the os pubis, and the assessment of 41 cadaveric pubic bones are reported on. The anatomy of the os pubis is highly variable. The prevalence of exostosis in the os pubis appears to be higher in male horses. Palpation and ultrasonography of the pelvis per rectum and cystoscopy are valuable diagnostic tools. Depending on the extent of changes in the bladder wall, surgical removal of the exostosis should be considered in order to prevent cystorrhexis. In horses that present with haematuria, closer assessment of the os pubis for the presence of an exostosis is warranted.

Spinous Process Osteochondroma as a Rare Cause of Lumbar Pain

We present a case of a 5th Lumbar Vertebra (L5) spinous process osteochondroma as a rare cause of lumbar pain in an old patient. A 70-year-old male presented with progressive and disabling lower lumbar pain. Tenderness over the central and left paraspinal area of the lower lumbar region and a palpable mass were evident. CT scan showed a mass arising from the spinous process of L5. Marginal resection of the tumor was performed through a posterior approach. The histological study revealed an osteochondroma. After surgery, pain was completely relieved. After one year there was no evidence of local recurrence or symptoms. Osteochondromas rarely involve the spine, but when they do symptoms like pain, radiculopathy/myelopathy, or cosmetic deformity may occur. The imagiologic exam of election for diagnosis is CT scan. When symptomatic the treatment of choice is surgical resection. The most concerning complication of osteochondromas is malignant transformation, a rare event.

Femoral exostosis causing vastus medialis pain in an active young lady: a case report.

BACKGROUND:
Musculoskeletal conditions are a common reason for consultation to General Practitioners (GPs)/family physicians in primary care. Osteochondromas are the most common benign bone tumours and usually occur in the metaphyseal region of long bones. Despite the distal femur being the commonest location to find these benign bone tumours, this is the first case report in the literature specifically describing vastus medialis muscle pain as the presenting symptom due to underlying bursa formation secondary to local pressure effects.

CASE PRESENTATION:
Twenty nine year old female of white British ethnic origin, presenting to a primary care clinic with a three year history of intermittent left distal medial thigh pain.

CONCLUSION:
The benign bone tumour, femoral exostosis/osteochondroma, was diagnosed via Magnaetic Resonance Imaging (MRI) and treated conservatively, with surgical excision an option if not resolving. GPs/family physicians need to be aware of this diagnosis and that femoral exostosis/osteochondroma can present to primary care physicians, particularly within the second decade of life.

Osteocondromatosis

Paciente femenina de 20 años con antecedente de osteocondromatosis múltiple, quien ingresa por coxalgia, edema y eritema en rodilla derecha. El osteocondroma representa el tumor benigno o lesión pseudotumoral más frecuente del hueso, siendo lesiones del desarrollo más que tumores como tal. Esto resulta de la separación de uno de los fragmento de la placa de crecimiento epifisiario, el cual se hernia a través del periostio[1]. Radiológicamente se describe como una lesión exofítica con continuidad cortical y medular con predilección por la metáfisis de los huesos largos, especialmente en los miembros inferiores. Su presentación puede ser solitaria o múltiple. La osteocondromatosis múltiple ó aclasia diafisiaria, se define como la presencia de dos o mas osteocondromas en diferentes localizaciones; siendo una patología de herencia autosómica dominante[2]. Dada la afectación de las metáfisis en desarrollo, los pacientes presentan talla baja, con desproporción entre el tronco y las extremidades inferiores, con presentación usual de genu valgo/varo. El crecimiento rápido de la lesión o la presencia de signos como aumento en temperatura, edema y eritema sugieren una transformación maligna[2].

Cirurgia ortognática associada á cirurgia das ATMs acometidas por artrite reumatóide ou osteocondroma

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estabilidade sagital da condiloplastia associada à cirurgia ortognática para o tratamento do osteocondroma mandibular

The aim of this study was to evaluate the stability of the conservative condylectomy technique and articular disc repositioning as the surgical treatment approach for management of mandibular condylar osteochondroma, with appropriate Orthognathic surgery. Fifteen patients (12 females and 3 males), average age of 32.3 years (range, 13 to 56 years), with unilateral active osteochondroma of the mandibular condyle were analyzed. All patients underwent conservative condylectomy, recontouring of the remaining condylar neck stump and articular disc repositioned and indicated orthognatic surgical procedures. Average post surgical follow-up was 19 months. Each patient's lateral cephalograms were traced at 3 intervals (presurgery, immediate post surgery and long-term follow-up). Immediate after surgery the oclusal plane angle decreased -2.8 ± 4.5o, the maxillomandibular complex rotated counter-clockwise with advancement at menton 5.3 ± 5.6 mm, pogonion 5.0 ± 5.1 mm, B point 3.4 ± 4.2 mm and A point 1.0 ± 1.5 mm. The long-term follow-up showed significant changes in overbite (-0.6 ± 0.5 mm) and SNGoMe (0,93° ± 1,53°). Horizontally and vertically small instabilities occurred in Me (-1.21 ± 1.94 mm) and PNS (-1.48 ± 1.67 mm) respectively. The treatment protocol studied produced counterclockwise rotation and maxillofacial mandibular advancement. The long-term follow-up showed solid dental and skeletal stability with horizontal instability of Me and PNS in the vertical direction.

Sellar collision tumor involving pituitary gonadotroph adenoma and chondroma: a potential clinical diagnosis

We report on a 74-year-old male patient who presented with progressive neuroophthalmologic symptoms soon after the administration of a long-acting gonadotropin-releasing hormone agonist for treatment of a prostate cancer. Imaging revealed a destructively growing and extensively calcified sellar mass inconsistent with a pituitary adenoma. A transseptal transsphenoidal tumor mass reduction yielded a histological diagnosis of a collision tumor comprised of a gonadotroph adenoma intermingled with osteochondroma. We discuss a potential causal relationship between the administration of the long-acting gonadotropin-releasing hormone agonist and the sudden appearance of the previously unsuspected sellar lesion. Although the association of these two tumors is very likely coincidental, the possibility of causal relationship is addressed.

Aluminum and iron can be deposited in the calcified matrix of bone exostoses.

International audience