피질 침범을 동반한 수부의 기괴 방골성 골연골성 증식증: 증례 보고

Bizarre Parosteal Osteochondromatous Proliferation with Cortical Erosion in the Hand: A Case Report

  • 김미선 (인제대학교 의과대학 일산백병원 영상의학과학교실) ;
  • 김용훈 (인제대학교 의과대학 일산백병원 영상의학과학교실) ;
  • 황윤준 (인제대학교 의과대학 일산백병원 영상의학과학교실) ;
  • 서정욱 (인제대학교 의과대학 일산백병원 영상의학과학교실) ;
  • 김수영 (인제대학교 의과대학 일산백병원 영상의학과학교실) ;
  • 이병훈 (인제대학교 의과대학 일산백병원 영상의학과학교실) ;
  • 이지영 (인제대학교 의과대학 일산백병원 영상의학과학교실)
  • Kim, Mi-Sun (Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Kim, Yong-Hoon (Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Hwang, Yoon-Joon (Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Seo, Jung-Wook (Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Kim, Su-Young (Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Lee, Byeong-Hoon (Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Lee, Ji-Young (Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital)
  • 발행 : 2011.10.01

초록

Bizarre parosteal osteochondromatous proliferation (이하 BPOP)은 드문 양성 골 병변으로 손과 발의 작은 뼈에서 발생한다. BPOP의 특징적인 영상 소견은 골 표면의 경계가 좋은 석회화된 종괴로 인접 연부조직의 종창이나 골피질의 파괴, 골수질의 침범을 동반하지 않는다. 저자는 자기공명영상에서 골피질 미란과 골수 부종, 인접 연부조직의 조영증강과 같은 공격적인 영상 소견을 보여 악성 종양이나 염증성 병변으로 오진하였던 BPOP 한 예를 경험하여 보고하고자 한다.

Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare osseous lesion occurring in the long bones of distal extremities. Typical imaging findings of BPOP show a well-defined calcified osseous mass without soft tissue swelling, cortical destruction, and medullary involvement. We experienced rare aggressive magnetic resonance imaging findings of BPOP with cortical erosion, bone marrow edema, and adjacent soft tissue enhancement, which was misdiagnosed as a malignancy or inflammatory lesion.

키워드

참고문헌

  1. Torreggiani WC, Munk PL, Al-Ismail K, O'Connell JX, Nicolaou S, Lee MJ, et al. MR imaging features of bizarre parosteal osteochondromatous proliferation of bone (Nora's lesion). Eur J Radiol 2001;40:224-231 https://doi.org/10.1016/S0720-048X(01)00362-X
  2. Soon JL, Chang HC, Sim CS, Teoh LC, Low CO. A case of Bizarre Parosteal Osteochondromatous Proliferation of the hand. Singapore Med J 2003;44:27-30
  3. Joseph J, Ritchie D, MacDuff E, Mahendra A. Bizarre parosteal osteochondromatous proliferation: a locally aggressive benign tumor. Clin Orthop Relat Res 2011;469:2019-2027 https://doi.org/10.1007/s11999-011-1898-7
  4. Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH. Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics 2000;20:1407-1434 https://doi.org/10.1148/radiographics.20.5.g00se171407
  5. Helliwell TR, O'Connor MA, Ritchie DA, Feldberg L, Stilwell JH, Jane MJ. Bizarre parosteal osteochondromatous proliferation with cortical invasion. Skeletal Radiol 2001;30:282-285 https://doi.org/10.1007/s002560100347
  6. Ly JQ, Bui-Mansfield LT, Taylor DC. Radiologic demonstration of temporal development of bizarre parosteal osteochondromatous proliferation. Clin Imaging 2004;28:216-218 https://doi.org/10.1016/S0899-7071(03)00235-3
  7. Meneses MF, Unni KK, Swee RG. Bizarre parosteal osteochondromatous proliferation of bone (Nora's lesion). Am J Surg Pathol 1993;17:691-697 https://doi.org/10.1097/00000478-199307000-00006
  8. Yuen M, Friedman L, Orr W, Cockshott WP. Proliferative periosteal processes of phalanges: a unitary hypothesis. Skeletal Radiol 1992;21:301-303
  9. Sakamoto A, Imamura S, Matsumoto Y, Harimaya K, Matsuda S, Takahashi Y, et al. Bizarre parosteal osteochondromatous proliferation with an inversion of chromosome 7. Skeletal Radiol 2011;40:1487-1490 https://doi.org/10.1007/s00256-011-1173-8
  10. Choi JH, Gu MJ, Kim MJ, Choi WH, Shin DS, Cho KH. Fibrosarcoma in bizarre parosteal osteochondromatous proliferation. Skeletal Radiol 2001;30:44-47 https://doi.org/10.1007/s002560000265
  11. Michelsen H, Abramovici L, Steiner G, Posner MA. Bizarre parosteal osteochondromatous proliferation (Nora's lesion) in the hand. J Hand Surg Am 2004;29:520-525 https://doi.org/10.1016/j.jhsa.2004.02.002