Second toe swelling: Nora%26apos;s lesion or glomus tumour, case report and literature review

作者：Mohammad A^*; Kilcoyne A; Blake S; Phelan M

来源：Irish Journal of Medical Science, 2012, 181(3): 357-360.

DOI：10.1007/s11845-009-0435-0

• Nora%26apos
• s lesion
• Toe nails
• Nail diseases
• Differential diagnosis
• Histopathology

We report a rare case of bizarre parosteal osteochondromatous proliferation (BPOP, Nora%26apos;s lesion) of the right second toe in a 60-year-old man who presented with painful, bluish and bulbous swelling of the right second toe without any break in the skin. %26lt;br%26gt;Physical examination, plain radiography and magnetic resonance imaging (MRI) scan of the foot, histology of the excised tissue. %26lt;br%26gt;Bizarre parosteal osteochondromatous proliferation. %26lt;br%26gt;Radiographs showed a calcified/ossified lesion adjacent to the tuft of the terminal phalanx of the second toe. MRI showed a small low signal nodule on T1- and T2-weighted images in a subungual position adjacent to the terminal phalanx with sclerosis. The second toe was excised and the histology from excised tissue was consistent with %26quot;bizarre parosteal osteochondromatous proliferation%26quot;. There was no malignant change on histology. Local excision of the entire lesion was done and there has been no recurrence to date. %26lt;br%26gt;BPOP, although a benign lesion, behaves aggressively with rapid growth and has a high risk of local recurrence after local resection (Nora et al. in Am J Surg Pathol 7(3):245-250, 1983; Meneses et al. in Am J Surg Pathol 17(7):691-697, 1993). Its clinical presentation can be confused with glomus tumour, subungual exostosis and enchondroma. The distinguishing features of BPOP and several relevant different differential diagnoses are discussed in this case report.

• 出版日期2012-9