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Bizarre Parosteal Osteochondromatous Proliferation
Eric Walker, MD, MHA, FACR, FACHE; Catherine C. Roberts, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Bizarre parosteal osteochondromatous proliferation (BPOP)
              • Synonyms

                • Nora lesion
              • Definitions

                • Benign surface lesion of bone composed of spindle cells, cartilage, and bone
                • May be part of continuum from fibroosseous pseudotumor of digits to acquired osteochondroma

              IMAGING

              • General Features

                • Imaging Recommendations

                  • Radiographic Findings

                    • CT Findings

                      • MR Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Yoshida A et al: Bizarre parosteal osteochondromatous proliferation. In Fletcher CDM et al: World Health Organization Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 348-50, 2020
                                                2. Gholamrezanezhad A et al: Peering beneath the surface: juxtacortical tumors of bone (part II). Clin Imaging. 50:113-22, 2018
                                                3. Doganavsargil B et al: A bizarre parosteal osteochondromatous proliferation (Nora's lesion) of metatarsus, a histopathological and etiological puzzlement. Joint Bone Spine. 81(6):537-40, 2014
                                                4. Kransdorf MJ et al: Extraskeletal osseous and cartilaginous lesions. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 555-9, 2014
                                                5. Rappaport A et al: Nora's lesion or bizarre parosteal osteochondromatous proliferation: a rare and relatively unknown entity. JBR-BTR. 97(2):100-2, 2014
                                                6. Broehm CJ et al: Bizarre parosteal osteochondromatous proliferation: a new cytogenetic subgroup characterized by inversion of chromosome 7. Cancer Genet. 206(11):402-5, 2013
                                                7. Mahajan S et al: "Nora lesion" - bizarre parosteal osteochondromatous proliferation. J Clin Orthop Trauma. 3(2):119-21, 2012
                                                8. Weiss SW et al: Osseous soft tumors. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 1044-7, 2008
                                                9. Endo M et al: Bizarre parosteal osteochondromatous proliferation with a t(1;17) translocation. Virchows Arch. 447(1):99-102, 2005
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Bizarre parosteal osteochondromatous proliferation (BPOP)
                                                            • Synonyms

                                                              • Nora lesion
                                                            • Definitions

                                                              • Benign surface lesion of bone composed of spindle cells, cartilage, and bone
                                                              • May be part of continuum from fibroosseous pseudotumor of digits to acquired osteochondroma

                                                            IMAGING

                                                            • General Features

                                                              • Imaging Recommendations

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Yoshida A et al: Bizarre parosteal osteochondromatous proliferation. In Fletcher CDM et al: World Health Organization Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 348-50, 2020
                                                                                              2. Gholamrezanezhad A et al: Peering beneath the surface: juxtacortical tumors of bone (part II). Clin Imaging. 50:113-22, 2018
                                                                                              3. Doganavsargil B et al: A bizarre parosteal osteochondromatous proliferation (Nora's lesion) of metatarsus, a histopathological and etiological puzzlement. Joint Bone Spine. 81(6):537-40, 2014
                                                                                              4. Kransdorf MJ et al: Extraskeletal osseous and cartilaginous lesions. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 555-9, 2014
                                                                                              5. Rappaport A et al: Nora's lesion or bizarre parosteal osteochondromatous proliferation: a rare and relatively unknown entity. JBR-BTR. 97(2):100-2, 2014
                                                                                              6. Broehm CJ et al: Bizarre parosteal osteochondromatous proliferation: a new cytogenetic subgroup characterized by inversion of chromosome 7. Cancer Genet. 206(11):402-5, 2013
                                                                                              7. Mahajan S et al: "Nora lesion" - bizarre parosteal osteochondromatous proliferation. J Clin Orthop Trauma. 3(2):119-21, 2012
                                                                                              8. Weiss SW et al: Osseous soft tumors. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 1044-7, 2008
                                                                                              9. Endo M et al: Bizarre parosteal osteochondromatous proliferation with a t(1;17) translocation. Virchows Arch. 447(1):99-102, 2005