Bizarre Parosteal Osteochondromatous Proliferation: A Case Series and Literature Review

Bizarre parosteal osteochondromatous proliferation (BPOP), also known as Nora's lesion, is a rare, benign bone tumor predominantly affecting the small bones of the hands and feet. It presents as a diagnostic challenge due to its radiologic and histologic resemblance to malignant bone lesions, such as osteosarcoma and parosteal chondrosarcoma.

This case series describes the clinical presentation, imaging features, surgical management, and post-operative outcomes of three patients with BPOP involving the small bones of the hand. Radiological imaging, including magnetic resonance imaging and computed tomography scans, played a crucial role in identifying periosteal-based lesions with cortical involvement. Histopathological examination confirmed the diagnosis, distinguishing it from more aggressive conditions. Surgical excision with wide margins was the primary treatment and resulted in favorable outcomes without evidence of recurrence during follow-up. Despite its benign nature, BPOP has a high recurrence rate, emphasizing the importance of long-term monitoring.

This series contributes to the growing literature on BPOP, highlighting the need for accurate diagnosis and appropriate surgical techniques. Future research into the genetic background of BPOP may provide further insights into its pathogenesis and its recurrence, potentially guiding more effective management strategies.