Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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November 3, 2016
Giant Lateral Pterygoid Plate Osteochondroma
- Background:
- Osteochondromata (exostoses) account for 40 – 45% of benign bone lesions.
- Osteochrondromata most commonly arise from long bones. Those arising from the skull base are rare.
- Malignant transformation occurs in ~1%, but this is higher in patients with hereditary multiple exostoses (diaphyseal aclasis).
- Clinical Presentation:
- Usually clinically silent; if symptomatic, due to impingement on surrounding structures
- Key Diagnostic Features:
- Nonaggressive lesion arising from bone with medullary continuity; may be sessile or pedunculated. Pedunculated lesions often have a characteristic cauliflower shape.
- Cartilage cap which may be seen on CT, but is better demonstrated on MRI
- Differential Diagnoses:
- Osteoma: Normal or homogenously dense cortical bone, typically spherical
- Chondrosarcoma: Thickened cartilage cap or soft tissue involvement
- Treatment:
- Resection for impingement symptoms or features of malignant transformation
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