title: Florid reactive periostitis ossificans of the humerus: Case report and differential diagnosis of periosteal lesions of long bones.
abstract: A case of florid reactive periostitis ossificans (RPO) arising in a long bone is presented. This is a rare bone proliferation with a pronounced periosteal reaction. Less than 100 cases have been described in the literature with far fewer outside the bones of the hand, feet, fingers, and toes. Although the etiology is unknown, a relationship to preceding trauma is suggested. The imaging and histologic features show an overlap with other bone lesions including bizarre parosteal osteochondromatous proliferation, subungual exostosis, and malignant surface tumors of bone and cartilage which include, periosteal and parosteal osteosarcoma. It is important to recognize the clinical presentation and diagnostic features of RPO as a benign entity so that it is not mistaken for a more aggressive neoplasm. We present a case of a right distal humeral lesion that on histopathological review revealed florid RPO. This diagnosis was not suspected on imaging studies, but was made on open biopsy of the mass. The patient remains disease free, years postoperatively. In addition to presenting this unique case report, we review the pertinent literature, and offer a differential diagnosis and treatment strategy for its management.
authors: Abha Soni, Shi Wei, Gene P Siegal, R.W. Mowry, Endowed Professor of Pathology, the Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, United States.
authors: Abha
authors: A
authors: Soni
authors: Abha Soni, Shi Wei, Gene P Siegal, R.W. Mowry, Endowed Professor of Pathology, the Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, United States.
authors: Alec
authors: A
authors: Weil
authors: Abha Soni, Shi Wei, Gene P Siegal, R.W. Mowry, Endowed Professor of Pathology, the Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, United States.
authors: Shi
authors: S
authors: Wei
authors: Abha Soni, Shi Wei, Gene P Siegal, R.W. Mowry, Endowed Professor of Pathology, the Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, United States.
authors: Kenneth A
authors: KA
authors: Jaffe
authors: Abha Soni, Shi Wei, Gene P Siegal, R.W. Mowry, Endowed Professor of Pathology, the Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, United States.
authors: Gene P
authors: GP
authors: Siegal
keywords: Bizarre parosteal osteochondromatous proliferation (Nora’s lesion); Florid reactive periostitis ossificans; Periosteal and parosteal osteosarcomas; Reactive tumor-like lesions of long bones