J Korean Soc Surg Hand.  2014 Sep;19(3):145-149. 10.12790/jkssh.2014.19.3.145.

Melorheostosis of the Trapezium

• Choi HC
• Jung JH
• Lee JY

• KMID: 2194136
• DOI: http://doi.org/10.12790/jkssh.2014.19.3.145

Abstract

We report a 56-year-old female with symptomatic protrusion of the bony lesion in the trapezium. Excision and biopsy of the bony lesion revealed thickened and sclerotic bony trabecula with adjacent zone of fibrocartilage, which is comparable with melorheostosis. This lesion with unique radiologic and histologic findings may be important to differentiate with other bony lesions such as myositis ossifications and osteosarcoma.

Keyword

Melorheostosis; Trapezium; Histology

MeSH Terms

Biopsy
Female
Fibrocartilage
Humans
Melorheostosis*
Middle Aged
Myositis
Osteosarcoma

Figure

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  Fig. 1. A 56-year-old female visited to our hospital with palpable mass in the volar aspect of left hand thenar area. Upon examination there was pain on palpation on the above mass.

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  Fig. 2. Plain radiographs showed ovoid sclerotic lesion in juxtacortical area of the trapezium and irregular eccentric bone formation along the distal radius.

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  Fig. 3. Magnetic resonance images showed low signal intensity juxta-cortical nodular lesion in the volar aspect of the trapezium.

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  Fig. 4. Hard, ovoid lesion in volar side of the trapezium was seen intraoperatively.

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  Fig. 5. Gross finding after excision. A 2.3×1.4×2.0 cm3 sized sclerotic bone lesion was seen.

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  Fig. 6. Postoperative radiographs showed complete removal of the trapezial bony lesion.

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  Fig. 7. Microscopic histology showed thickened and sclerotic bony trabecula with adjacent zone of fibrocartilage (H&E, ×40).

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  Fig. 8. Clinical follow-up showed normal function of the thenar muscles.

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