Bizarre Parosteal Osteochondromatous Proliferation of Long Bones: Two New Cases and Literature Study
Bibliographic record
Abstract
In research on tumors of mesenchymal origin, although the type localized in the short, tubular bones has been evaluated in detail, there have been no reports to date regarding the clinical, radiological and treatment characteristics of the type localized in the long bones. In this study, Nora’s lesions localized in the long bones were investigated in terms of their characteristics and behavior. An extensive literature review was performed using PubMed, MEDLINE (1983 - 2012) and Google Scholar. Search terms included ‘‘bizarre parosteal osteochondromatous proliferation’’ (BPOP) and ‘‘Nora’s lesion’’. The literature search yielded 88 articles and a total of 43 patients. The median age of the cases was 26 years. BPOP occurred with equal frequency in men and women. The most frequent sites of involvement were the femur (25%) and the ulna (23%). Plain radiographs of 20 cases were available, but only a small number of cases had CTs (n = 11) and MRIs (n = 12) performed. It was determined that 66% of the lesions led to cortical changes, while 23.5% led to medullary invasion or soft tissue infiltration. As to treatments, “simple excision” (intralesional) was performed on seven lesions, marginal resection was performed in nine patients, wide resection was performed in two patients, “shark-bite” surgery was performed in one patient and “shave excision” was performed in one patient. The mean follow-up period was 30.9 months. Local recurrence rate was 18.75%. Clinically and in terms of radiological images, we believe that this lesion observed in the long bones consists of four phases: stages I, II, III and IV. We believe this type of lesion demonstrates no spontaneous recovery, and that it is a progressive lesion involving cortical destruction and medullary infiltration. As such, we consider marginal resection to be the appropriate technique for treating this lesion. J Med Cases. 2014;5(6):315-325 doi: https://doi.org/10.14740/jmc1624w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.009 | 0.005 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.004 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".