Bizarre parosteal osteochondromatous proliferation: Nora's lesion

The purpose of this study was to review the imaging and anatomopathologic findings and to discuss the main differential diagnosis of bizarre parosteal osteochondromatous proliferation [BPOP] or Nora's lesion, a rare benign surface lesion of the bone. Histologically confirmed plain radiographs, ultrasound, CT and MRI images of four patients with BPOP were obtained and retrospectively reviewed. Three cases involving the hand and one involving the foot are reported. On plain radiographs, BPOP is a well-marginated, calcified or ossified mass arising directly from the cortical surface of the underlying bone. Ultrasound images show a low echoic peripheral cap around the lesion. CT images show the wide base of the lesion. On MRI, BPOP was of a low signal on T1, enhancing following gadolinium administration. Underlying bone and adjacent surrounding soft tissues were normal

Streptococcus bovis endocarditis: Clinical, Echocardiographic and prognostic features.

The aim of this study was to determine clinic and echocardiographic characteristics of Streptococcus bovis endocarditis [El] and its prognosis. We studied the clinic and echocardiographic characteristics of 54 patients with a Streptococcus bovis El among 350 cases of El. We included 44 men and 10 women, 64 +/- 15 years of age, with a native valvular disease in 31.5% of cases and a valvular prosthesis in 13%. 74% had a worsened general state; 48% presented with signs of cardiac insufficiency. 12 patients [22%] were followed for cancer including 7 digestive colic localizations [confirmed by coloscopy and histology]. Vegetation was identified in all patients. It was a left localization in 98.1%. Vegetation diameter was>10 mm in 37 patient s [68.5%] and>20 mm in 9 patients [16%]. During the follow-up, 59.3% developed an embolic accident, 17 cases of CVA and 7 cases of spondylodiscitis [7 out of 11 cases of spondylodiscitis described in the 350 cases of El]. Mortality reached 7%. The statistical analysis showed that Streptococcus Bouis was the major predictive factor for embolic complications, especially for spondylodiscitis. Streptococcus bovis El is more frequent in patients with digestive colic neoplasia. It is characterized by large vegetation which has a high embolic potential worsening the prognosis

[Desmoid tumor of shoulder-Girdle]

Desmoid tumour is an uncommon connective tissue tumour arising from musculoaponevrotic tissue characterized by spindle cell fibroblast and myofibroblast proliferation. Although considered as a benign lesion, it can be very aggressive locally, and has a high rate of local recurrences afer surgical excision. The cause is unknown and it most often encountered in young women. Abdominal localization is the most frequent site. Extra-abdominal desmoid tumors particularly located in the girdles or the most proximal part of the limbs. We report a case of a 31 year old woman with desmoid with tumour of the scapular region which was treated with wide excision, but in the following year the tumour reccured locally of the shoulder-girdle and infiltrated into the brachial plexus. Nevertheless, surgical treatment of recurrent tumors is difficult and often insufficient, compromising functional outcome. Radiotherapy has been advocated for better control tumor growth