Osteochondroma developing from the xyphoid appendix into an abdominal wall scar from a previous laparotomy

Giant costal osteochondroma in a man with multiple exostoses

We report the case of a 42-year-old man who presented with kyphosis resulting from a giant symptomatic costal osteochondroma around the left fourth rib. The osteochondroma on the left side of the back was 56 cm × 47 cm × 33 cm and was painful. The size and growth of the tumor suggested a malignant transformation of a large costal osteochondroma. Multiple osteochondromas were also found on the legs. The patient's family history revealed hereditary characteristics. This patient was clinically diagnosed as a case of multiple familial osteochondromatosis. Complete removal of the tumor relieved the symptoms, and histopathologic examination confirmed malignant transformation of chondrosarcoma. There was no recurrence after 16 months of follow-up.

Heterotopic ossifications in midline abdominal scars: a critical review of the literature

Heterotopic ossification (HO) is the formation of bone outside the skeletal system, including old incisions. Although a well-known complication after orthopaedic surgery, it is still considered an uncommon phenomenon after vascular surgery. Recent data, however, show that up to 25% of all patients develop HO after midline abdominal surgery. In this article, we present the case of a symptomatic HO, 7 years after an aortobiiliac prosthetic reconstruction for an abdominal aortic aneurysm. Furthermore, we review current insights into the aetiology and show bone morphogenetic proteins to play a crucial role. Treatment options are also reviewed, but lacking any supportive evidence for other therapies, surgical excision with primary closure is the treatment of choice.