[01] Josphine Jenifer P., PG Department of Bioscience, CMR Institute of Management Studies, OMBR Layout, Banasawadi, Bangalore, Karnataka, India. [02] Narendra Nixon, PG Department of Bioscience, CMR Institute of Management Studies, OMBR Layout, Banasawadi, Bangalore, Karnataka, India. [03] Priyanka S., PG Department of Bioscience, CMR Institute of Management Studies, OMBR Layout, Banasawadi, Bangalore, Karnataka, India. [04] Amrit Rai, PG Department of Bioscience, CMR Institute of Management Studies, OMBR Layout, Banasawadi, Bangalore, Karnataka, India. [05] Seshadri B., PG Department of Bioscience, CMR Institute of Management Studies, OMBR Layout, Banasawadi, Bangalore, Karnataka, India. [06] Anusha K., PG Department of Bioscience, CMR Institute of Management Studies, OMBR Layout, Banasawadi, Bangalore, Karnataka, India. [07] Vasu R., PG Department of Bioscience, CMR Institute of Management Studies, OMBR Layout, Banasawadi, Bangalore, Karnataka, India. [08] Ravi Theaj Prakash U., PG Department of Bioscience, CMR Institute of Management Studies, OMBR Layout, Banasawadi, Bangalore, Karnataka, India. [09] Ramakrishnan M., PG Department of Bioscience, CMR Institute of Management Studies, OMBR Layout, Banasawadi, Bangalore, Karnataka, India.

Osteochondromas are the rare benign and malignant tumour of the growing bone, usually affecting the young adults. Solitary osteocartilaginous exostosis is more common than the hereditary multiple exostosis (HME). The first 3 decades of life has maximum chances of getting affected with osteochondroma and hardly occurs in craniofacial bones because of the fact that these bones are not formed by endochondral ossification. Most of the symptoms occur at the periphery of the bone tissues, with causes of osteochondroma being unknown. It involves in genetic condition and is associated with mutations of EXT1 or EXT2 genes. Diagnosis is difficult at symptomless stage, incidentally it is diagnosed when X-ray is carried out. Detection of tumor by ultra sound is accurate than other diagnosis process. No treatment is required other than regular monitoring of tumor. Standard allele specific PCR based techniques on osteochondroma showing both recombine and intact alleles were reported. The observation shows that osteochondroma complicated clonal growth is due to EXT-1-null chondrocytes, variation in the percentage of lacZ genes and researchers recommended that narrow follow ups are required for further developmental analysis with absolute certainty. In this review, a report on research and developments of osteochondroma is discussed with authors suggestions.

Bone deformity, Bone Morphogenic Proteins, Gene mutation, Multiple Hereditary Exostosis, Osteochondroma, Solitary Hereditary Exostosis

[01] Kitsoulis, P., Galani, V., Stefanaki, K., Paraskevas, G., Karatzias, G., Agnantis, J. N, and Bai, M. (2008). Osteochondromas: Review of the Clinical, Radiological and Pathological Features. In Vivo. vol. 22 (5), pp. 633–646. [02] Hameed, S., Nak, M. A., Safderi., H. and Rao, S. K. (2011). Prepubertal Presentation of Solitary Osteochondroma of Thoracic Spine– A Case Report. Malaysian Orthopaedic Journal. vol. 5(2), pp. 34-36. [03] Shim, H. J., Park, K. C., Shi, H. S., Jeong, H. S. and Hwang, H. J. (2012). Solitary osteochondroma of the twelfth rib with intraspinal extension and cord compression in a middle-aged patient. BioMed Central Musculoskeletal Disorders. vol. 13(57), pp. 1-6. [04] Fukunaga, S., Futani, H. and Yoshiya, S. (2007). Endoscopically assisted resection of a scapular osteochondroma causing snapping scapula syndrome. World Journal of Surgical Oncology. vol. 5(37), pp. 1-7. [05] Bovée G. M. V. J. (2010). EXTra hit for mouse osteochondroma. Proceedings of the National Academy of Sciences (PNAS). vol. 107 (5), pp. 1813–1814. [06] Watura, C. and Patel, S. (2012). Unusual presentation of more common disease/injury-Osteochondroma mimicking deep vein thrombosis in a young cricketer. BioMed Central Case Reports. pp. 1-3. [07] Grivas, B. T., Polyzois, D. V., Xarchas, K., Liapi, G. and Korres, D. (2005). Seventh cervical vertebral body solitary osteochondroma. Report of a case and review of the literature. European Spine Journal. vol.14, pp. 795–798. [08] Natale, M., Rotondo, M, Avanzo, D. R. andScuotto, A. (2013). CASE REPORT Solitary lumbar osteochondroma presenting with spinal cord compression. British Medical Journal (BMJ) Case Report. pp. 1-4. [09] Cory, M., Czajka, M. D., Matthew, R. and DiCaprio, M. D. (2015). What is the Proportion of Patients With Multiple Hereditary Exostoses Who Undergo Malignant Degeneration? Clinical Orthopaedics and Related Research. vol.473, pp. 2355–2361. [10] Kevin, B. and Jones, M. D. (2011). Glycobiology and the Growth Plate: Current Concepts in Multiple Hereditary Exostoses. Journal of Pediatric Orthopaedics. vol. 31 (5), pp. 577–586. [11] Xia, P., Xu, H., Shi, Q. and Li, D. (2016). Identification of a novel frameshift mutation of the EXT2 gene in a family with multiple osteochondroma. ONCOLOGY LETTERS. vol.11, pp. 105-110. [12] Ashraf, A., Larson, A. N., Wetjen, M. N., Guidera, J. K., Ferski, G. and Mielke, H. C. (2013). Spinal stenosis frequent in children with multiple hereditary exostoses, Journal of Children's Orthopaedics. vol.7, pp. 183–194. [13] Bottner, F., Rodl, R., Kordish, I., Winklemann, W., Gosheger, G. and Lindner, N. (2003). Surgical treatment of symptomatic osteochondroma. A three-to eight-year follow- up study. Journal of Bone and Joint Surgery. vol.85, pp. 1161-1165. [14] Bovée, G. M. V. J. and Hogendoorn, P. C. W. (2008). Multiple Osteochondromas. Orphanet Journal of Rare Diseases, vol. 3(3), pp. 1-7. [15] Wicklund, C. L., Pauli, R. M., Johnston, D. and Hecht, J. C. (1995). Natural history study of hereditary multiple exostoses. American Journal of Medical Genetics, vol. 55, pp. 43–46. [16] Bozzola, M., Gertosio, C., Gnoli, M., Baronio, F., Pedrini, E., Meazza, C. and Sangiorgi, L. (2015). Hereditary multiple exostoses and solitary osteochondroma associated with growth hormone deficiency: to treat or not to treat?. Italian Journal of Pediatrics, vol. 41(53), pp. 1-6. [17] Hongo, H., Oya, S., Abe, A. and Matsui, T. (2015). Solitary Osteochondroma of the Skull Base: A Case Report and Literature Review. Journal of Neurological Surgery Reports, vol. 76(1), pp. 13–17. [18] Pannier, S. and Legeai-Mallet, L. (2008). Hereditary multiple exostoses and enchondromatosis. Best Practice & Research Clinical Rheumatologyvol. 22(1), pp. 45-54. [19] Kadu, V., Saindane, A., Goghate, N. andGoghate. N. (2015). Osteochondroma of the Rib: a rare radiological appearance. Journal of Orthopaedic Case Reports, vol. 5 (1), pp. 62-64. [20] Rosa. B., Campos, P., Barros, A., Karmali, S., Ussene, E., Durão, C., Silva, D. A. J. and Coutinho, N. (2016). Spinous Process Osteochondroma as a Rare Cause of Lumbar Pain. Case Reports in Orthopedics, vol. 2016 (2016), pp. 1-4. [21] Gaetani, P., Tancioni, F., Merlo, P., Villani, L., Spanu, G. and Baena, R. R. (1996). Spinal chondroma of the lumbar tract: case report. Surgical Neurology, vol. 46 (6), pp. 534–539. [22] Peterson, H. A. (1989). Multiple hereditary osteochondromata. Clinical Orthopaedics and Related Research, vol. 239, pp. 222-230. [23] Adullah, F., Kanard, R., Femino, D., Ford, H. and Stein, J. (2006). Osteochondroma causing diaphragmatic ruputure and bowel obstruction in a 14 years old boy. Pediatric Surgery International, vol. 22, pp. 401-403. [24] Arai, T., Akiyama, Y., Nagasaki, H., Murase, N., Okabe, S., Ikeuchi, T., Saito, K., Iwai, T. and Yuasa, Y. (1999). EXTL23/EXTR1 alternations in colorectal cancer cell lines. International Journal of Oncology, vol. 15, pp. 915-919. [25] Clement, N. D., Duckworth, A. D, Baker, A. D. and Porter, D. E. (2012). Skeletal growth patterns in hereditary multiple exostoses: a natural history. Journal of pediatric orthopedics. Part B, vol. 21, pp. 150-154. [26] Wicklund, L. C., Pauli, R. M, Johnston, D. and Hecht, J. T. (1995). Natural history study of hereditary multiple exostoses. American Journal of Medical Genetics, vol. 55, pp. 43-46. [27] Cañete, P. M. D., Fontoira, M. E., José, S. G. B. and Mancheva, M. S. (2013). Osteochondroma: radiological diagnosis, complications and variants. Revista Chilena de Radiologia, vol. 19 (2), pp. 73-81. [28] Mark, D., Murphey, D. M., Choi, J. J., Kransdorf, J. M., Flemming, D. J. and Gannon, H. F. (2000). Imaging of Osteochondroma: Variants and Complications with Radiologic-Pathologic Correlation. AFIP ARCHIVES, vol. 20 (5), pp. 1407-1434. [29] Purandare, N. C., Rangarajan, V., Agarwal, M., Sharma, A. R., Shah, S., Arora, A. and Parasar, D. S. (2009). Integrated PET/CT in evaluating sarcomatous transformation in osteochondromas. Clinical Nuclear Medicine, vol. 34(6), pp. 350-354. [pubmed] [30] Malghem, J., Berg, B. V., Noel, H. and Maldague, B. (1992). Benign osteochondromas and exostoticchondro sarcomas: evaluation of cartilage cap thickness by ultrasound. Skeletal Radiology, vol. 21, pp. 33-37. [31] Sakamoto, A., Tanaka, K., Matsuda, S., Harimaya, K. and Iwamoto, Y. (2002). Vascular compression caused by solitary osteochondroma: useful diagnostic methods of magnetic resonance angiography and Doppler ultrasonography. Journal of Orthopaedic Science, vol. 7 (4) pp. 439-443. [32] Natale, M., Rotondo, M., D'Avanzo, R. and Scuotto,A., (2013), Solitary lumbar osteochondroma presenting with spinal cord compression, British Medical Journal (BMJ) Case Report, Vol. 2013 (2013), pp. 1-4. [33] Wirganowicz, P., Watts, Z. and Hugh, G. (1997). Surgical risk for elective excision of benign exostoses (tumors). Journal of Pediatric Orthopaedics, vol.17, pp. 455-459. [34] Sharipo, F., Simon S. and Glimcber, M. J. (1979). Hereditary multiple exostoses. Anthropometric, Roentgenographic, and clinical aspects. The Journal of Bone & Joint Surgery, vol. 61, pp. 815-824. [35] Canella, P., Gardin, F. and Borriani, S. (1981). Exostosis: development, evolution and relationship to malignant degeneration. Italian journal of orthopaedics and traumatology, Vol. 7, pp. 293-298. [36] Ohnishi, T., Horii, E., Shukuki, K. andHattori, T.(2011). Surgical Treatment for Osteochondromas in Pediatric Digits. Journal of hand surgery, vol. 36(3), spp. 432-438. [37] Landi, A., Rocco, P., Mancarella,C., Tarantino, R. and Raco, A.(2012). Malignant transformation of cervical ostochondroma in patient with hereditary multiple exostoses (HME): Case report and review of the literature. Journal of Solid Tumors, vol. 2(3) pp. 63-70. [38] Kumar, M., Malgonde, M. and Jain, P. (2014). Osteochondroma Arising from the Proximal Fibula: A Rare Presentation. Journal of Clinical and Diagnostic Research. Vol. 8(4) pp. 1-3. [39] Herrera-Perez, M., Mendoza, D. A. M., Bergua-Domingo, D. M. J, and Pais-Brito, L. J. (2013), Osteochondromas around the ankle: Report of a case and literature review. International Journal of Surgery Case Reports, Vol. 4(11), pp. 1025–1027. [40] King, A. E., Hamstra, A. D., Li, Y., Hanauer. A. D., C. hoi, W. S., Jong. N., Farley, AF. and Caird, S. M. (2014); Osteochondromas After Radiation for Pediatric Malignancies: A Role for Expanded Counseling for Skeletal Side Effects. Journal of Pediatric Orthopaedics, vol.34 (3), pp. 331–335. [41] Cuellar, A., Inui, A., James, A. M., Borys. M. and Reddi, H. A. (2014). Immunohistochemical Localization of Bone Morphogenetic Proteins (BMPs) and their Receptors in Solitary and Multiple Human Osteochondromas, Journal of Histochemistry & Cytochemistry, vol. 62(7), pp. 488–498. [42] Cuellar, A. and Reddi, H. (2013). Cell biology of osteochondromas: Bone morphogenic protein signalling and heparansulphates. International Orthopaedics Journal (International Society of Orthopaedic Surgery and Traumatology) vol. 37, pp. 1591–1596. [43] Mazur, D. M., Mumert. L. M. and Schmidt, H. M. (2015). Treatment of costal osteochondroma causing spinal cord compression by costotransversectomy: case report and review of the literature. Clinics and Practice Journal, vol. 5(734), pp. 40-43. [44] Andrea, D. E. C., Kroon, M. H., Wolterbeek, R., Romeo, S., Rosenberg, E. A., Young, D. R. B., Liegl, B., Inwards, Y. C., Hauben, E., McCarthy, F. E, Idoate, M., Nicholas, A., Athanasou, A. N. and Jones, B. K. (2012). Interobserver Reliability in the Histopathological Diagnosis of Cartilaginous Tumors in Patients with Multiple Osteochondromas. Modern Pathology Review, vol. 25(9), pp. 1275–1283. [45] Sciubba, M. D., Macki, M., Germscheid, M. B., Wolinsky, P. J., Boriani, S., Bettegowda, C., Chou, D., Luzzati, A., Reynolds, J. J., Szövérfi, Z., Zadnik, P., Rhines, D. L., Gokaslan, L. Z., Fisher, G. C., Varga, P. P., Hogendoorn, W. C. P and Bovée, G. M. V. J. (2015). Long-term outcomes in primary spinal osteochondroma: a multicenter study of 27 patients. Journal of Neurosurgery: Spine, vol, 22 (6), pp. 582–588. [46] Matsumotoa, K., Iriea, F., Mackemb, S. and Yamaguchia, Y. (2010),A mouse model of chondrocyte-specific somatic mutation reveals a role for Ext1 loss of heterozygosity in multiple hereditary exostoses. Proceedings of the National Academy of Sciences (PNAS), vol. 107 (24), pp. 10932 – 10937. [47] Davis, L. D. and Mulligan, E. M. (2015. Osteochondroma-Related Pressure Erosions in Bony Rings Below the Waist. The Open Orthopaedics Journal, vol. 9, pp. 20-524. [48] Toepfer, A., Pohlig, F., Mühlhofer, H., Lenze, F., Rothe, E. V. R. and Lenze, U. (2013). A popliteal giant synovial osteochondroma mimicking a parosteal osteosarcoma. World Journal of Surgical Oncology, vol. 11(241), pp. 1-7. [49] Sakamoto, (2013). Usage of a Curved Chisel When Resecting Osteochondroma in the Long Bone. Clinics in Orthopedic Surgery, vol. 5, pp. 87-88. [50] Hajji, R., Jiber, H., Zrihni, Y., Zizi, O. Bouarroum, A. (2013), Case report Intraoperative rupture of popliteal artery pseudo aneurysm secondary to distal femur osteochondroma: case report and review of the literature, Pan African Medical Journal. pp. 1-3. [51] Niu, F. X., Yi. H. J., Hu, J. and Xiao, B. L. (2015) Chronic radial head dislocation caused by a rare solitary osteochondroma of the proximal radius in a child: a case report and review of the literature. BioMed Central Research Notes, vol. 8: 131, pp. 1-4. [52] Kuraishi, K., Hanakita, J., Takahashi, T., Watanabe, M. and Honda, F., (2014). Symptomatic Osteochondroma of Lumbosacral Spine: Report of 5 Cases. Neurologia medico-chirurgica Journal (Tokyo), vol. 54, pp.408–412. [53] Scott, E, M., White, F. J. and Jennings, P, E. (1995), Popliteal vein thrombosis associated with Femoral osteochondroma and popliteal artery pseudoaneurysm. pp. 441-442. [54] Panagopoulos, I., Bjerkehagen, B., Gorunova, L., Taksdal, L. and Heim, S. (2015). Rearrangement of chromosome bands 12q14~15 causing HMGA2-SOX5 gene fusion and HMGA2 expression in extraskeletal osteochondroma. ONCOLOGY REPORTS, vol. 34, pp, 577-584. [55] Pal, P. and Chatterjee, G. (2015). Giant Solitary Osteochondroma of Iliac Crest - a Case Report. [56] International Journal of Scientific Research (IJSR), vol. 5: 3, pp. 199-201.