Unusual Presentation of Bizarre Parosteal Osteochondromatous Lesion of the Second Toe (Nora’s Lesion)

Abstract

Bizarre parosteal osteochondromatous proliferation (BPOP) of bone is a rare benign neoplasm. This report presents the first case of BPOP associated with gangrenous changes and ulceration after remaining symptomless for 20 years. The authors hypothesize that the cause of gangrene may be attributed either to vascular occlusion due to pressure, trauma, or malignant transformation of the lesion. Although local excision of the tumor is the treatment of choice, the authors resorted to ray excision, as gangrenous changes and ulceration were present and there was the possibility of malignant change.