Pediatric Osteochondrolipoma of the First Metacarpal: A Case Report and Literature Review
J. Graham Andre, Courtney Schneidau, Joseph Chang, Christopher StutzIntroduction
Osteochondrolipoma (OCL) is a rare benign soft tissue neoplasm composed of mature adipose, cartilaginous, and osseous tissue. Reports in the pediatric population are exceedingly uncommon, and the lesion is seldom included in the differential diagnosis of a hand mass in a child. We report an OCL arising adjacent to the first metacarpal in a 9‐year‐old male.
Case Presentation
A 9‐year‐old male presented with a firm, nonmobile, nontender mass overlying the dorsoradial aspect of the left first metacarpal. Radiographic evaluation demonstrated an ovoid soft tissue density with irregular central calcification. MRI demonstrated a well‐circumscribed mass with a thin hypointense capsule abutting the dorsal cortex of the first metacarpal, containing scattered foci of T1 hyperintense macroscopic fat. The mass was juxtacortical at the time of excision, in contact with the dorsal periosteum but without continuity with the underlying cortex. Histologic evaluation demonstrated mature adipose, cartilaginous, and osseous tissue, establishing the diagnosis of OCL.
Conclusion
Although rare, OCL should be included in the differential diagnosis for a slow‐growing, painless soft tissue mass in pediatric patients of all age groups. In this case, complete marginal excision resulted in an uncomplicated recovery with no evidence of recurrence at 10 weeks postoperatively; however, conclusions regarding long‐term outcomes cannot be drawn from a single case with limited follow‐up.