Huge Bursitis and Bursal Synovial Osteochondromatosis associated with Scapular Osteochondroma Mimicking a Giant Calcific Mass of the Chest Wall: A Case Report

Osteochondroma is the most common benign bone tumor but it rarely arises from the scapula. Scapulothoracic bursitis is quite rare and osteochondroma is one of the unusual causes of this condition. Synovial chondromatosis may occur extremely uncommonly in this bursa. We reported an unusual case of scapulothoracic bursitis with synovial chondromatosis which is caused by osteochondroma. To the best of our knowledge, there is no defined chondromatosis in the scapulothoracic bursa secondary to scapular osteochondroma in the literature. An osteochondroma originating from the inner surface of the scapula can irritate this bursa and scapulothoracic bursitis may develop.1-2 Clinical manifestations are usually pain and swelling on the posterior chest wall. Patients may also declare crepitation by shoulder rotation. Ultrasonography can reveal a fluid collection between the serratus anterior muscle and chest wall. On computed tomography (CT) a hypodense, well-demarcated cystic mass may be seen at this location. Its magnetic resonance (MR) imaging features are similar to other cystic lesions. It is hypointense on T1-weighted images and hyperintense on T2-weighted images.3 Synovial chondromatosis or osteochondromatosis is a benign synovial metaplastic proliferation that occurs extremely uncommonly in bursae. When we searched "large scapulothoracic bursa chondromatosis" phrases in lliterature review of Chochran Database and Web of Science, we could not find any case reports of synovial chondromatosis in large scapulothoracic bursa. The bursal chondroid bodies appear hypointense on T1-weighted images and hyperintense on T2-weighted images but the signal intensity decreases in all sequences as the calcific or ossific component of these nodules increases. We here report an unusual case of scapulothoracic bursitis with synovial osteochondromatosis which is caused by osteochondroma. A written informed consent was taken from the patient. Corresponding author: Hayri Ogul M.D., Address: Kazim Karabekir Mah. Terminal Cad. Site Polat Apt. B Blok, Kat 1, No 2, Erzurum, Turkey, Telephone: +90 442 2361212-1521 (work), Fax: +90(442) 2361301. E-mail: drhogul@gmail.com The authors received no financial support for the research and/or authorship of this article. The authors declare that they have no conflict of interest to the publication of this article. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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