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Sharma R, Mahajan S, Gupta D. Aggressive Cranial Osteoblastoma of the Parietotemporo-Occipital Bone: A Case Report and Review of Literature with Special Emphasis on Recurrence/Residue. World Neurosurg 2020; 142:255-267. [PMID: 32569763 DOI: 10.1016/j.wneu.2020.06.093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/12/2020] [Indexed: 10/24/2022]
Abstract
Osteoblastoma is a rare nonfibroblastic osteoid tissue-forming primary bony tumor usually arising in the medullary cavity/diploic space of any bone. The calvarium is an extremely rare site of its origin. Clinically, 2 types of osteoblastoma are noted: benign/conventional/typical and aggressive/high grade. Their imaging features are nondifferentiating and nonspecific, histopathologic features have a few subtle but nonspecific differences, and they have highly distinct clinical behavior. We report an extremely rare case of a patient with large aggressive cranial osteoblastoma, who developed massive inoperable multifocal recurrence 15 months after total en bloc resection with wide margins. A concise review of cases of aggressive osteoblastomas involving the cranium available in the English literature is also presented as an update.
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Affiliation(s)
- Rajeev Sharma
- Department of Neurosurgery, All India Institutes of Medical Sciences, New Delhi, India.
| | - Swati Mahajan
- Department of Pathology, All India Institutes of Medical Sciences, New Delhi, India
| | - Deepak Gupta
- Department of Neurosurgery, All India Institutes of Medical Sciences, New Delhi, India
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Vlychou M, Inagaki Y, Stacey R, Athanasou NA. Primary intraosseous meningioma: an osteosclerotic bone tumour mimicking malignancy. Clin Sarcoma Res 2016; 6:14. [PMID: 27525058 PMCID: PMC4983411 DOI: 10.1186/s13569-016-0054-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 07/27/2016] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Sclerotic tumours of the calvarial bones are rare and may be due to primary and secondary bone tumours as well as extradural tumours of meningeal origin. CASE PRESENTATION We report a case of primary intraosseous meningioma (PIM) which arose in the frontal bone of a 63 year old woman who complained of progressive pain and thickening of the right skull. Radiology showed a large osteosclerotic lesion in the right frontal bone. Histology showed an intraosseous lesion containing dense fibrous tissue in which there were scattered cells that expressed epithelial membrane antigen and progesterone receptor. The tumour was partially resected and 3 years after operation has not recurred. CONCLUSIONS PIM is a rare tumour which needs to be distinguished from primary/secondary osteosclerotic calvarial bone tumours.
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Affiliation(s)
- M Vlychou
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre Windmill Road, Oxford, OX3 7HE UK
| | - Y Inagaki
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre Windmill Road, Oxford, OX3 7HE UK
| | - R Stacey
- Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals, Headley Way, Oxford, OX3 9DU UK
| | - N A Athanasou
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre Windmill Road, Oxford, OX3 7HE UK
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Kakkar A, Nambirajan A, Suri V, Sarkar C, Kale SS, Singh M, Sharma MC. Primary Bone Tumors of the Skull: Spectrum of 125 Cases, with Review of Literature. J Neurol Surg B Skull Base 2016; 77:319-25. [PMID: 27441157 DOI: 10.1055/s-0035-1570347] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/31/2015] [Indexed: 10/22/2022] Open
Abstract
AIMS Primary skull bone tumors, benign or malignant, are rare, and include a vast repertoire of lesions. These tumors are not reported systematically in the literature, with most studies being on individual entities or as single case reports. METHODS Primary bone tumors diagnosed over a period of 12 years were retrieved, histological diagnoses reviewed, and clinical parameters noted. RESULTS We identified 125 primary skull bone tumors. The mean age at diagnosis was 32 years (range: 2-65 years). Majority of patients were adults (82.4%); male preponderance was noted (72.8%). Malignant tumors were more frequent than benign tumors. Most common malignant tumor was chordoma (n = 37), while most common benign tumor was osteoma (n = 7). Tumors were most frequently located at the skull base, of which clivus was most common location. Chordomas accounted for majority of clival tumors, while chondrosarcoma predominated at other skull base locations. Benign tumors were extremely rare in skull base. Tumors of the vault bones were infrequent; with chondrosarcoma and osteoma being the most common malignant and benign tumors, respectively. CONCLUSIONS This is the largest series of primary skull bone tumors from India. Documentation of such a series will aid in approaching differential diagnosis of skull tumors in a systematic manner.
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Affiliation(s)
- Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Aruna Nambirajan
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishali Suri
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Chitra Sarkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Shashank S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Manmohan Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Mehar Chand Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Abstract
Osteoblastoma is a rare neoplasm, accounting for only 1% of the primary bone neoplasms. We report a case of periosteal osteoblastoma, a rare subtype of osteoblastoma. To the best of our knowledge, only 30 cases of periosteal osteoblastoma appear in the English literature. Our case is that of a 41-year-old male with vague intermittent knee pain over a two-year period. Diagnostic imaging revealed an aggressive-appearing lesion in the posterior distal femur, which was initially considered to be a surface osteosarcoma. Roentgenographic, CT, MRI, and bone scan features are presented.
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Pelargos PE, Nagasawa DT, Ung N, Chung LK, Thill K, Tenn S, Gopen Q, Yang I. Clinical characteristics and diagnostic imaging of cranial osteoblastoma. J Clin Neurosci 2015; 22:445-9. [DOI: 10.1016/j.jocn.2014.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 10/01/2014] [Indexed: 12/12/2022]
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Fu X, Jiang J, Luo BN, Tian XY, Li Z. Intraspinal dural-based primary osteoblastoma with aneurysmal bone cyst-like change. Neuropathology 2014; 34:510-5. [PMID: 24984761 DOI: 10.1111/neup.12131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 05/01/2014] [Indexed: 11/30/2022]
Abstract
Osteoblastoma is a benign bone-forming neoplasm that occurs commonly in the posterior elements of the spine and the sacrum. However, so far there has been no report of intradural osteoblastoma described in the literature. We present a unique case of intraspinal dural-based osteoblastoma with aneurysmal bone cyst-like change without evidence of vertebral involvement. An 11-year-old Chinese girl presented with a 3-month history of gradually progressive back pain and a weakness of both lower limbs. Thoracic MRI revealed a well-demarcated subdural mass at the T5 level with heterogeneous enhancement. Histologically, the tumor was found to be attached to the dura and composed of numerous osteoid spicules and trabecular bone with diffusely scattered osteoclast-type, multinucleated giant cells. Ectactic blood vessels and blood-filled cystic spaces were also observed. A diagnosis of primary intraspinal dural-based osteoblastoma with aneurysmal bone cyst-like change was made. To our best knowledge, this is possibly the first case of primary osteoblastoma arising from meninges. Meningeal osteocartilaginous tumors are rare, with obscure histogenesis. The differential diagnosis of osteoblastoma in unusual locations is difficult and the confirmation of diagnosis should be cautiously made. Awareness of dural-based osteoblastoma and its histological features is important to avoid a diagnostic pitfall caused by histological similarities to other intra-craniospinal lesions with osteoid differentiation or bone formation.
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Affiliation(s)
- Xinge Fu
- Department of Pathology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
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Imaging characteristics of occipital bone osteoblastoma. Case Rep Radiol 2013; 2013:930623. [PMID: 23956913 PMCID: PMC3730196 DOI: 10.1155/2013/930623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 07/02/2013] [Indexed: 11/18/2022] Open
Abstract
Osteoblastoma is a rare benign tumor of the calvarium. We present the case of a 20-year-old female with occipital osteoblastoma and discussion of imaging modalities of calvarial osteoblastoma. To our knowledge, this is the ninth reported case of occipital osteoblastoma. Imaging characterization of osteoblastoma may vary. Plain radiograph, CT, MRI, and CT angiography establish osteoblastoma characterization and vascular supply prior to surgical resection.
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Periosteal osteoblastoma of the distal femur: a case report and a review of the literature with special emphasis on the MR features. Int Cancer Conf J 2012. [DOI: 10.1007/s13691-012-0020-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Antemortem trauma and survival in the late Middle Pleistocene human cranium from Maba, South China. Proc Natl Acad Sci U S A 2011; 108:19558-62. [PMID: 22106311 DOI: 10.1073/pnas.1117113108] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Paleopathological assessment of the late Middle Pleistocene archaic human cranium from Maba, South China, has documented a right frontal squamous exocranially concave and ridged lesion with endocranial protrusion. Differential diagnosis indicates that it resulted from localized blunt force trauma, due to an accident or, more probably, interhuman aggression. As such it joins a small sample of pre-last glacial maximum Pleistocene human remains with probable evidence of humanly induced trauma. Its remodeled condition also indicates survival of a serious pathological condition, a circumstance that is increasingly documented for archaic and modern Homo through the Pleistocene.
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Huang J, Petersson F. Intracerebral metaplastic meningioma with prominent ossification and extensive calcification. Rare Tumors 2011; 3:e20. [PMID: 21769319 PMCID: PMC3132124 DOI: 10.4081/rt.2011.e20] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Revised: 04/08/2011] [Accepted: 04/15/2011] [Indexed: 12/13/2022] Open
Abstract
We present a patient (male 26 years) with a short history of recurrent seizures induced by a largely intracerebrally located frontal lobe meningioma. The tumor displayed a heretofore unpublished combination of extensive metaplastic bone formation and prominent non-psammomatous calcifications with focal chicken-wire pattern.
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Affiliation(s)
- Jingxiang Huang
- Department of Pathology, National University Health System, Singapore
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Abstract
Primary tumors of the calvarium are infrequent, and with the exception of osteoma, lesions confined to the surface of the skull are very rare. The differential diagnosis includes benign and malignant matrix forming tumors, other mesenchymal tumors, and reactive lesions. Fibro-osseous lesions are characteristically centered within bone and surface fibro-osseous lesions always prompt consideration of parosteal osteosarcoma, which is rare but well documented in the calvarium. We present 2 cases of a distinctive lesion of the temporal bone intimately related to the occipito-mastoid suture and typically presenting as a retroauricular soft tissue mass with calcific densities, confined to the soft tissues on the outer table of the skull without intraosseous involvement. The lesion is characterized histologically by rounded and ovoid zones of ossification within a bland fibrous stroma. The first 2 cases were documented in 1999 as "Protuberant fibroosseous lesion of the temporal bone.:" We present a further 2 cases, 1 of 2 years duration and the other with a 10-year history. This distinctive entity, which must be distinguished from other fibro-osseous lesions, including subtle low-grade parosteal osteosarcoma, seems to behave in a benign fashion and thus far recurrence is not documented. Local excision seems adequate. The pathologic features in the original report were documented by Prof Peter Bullough. As these cases were recognized by him alone we propose calling this entity "Bullough lesion" or, better still, "Bullough's Bump!"
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Tawil A, Comair Y, Nasser H, Hourani R, Rebeiz J, Chamoun R. Periosteal osteoblastoma of the calvaria mimicking a meningioma. Pathol Res Pract 2008; 204:413-22. [DOI: 10.1016/j.prp.2008.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Revised: 12/15/2007] [Accepted: 01/09/2008] [Indexed: 10/22/2022]
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Shang H, Trinkaus E. An ectocranial lesion on the middle Pleistocene human cranium from Hulu Cave, Nanjing, China. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2008; 135:431-7. [DOI: 10.1002/ajpa.20763] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Nielsen GP, Rosenberg AE. Update on bone forming tumors of the head and neck. Head Neck Pathol 2007; 1:87-93. [PMID: 20614288 PMCID: PMC2807498 DOI: 10.1007/s12105-007-0023-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 06/19/2007] [Indexed: 10/22/2022]
Affiliation(s)
- G. Petur Nielsen
- Department of Pathology, James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
| | - Andrew E. Rosenberg
- Department of Pathology, James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
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Mortazavi SMJ, Wenger D, Asadollahi S, Shariat Torbaghan S, Unni KK, Saberi S. Periosteal osteoblastoma: report of a case with a rare histopathologic presentation and review of the literature. Skeletal Radiol 2007; 36:259-64. [PMID: 16868789 DOI: 10.1007/s00256-006-0169-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2006] [Revised: 05/07/2006] [Accepted: 05/15/2006] [Indexed: 02/02/2023]
Abstract
Osteoblastoma is an uncommon benign bone tumor most commonly located in the vertebral column or metaphysis of a long bone. Periosteal location is rare. We report a periosteal-based osteoblastoma, arising from the proximal tibia, in a 20-year-old woman who presented with knee swelling and pain of 2-year duration. Imaging studies showed a metaphyseal surface-based lesion with patchy radiodensities. The cortico-medullary junction was intact. The lesion was totally excised. Histopathologic evaluation disclosed immature bone and osteoid deposition in a vascularized stroma, associated with numerous osteoblasts and osteoclasts rimming the bony trabeculae. Plate-like arrangements of cartilage in the margin of the neoplastic tissue were also identified. At 16 months postoperatively, the patient was well without recurrence. Although extremely unusual, the presence of cartilage does not necessarily exclude the diagnosis of osteoblastoma.
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Affiliation(s)
- S M Javad Mortazavi
- Department of Orthopedic Surgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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