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Li Y, Wang B, Feng C, Cheng G, Luo Z. The CT and MRI features of benign calvarium and skull base osteoblastoma. Br J Radiol 2024; 97:779-786. [PMID: 38310336 PMCID: PMC11027332 DOI: 10.1093/bjr/tqae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/07/2023] [Accepted: 01/26/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVE We retrospectively reviewed the CT and MRI features of patients with benign osteoblastoma in the calvarium and skull base (CSBOB). METHODS Nine cases of pathologically confirmed benign CSBOB were analysed retrospectively. The patients had undergone CT and/or MRI. Tumour location, size, and imaging features were reviewed and recorded. RESULTS The patients included four males and five females with a mean age of 27.0 years (age 14-40 years). The tumours were located in the frontal bone in 3 patients, the occipital bone in 3 patients, and in the parietal bone, sphenoid bone, and skull base in 1 patient each. On CT, the tumours measured 5.1 ± 3.3 (1.8-8.4) cm. Seven tumours were shown to have caused expansile bony destruction with an eggshell appearance and varying degrees of calcification or matrix mineralization. Multiple septa were observed in 5 tumours. Intracranial growth was observed in 5 tumours. On MRI, 7 tumours showed heterogeneous hypo- to isointensity on T1WI. Heterogeneous high signal patterns with low signal rims and septa were observed in 6 tumours on T2WI, and 4 showed a fluid-fluid level. On contrast-enhanced imaging, 6 tumours showed peripheral and septal enhancement, and 2 showed the dural tail sign. CONCLUSIONS Benign CSBOB is a rare tumour characterized by expansile bony destruction, septa, a sclerotic rim and calcification or matrix mineralization on CT and MRI. ADVANCES IN KNOWLEDGE The findings from this study contribute to a better understanding of benign CSBOB and provide valuable imaging features that can aid in its diagnosis and differentiation from other tumours in the calvarium and skull base.
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Affiliation(s)
- Yulin Li
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Bing Wang
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Chenya Feng
- Department of Radiology, Nan fang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Guanxun Cheng
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Zhendong Luo
- Department of Radiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
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2
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Yadav SK, Rajnish RK, Jacob AM, Rao M. Chronic neck pain in a child: a case of osteoblastoma of the C5 cervical vertebra. BMJ Case Rep 2024; 17:e257171. [PMID: 38286577 PMCID: PMC10826527 DOI: 10.1136/bcr-2023-257171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
Osteoblastoma is a primary bone-forming tumour that usually occurs in the second decade with an affinity to the posterior elements when found in the spine. Its occurrence in the early first decade is uncommon and often causes a diagnostic dilemma. It usually has a late presentation and the symptoms may be non-specific which may lead the clinician to overlook this particular entity. We present a case of osteoblastoma of the posterior elements of the C5 vertebra in a pre-adolescent child who was diagnosed and successfully managed with surgical resection in a timely fashion that led to favourable recovery postoperatively.
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Affiliation(s)
- Sandeep Kumar Yadav
- Orthopedics, All India Institute of Medical Sciences Jodhpur, Jodhpur, India
| | | | - Akhil Mathew Jacob
- Orthopedics, All India Institute of Medical Sciences Jodhpur, Jodhpur, India
| | - Meenakshi Rao
- Pathology, All India Institute of Medical Sciences Jodphur, Jodhpur, India
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3
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Song GZ, Chen BY, Li YJ, Wei X. [Osteoblastoma of cervical arch:a case report]. Zhongguo Gu Shang 2024; 37:95-7. [PMID: 38286459 DOI: 10.12200/j.issn.1003-0034.20220079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Affiliation(s)
| | | | - Yong-Jun Li
- Aerospace Center Hospital, Beijing 100049, China
| | - Xing Wei
- Aerospace Center Hospital, Beijing 100049, China
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Yamaga K, Kuwamoto S, Tanishima S, Yamashita H, Asano N, Matsushita M, Akahori K, Osaki M, Hisaoka M, Nagashima H. An unresectable osteoblastoma of the axis controlled with denosumab. J Orthop Sci 2024; 29:379-383. [PMID: 35469739 DOI: 10.1016/j.jos.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/10/2022] [Accepted: 02/14/2022] [Indexed: 02/09/2023]
Affiliation(s)
- Kensaku Yamaga
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan.
| | - Satoshi Kuwamoto
- Department of Pathology, Tottori University Hospital, Yonago, Tottori, Japan
| | - Shinji Tanishima
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | | | - Naofumi Asano
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Michiko Matsushita
- Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Keiichi Akahori
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Mari Osaki
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Masanori Hisaoka
- Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Hideki Nagashima
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
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Alsabbagh BM, Alessa A, Aljohani H, Alhammad O. Large skull osteoblastoma presented as aneurysmal bone cyst (ABC). Neurosciences (Riyadh) 2023; 28:277-280. [PMID: 37844945 PMCID: PMC10827031 DOI: 10.17712/nsj.2023.4.20230060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/04/2023] [Indexed: 10/18/2023]
Abstract
Aneurysmal bone cysts (ABCs) are rare benign vascular bony lesions mostly encountered in young patients. These cysts can occur as primary lesions or, less frequently, secondary to other pathologies such as osteoblastomas. Skull ABCs are rare and can extend intracranially, presenting with hydrocephalus and bleeding. Here we illustrate the case of a 9-year-old male who presented with headache, nausea, and vomiting, without neurological deficit. Radiological investigations showed a soap-bubble lesion with mass effect over the right cerebellum. The patient underwent right sub-occipital craniotomy with marginal wide resection of the cystic lesion. The patient had excellent outcomes. The histopathological report was consistent with osteoblastoma with an aneurysmal bone cyst.
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Affiliation(s)
- Badriah M. Alsabbagh
- From the Department of Neurosurgery (Alsabbagh, Alessa, Aljohani), King Saud Medical City, from the Department of Neurosurgery (Alhammad), King Faisal Specialist Hospital & Research Centre Riyadh, Kingdom of Saudi Arabia
| | - Awn Alessa
- From the Department of Neurosurgery (Alsabbagh, Alessa, Aljohani), King Saud Medical City, from the Department of Neurosurgery (Alhammad), King Faisal Specialist Hospital & Research Centre Riyadh, Kingdom of Saudi Arabia
| | - Hanan Aljohani
- From the Department of Neurosurgery (Alsabbagh, Alessa, Aljohani), King Saud Medical City, from the Department of Neurosurgery (Alhammad), King Faisal Specialist Hospital & Research Centre Riyadh, Kingdom of Saudi Arabia
| | - Othman Alhammad
- From the Department of Neurosurgery (Alsabbagh, Alessa, Aljohani), King Saud Medical City, from the Department of Neurosurgery (Alhammad), King Faisal Specialist Hospital & Research Centre Riyadh, Kingdom of Saudi Arabia
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Bews EA, Aytek AI, Yavuz AY, Kaya EH, Savran G, Kalata M, Bethard JD. Differential diagnosis of an osseous cranial tumor from Hellenistic Muğla, Turkey. Int J Paleopathol 2023; 40:103-108. [PMID: 36724548 DOI: 10.1016/j.ijpp.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/21/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This project evaluates a cranial lesion from a Hellenistic-era individual excavated by the Muğla Archaeological Museum in Gülağzı, Turkey. MATERIALS An osseous tumor measuring 3.02 × 3.54 × 2.98 cm originating from the occipital bone of a probable young adult male. METHODS The tumor was examined using gross morphological inspection, plain radiography (x-ray), and computed tomography (CT) imaging to identify potential differential diagnoses for the osseous cranial tumor. RESULTS The lesion in question displays features highly consistent with both osteoid osteoma and osteoblastoma. The tumor had a non-sclerotic, sharply demarcated border, a radiolucent nidus measuring less than 2 centimeters in diameter, and homogeneous sclerotic bone surrounding the nidus. CONCLUSIONS Differential diagnosis determined the osseous tumor to be a benign neoplasm, and in this case the features of the tumor are highly consistent with a diagnosis of either osteoblastoma or osteoid osteoma. SIGNIFICANCE The identification of novel neoplastic cases in paleopathology represents an important contribution to ongoing discussions regarding the temporality and regional variability of neoplastic conditions in the past. Additionally, a rigorous diagnostic study augmented by x-ray, CT scans, and 3D modeling provides data that can be utilized in future paleopathological studies. LIMITATIONS Diagnostic interpretation would be aided by histological examination of the tumor, which was impossible in this case. Histological examination would provide a definitive diagnosis. SUGGESTIONS FOR FURTHER RESEARCH Given the high incidence of benign tumors in the clinical literature but a paucity of reports in the paleopathological record, further research is indicated to better understand the implications of benign neoplasms in antiquity.
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Affiliation(s)
| | | | | | | | | | - Megan Kalata
- Creighton University School of Medicine, United States
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Abstract
ABSTRACT We present a case of rib osteoblastoma in a patient with NK/T cell lymphoma. Osteoblastoma was incidentally found in a 63-year-old man in the axillary segment of the fifth rib and was misdiagnosed as lymphomatous involvement on staging 18F-FDG PET/CT. The radiological features in the CT component of PET/CT were atypical. After surgery, the diagnosis of osteoblastoma was confirmed by histopathologic findings.
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Affiliation(s)
- Pan Tang
- From the Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan
| | - Yifan Zhang
- Department of Nuclear Medicine, Qinghai Province People's Hospital, Xining, Qinghai, China
| | - Rong Tian
- From the Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan
| | - Guocai Yang
- Department of Nuclear Medicine, Qinghai Province People's Hospital, Xining, Qinghai, China
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8
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Shi YZ, Ren MS, Zhang N, Zhan YB, Zang GX, Sun HC. [The clinical and pathological analysis of osteoblastoma in the jaw: a case report]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:189-191. [PMID: 35152657 DOI: 10.3760/cma.j.cn112144-20210707-00317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Y Z Shi
- Department of Pathology, School and Hospital of Stomatology, China Medical University, Liaoning Prorincial key Laboratory of Oral Diseases, Shenyang 110002, China
| | - M S Ren
- Department of Pathology, School and Hospital of Stomatology, China Medical University, Liaoning Prorincial key Laboratory of Oral Diseases, Shenyang 110002, China
| | - N Zhang
- Department of Pathology, School and Hospital of Stomatology, China Medical University, Liaoning Prorincial key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Y B Zhan
- Department of Pathology, School and Hospital of Stomatology, China Medical University, Liaoning Prorincial key Laboratory of Oral Diseases, Shenyang 110002, China
| | - G X Zang
- Department of Pathology, School and Hospital of Stomatology, China Medical University, Liaoning Prorincial key Laboratory of Oral Diseases, Shenyang 110002, China
| | - H C Sun
- Department of Pathology, School and Hospital of Stomatology, China Medical University, Liaoning Prorincial key Laboratory of Oral Diseases, Shenyang 110002, China
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Laverde Mächler A, Suárez Fernández JP, Domínguez Grande ML, Vigil Díaz C, González García FM. Osteoblastoma of the Lumbar Spine: Findings in SPECT/CT. Clin Nucl Med 2022; 47:e87-e88. [PMID: 34238805 DOI: 10.1097/rlu.0000000000003794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Osteoblastoma is an uncommon benign osteoid tissue-forming bone tumor. We present the case of a 16-year-old adolescent boy with lower back pain that radiated down the right thigh. Lumbar MRI and CT findings were consistent with a long-standing osteoid osteoma located in the right laminae and pedicle of L3. SPECT/CT with 99mTc-DPD showed a highly increased osteogenic activity within the lesion, especially in the core region, also suggesting an osteoid osteoma. Surgical en bloc resection was performed with a final histological diagnosis of osteoblastoma.
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Affiliation(s)
- Alfredo Laverde Mächler
- From the Servicio de Medicina Nuclear, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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10
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Silveira FM, Romanini J, Pellicoli ACA, Carrard VC, Martins MAT, Martins MD. Osteoblastoma of the mandible in a male patient: a case report. Gen Dent 2021; 69:60-63. [PMID: 33661117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Osteoblastoma is a rare benign osteoblastic tumor accounting for less than 1% of all bone tumors; approximately 10% to 12% of cases occur in the maxillofacial skeleton. This case report describes the clinical, imaging, and histopathologic findings of an atypical osteoblastoma occurring in the mandible of a 60-year-old man. The characteristics of the lesion and the differential diagnosis from other bone pathoses are reviewed.
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11
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Moreno-Hoyos LF, Strassburger-Weidmann J, Castillo-Anaya V, Galindo-Agustín LO. [Osteoblastoma with atypical presentation in cuboid bone]. Acta Ortop Mex 2020; 34:422-425. [PMID: 34020524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Osteoblastoma is a benign, aggressive and rare osteoblastic tumor. Its most common location is in later elements of the spine and sacrum. The cuboid presentation is exceptional. CASE REPORT A 50-year-old male who began her condition in 2005, with pain and increased volume in the dorsolateral region of the middle foot. X-rays show bone grafting and a cuboid lesion, radiotransparent, heterogeneous, multilobed, with irregular edges that exceeds the lateral cortical. Angiotomography was performed where hypervascularized injury was observed; bone scan showed uptake of technetium 99, and MRI reported an injury with post-surgical, cystic and multilobed changes. Trans surgical biopsy was taken, increased atypia-free cellularity and few multinucleated giant cells were reported and Enneking 2 qualified. Treatment was initiated with resection of the tumor, cryotherapy, and placement of tricortical graft in the bone defect. He exhibited good post-surgical evolution. At three years of the surgical procedure, he's without tumor and asymptomatic. Although osteoblastoma does not usually occur in cuboid, it should be taken into account as a differential diagnosis. CONCLUSION Bone tumors, despite having common locations, can occur in rare areas and therefore the complete radiographic and histopathological clinical study in each patient is critical.
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Affiliation(s)
- L F Moreno-Hoyos
- Ortopedia y Traumatología, Hospital Ángeles Mocel. Ciudad de México. México
| | - J Strassburger-Weidmann
- Hospital Regional de Tlalnepantla del Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM). México
| | - V Castillo-Anaya
- Ortopedia y Traumatología, Hospital Ángeles Mocel. Ciudad de México. México
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Gahlot N, Jalan D, Elhence P. C4 cervical spine osteoblastoma associated with secondary aneurysmal bone cyst in an adolescent patient: 2-year follow-up. Spinal Cord Ser Cases 2019; 5:89. [PMID: 31700687 PMCID: PMC6821762 DOI: 10.1038/s41394-019-0233-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/26/2019] [Accepted: 10/06/2019] [Indexed: 11/08/2022] Open
Abstract
Introduction Osteoblastoma and aneurysmal bone cyst (ABC) are rare bone tumors with individual prevalence of <1%. Their combined occurrence is a rare subclass of tumors in the spinal column with only a few cases reported in literature. Case presentation The present case is a rare combination of aggressive osteoblastoma with secondary aneurysmal bone cyst masquerading as neck pain, arising from cervical C4 vertebra in a 19-year-old male. The patient presented with complaints of neck pain for 7 months, gradual in onset, dull, aching, and progressively increasing in severity. Neurological examination was normal. Radiology showed an expansile lytic mass arising from the posterior elements of C4 vertebra involving the left lateral mass. Piecemeal total removal was done and a posterior fusion from C3 to C5 was performed for stability. Histopathology confirmed the osteoblastoma with a secondary aneurysmal bone cyst. Postoperatively the patient recovered well, and no recurrence was seen on a 2-year follow-up. Discussion Simultaneous presence of an osteoblastoma with a secondary ABC arising from various bones, such as cranial fossa, ethmoid sinus, skull, and mandibular condyle, has rarely been reported. It is often diagnosed late due to nonspecific symptoms; but it has a good prognosis if early and complete resection is performed. Thorough surgical excision is always a challenge in spine cases due to surrounding important structures and meticulousness is required to prevent any recurrences. Hence, we recommend a surgical team comprising both spine and musculoskeletal oncologic surgeons to achieve best results.
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Affiliation(s)
- Nitesh Gahlot
- Department of Orthopedics, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan India
| | - Divesh Jalan
- Department of Orthopedics, Safdurjung and VMMC, New Delhi, India
| | - Poonam Elhence
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan India
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Ibebuike K, Roussot M, Watt J, Skead G, Dunn R. Diagnostic challenges and surgical management of co-existent osteoblastoma and aneurysmal bone cyst of the lumbar spine in a child: case report. Afr Health Sci 2019; 19:2294-2301. [PMID: 31656516 PMCID: PMC6794550 DOI: 10.4314/ahs.v19i2.56] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Osteoblastomas (OTB) with co-existent aneurysmal bone cysts (ABC) of the spine are extremely rare and more so in the lumbar spine. To the authors' knowledge, only one case of lumbar spine involvement has been reported in a paediatric patient. Objectives To highlight diagnostic challenges and surgical management of co-existent lumbar OTB-ACB in a child. Methods We present a 14-year old female with low back pain and progressive swelling of 2 months. She was evaluated by neuroimaging studies and histopathological assessment of resected tissue. Results X-ray showed a lytic lesion in L3 with loss of the left pedicle. Magnetic resonance imaging (MRI) revealed a fluid-filled, heterogeneously enhanced, lobulated lesion posterior to the vertebral bodies of L3, L4 and L5, which infiltrated the quadratus lumborum muscles bilaterally, and histologically diagnosed as ABC. The L3 pedicle also revealed an expanded, heterogeneously enhanced mass lesion which appeared to be different and showed no fluid-filled levels, histologically diagnosed as OTB. Surgical intervention involved tumour excision with partial spondylectomy of L3 vertebra, posterior instrumented stabilization and fusion. Conclusion The case highlights the diagnostic challenges of co-existent OTB-ABC and the significant role of surgical management via spinal reconstruction, stabilization and fusion after gross total tumour excision.
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Affiliation(s)
- Kaunda Ibebuike
- Visiting Spine Fellow, Division of Neurosurgery, Department of Surgery, Imo State University Teaching Hospital, Orlu, Nigeria
| | - Mark Roussot
- Department of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa
| | - James Watt
- Department of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa
| | - Garret Skead
- Division of Anatomical Pathology, University of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - Robert Dunn
- Department of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa
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Sonnylal L, Peterson JR, Decilveo AP, O'Connor IT, Wittig JC. Giant periosteal aggressive epithelioid osteoblastoma: 21-year-old male presents case in the midshaft of his femur. Skeletal Radiol 2018. [PMID: 29525944 DOI: 10.1007/s00256-018-2922-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We report a rare case of giant periosteal osteoblastoma in the femur of a 21-year-old male. The patient presented with a painful, firm, non-tender mass in his left thigh. The pain was worse at night and was temporarily relieved with NSAIDS. He had no fevers, night sweats, or weight loss. The patient underwent preoperative radiological studies including plain radiographs, MRI, bone scan, and CT scan. An open biopsy was subsequently performed that was consistent with an aggressive, epithelioid osteoblastoma. Pathology demonstrated a neoplasm characterized by cohesive sheets of epithelioid osteoblasts, mixed with areas of conventional osteoblastoma displaying prominent osteoblastic rimming of woven bone trabeculae in a fibrovascular stroma. The patient subsequently underwent resection, cryosurgery, fixation, and bone grafting with cortical strut allografts. At final follow-up, 32 months postoperatively, there was no evidence of local recurrence. The patient had resumed all his normal activities. He could run without pain and had no restrictions with activities. The goal of this case report is to aid professionals in the diagnosis and treatment of highly uncommon aggressive osteoblastomas.
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Affiliation(s)
- Laura Sonnylal
- John Theurer Cancer Center, Hackensack University Medical Center, 20 Prospect Avenue, Suite 501, Hackensack, NJ, 07601, USA
| | - Joel R Peterson
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | | | - Ian T O'Connor
- Georgetown University School of Medicine, Washington, D.C., USA
| | - James C Wittig
- John Theurer Cancer Center, Hackensack University Medical Center, 20 Prospect Avenue, Suite 501, Hackensack, NJ, 07601, USA.
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15
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Li X, Xin H, Yang S, Zhao M, Wang X, Zhang N. Breast osteoblastoma and recurrence after resection: Demonstration by color Doppler ultrasound. J Xray Sci Technol 2017; 25:787-791. [PMID: 28506022 DOI: 10.3233/xst-16235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Osteoblastoma is a rare benign primary bone tumor, which occurs in any part of the skeleton. Extraskeletal osteoblastoma is rather rare. We presented an extremely rare case of extraskeletal osteoblastoma located in the breast. The tumor recurred 7 months later after resection and transformed to aggressive osteoblastoma. The histopathological features, ultrasonic manifestations and ultrasonic differential diagnoses of the primary and recurrent tumors were discussed. The recommended treatment of the tumor is surgical excision. Due to its tendency of recurrence and potential malignant transformation, adequate resection and careful follow up is essential.
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Affiliation(s)
- Xia Li
- Department of Ultrasound, Shandong Provincial Hospital affiliated to Shandong University, Shandong University, Jinan, Shandong, P.R. China
| | - Hua Xin
- Department of Ultrasound, Shandong Provincial Hospital affiliated to Shandong University, Shandong University, Jinan, Shandong, P.R. China
| | - Shifeng Yang
- Department of Radiology, Shandong Provincial Hospital affiliated to Shandong University, Shandong University, Jinan, Shandong, P.R. China
| | - Miaoqing Zhao
- Department of Pathology, Shandong Provincial Hospital affiliated to Shandong University, Shandong University, Jinan, Shandong, P.R. China
| | - Ximing Wang
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China
| | - Nan Zhang
- Department of Ultrasound, Shandong Provincial Hospital affiliated to Shandong University, Shandong University, Jinan, Shandong, P.R. China
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Javed A, Hussain Shah SM. Giant Cementoblastoma Of Left Maxilla Involving A Deciduous Molar. J Ayub Med Coll Abbottabad 2017; 29:145-146. [PMID: 28712195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cementoblastoma is a relatively rare benign tumour. The clinicopathologic features, radiological findings, treatment and prognosis are reported here in a 10-year-old girl who presented to us from Afghanistan. The tumor was managed surgically and the histopathology confirmed the diagnosis of cementoblastoma. There was no evidence of recurrence at one year of follow up.
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Affiliation(s)
- Anam Javed
- Department of Oral and Maxillofacial Surgery, Ayub Teaching Hospital Abbottabad, Pakistan
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17
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Traoré O, Chban K, Hode AF, Diarra Y, Salam S, Ouzidane L. [Interest of imaging in tumors benign bone in children]. Pan Afr Med J 2016; 24:179. [PMID: 27795776 PMCID: PMC5072874 DOI: 10.11604/pamj.2016.24.179.9920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 06/08/2016] [Indexed: 11/15/2022] Open
Abstract
Benign bone tumors are more common than malignant tumors in pediatrics. The exostosis (ostéchondrome) is the most common. The different imaging techniques are pivotal in the study of tumors including its standard radiography. The aim of this work is to highlight the interest in imaging the diagnostic management of bone benign tumors in children through a retrospective study of 169 patients. All patients were investigated by plain radiography, scanner supplement with multiplanar reconstruction before and after injection of PDC and / or MRI 1. 5 Tesla was performed according to the indication. The average age is 6 years with a slight male predominance. Clinically, the swelling is present in 35% of cases. The pain in 29% of cases. The most common location is the metaphyseal long bone on: Femur: 25% of cases, humerus: 17% of cases, Tibia: 21% of cases. Main Benign tumors are found exostosis (20. 12%), bone cyst (31. 95%) and osteoblastoma (16, 57%). The imagery is used to specify the topography and extension of the lesion in the bone provide arguments in favor of benign and sometimes in favor of the cause of the injury. The only standard radiograph often provides a diagnosis of certainty in some cases.
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Affiliation(s)
- Ousmane Traoré
- Service de Radiologie Pédiatrique, Hôpital d'enfant CHU Ibn Rochd, Casablanca, Maroc
| | - Kamilia Chban
- Service de Radiologie Pédiatrique, Hôpital d'enfant CHU Ibn Rochd, Casablanca, Maroc
| | - Alzavine Fleur Hode
- Service de Radiologie Pédiatrique, Hôpital d'enfant CHU Ibn Rochd, Casablanca, Maroc
| | - Yaya Diarra
- Service de Radiologie Pédiatrique, Hôpital d'enfant CHU Ibn Rochd, Casablanca, Maroc
| | - Siham Salam
- Service de Radiologie Pédiatrique, Hôpital d'enfant CHU Ibn Rochd, Casablanca, Maroc
| | - Lachen Ouzidane
- Service de Radiologie Pédiatrique, Hôpital d'enfant CHU Ibn Rochd, Casablanca, Maroc
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Kraft CT, Morrison RJ, Arts HA. Malignant transformation of a high-grade osteoblastoma of the petrous apex with subcutaneous metastasis. Ear Nose Throat J 2016; 95:230-233. [PMID: 27304442 PMCID: PMC4911809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
We describe the clinical presentation, management, and pathologic findings in a case of osteosarcoma of the petrous apex with an atypical metastasis to the lower abdominal wall. We retrospectively reviewed the record of a 49-year-old man who was diagnosed with a right petrous apex lesion, which biopsy identified as a high-grade osteoblastoma. After two attempts at en bloc resection were not curative, radiation and chemotherapy were recommended. The patient subsequently developed a cutaneous lower abdominal mass that was diagnosed as an osteosarcoma. Meanwhile, the petrous apex tumor continued to grow despite treatment until the patient died from the burden of disease. Temporal bone osteoblastomas and osteosarcomas are both extremely rare, and they can be difficult to differentiate histologically. Our case illustrates this difficulty and demonstrates the possibility of a high-grade osteoblastoma's malignant conversion to an osteosarcoma.
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Affiliation(s)
- Casey T Kraft
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, 1904 Taubman Center, 1500 E. Medical Center Dr., SPC 5312, Ann Arbor, MI 48109-5312, USA
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Affiliation(s)
- Seok Won Kim
- Department of Neurosurgery, Chosun University Hospital, Gwangju, Korea
| | - Hyun-Sook Kim
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
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Li Z, Zhao Y, Hou S, Mao N, Yu S, Hou T. Clinical features and surgical management of spinal osteoblastoma: a retrospective study in 18 cases. PLoS One 2013; 8:e74635. [PMID: 24058612 PMCID: PMC3776745 DOI: 10.1371/journal.pone.0074635] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 08/04/2013] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate the clinical manifestation and surgical outcome of spinal osteoblastoma. METHODS From June 2006 to July 2011, 18 patients with spinal osteoblastoma treated surgically were analyzed retrospectively. There were 11 males and 7 females with an average age of 27.5 years(range, 16-38 years). The tumors were located at C5 in 7, C6 in 6, C7 in 3, C6-T1 1 in 1 and T11 in 1. Based on WBB classification, 16 were 1-3 or 10-12 and 2 were 4-9 and 1-3. 18 operations had been performed with en bloc resection. A posterior approach was used for 16 patients, and a combined posterior and anterior approach was used for 2 patients. Reconstruction using instrumentation and fusion was performed using spinal instrumentation in 13 patients. We used visual analogue scales (VAS) to evaluate the change of pain before and after the operation, and the McCormick System to assess functional status of the spine. Imaging test was used to review the stability and recurrence rate of spine cord, and the confluence of graft bones. RESULTS All cases were followed up for 24-80 months (average, 38.4 months). The average surgical time was 120.8 minutes (range, 80-220 minutes), with the average intraoperative blood loss of 520 ml (range, 300-1200 ml). During the follow-up period, the VAS grade reduced from 6.46±1.32 to 2.26±1.05 (P <0.05). 15 patients had neurological function improved and 3 remained no change which was evaluated by McCormick scale for spinal function status at final follow-up. CONCLUSIONS Spinal osteoblastoma has its own specific radiographic features. There is some recurrence in simple curettage of tumor lesion. The thoroughly en bloc resection of tumor or spondylectomy, bone fusion and strong in Ter fixation are the key points for successful surgical treatment.
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Affiliation(s)
- Zhonghai Li
- Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, Beijing, the People’s Republic of China
| | - Yantao Zhao
- Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, Beijing, the People’s Republic of China
| | - Shuxun Hou
- Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, Beijing, the People’s Republic of China
| | - Ningfang Mao
- Department of Orthopaedics, First Affiliated Hospital of PLA Second Military Medical University, Shanghai, the People’s Republic of China
| | - Shunzhi Yu
- Department of Orthopaedics, First Affiliated Hospital of PLA Second Military Medical University, Shanghai, the People’s Republic of China
| | - Tiesheng Hou
- Department of Orthopaedics, First Affiliated Hospital of PLA Second Military Medical University, Shanghai, the People’s Republic of China
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Nortjé CJ. Maxillo-facial radiology case 109. Benign osteoblastoma. SADJ 2013; 68:130. [PMID: 23951777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- C J Nortjé
- Faculty of Dentistry, University of the Western Cape.
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Abstract
Osteoblastoma occurring in the region of the hip is very rare, and vague symptoms with uncharacteristic radiographic features often lead to misdiagnosis. Because of radiographic and histological similarities, it must be carefully distinguished from osteoid osteoma, aneurysmal bone cyst, giant cell tumor, and osteosarcoma. Computed tomography is the preferred imaging modality as it is able to detect the nidus and images will not exhibit the flare phenomenon caused by surrounding inflammation seen with magnetic resonance imaging. For hip joint lesions in weight-bearing areas, intralesional curettage may achieve satisfactory outcomes as compared with wide resection. We herein report two cases of osteoblastoma in the hip region in which diagnosis was delayed that were successfully treated with curettage and followed by high-speed burring.
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Affiliation(s)
- Chen-Yuan Yang
- Therapeutical and Research Center of Musculoskeletal Tumor, Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Abstract
CASE REPORT We report the case of a 9-year-old female patient with a moderate swelling of the right maxilla. A tumor was diagnosed by conventional X-ray within the region of tooth 17 in the right tuber maxillae. The histological diagnosis after biopsy of the lesion was "fibrous dysplasia Jaffe-Lichtenstein". One year later, the tumor was still growing, and computed tomography was carried out. The first histological diagnosis was confirmed by another biopsy; the differential diagnosis was "ossifying fibroma". In the following years, the tumor grew and expanded into the right orbit and maxilla. Four years after the first diagnosis the tumor was removed operatively. DIFFERENTIAL DIAGNOSIS OF THE OPERATIVE SPECIMEN The histology showed round, partially trabecular or calcified bodies, known as psammoma-like ossicles. Therefore, in light of the clinical course and the radiographic appearance, the correct diagnosis was "psammous desmo-osteoblastoma". DISCUSSION The psammous desmo-osteoblastoma and its differential diagnosis are discussed in this article.
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Affiliation(s)
- C P Adler
- Referenzzentrum für Knochenkrankheiten, Pathologisches Institut, Universität Freiburg im Breisgau
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Mait JE, Perino G, Unnanuntana A, Chang TL, Doty S, Schneider R, Lane JM. Multimodality treatment of a multifocal osteoblastoma-like tumor of the lower extremity. Skeletal Radiol 2012; 41:1153-61. [PMID: 22327394 DOI: 10.1007/s00256-011-1345-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 12/07/2011] [Accepted: 12/09/2011] [Indexed: 02/02/2023]
Abstract
Osteoblastoma-like tumor is a rare condition with limited information on its orthopedic management in the current medical literature. The tumor histologically resembles an osteoblastoma, although the radiographic features are similar to those observed in primary vascular lesions. The treatment in the previously reported cases involved aggressive procedures including amputation, en bloc resection, and chemotherapy because of the uncertainty regarding the biological behavior of the tumor. We present a case of this entity that was successfully treated by a combination therapy including intralesional curettage with adjuvant cryotherapy, in situ and intravenous administration of bisphosphonates and radioablation.
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Affiliation(s)
- Jeffrey E Mait
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
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25
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Li ZH, Ma H, Fu Q, Hou TS. [Clinical manifestation and surgical treatment of spinal osteoblastoma]. Zhonghua Wai Ke Za Zhi 2012; 50:110-114. [PMID: 22490346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To investigate the clinical manifestation and surgical outcome of spinal osteoblastoma. METHODS From June 2006 to July 2010, 11 patients with spinal osteoblastoma treated surgically were analyzed retrospectively. There were 7 males and 4 females with an average age of 23.5 years (range, 16 - 34 years). The tumors were located at C(5) in 3, C(6) in 4, C(7) in 2, C(6) ~ T(1) in 1 and T(11) in 1. Based on WBB classification, 9 were 1 - 3 or 10 - 12 and 2 were 4 - 9 and 1 - 3. All the operations had been performed with en-bloc resection. The posterior approach was used for 9 patients, and combined posterior and anterior approach was used for 2 patients. Reconstruction using instrumentation and fusion was performed using spinal instrumentation in 8 patients. To evaluate the change of pain before and after the operation by visual analogue scales (VAS), and to assess functional status of the spine by McCormick scale. Imaging test was used to review the stability and recurrence rate of spine cord, and the confluence of graft bones. RESULTS All cases were followed up for 12 - 64 months (average, 28.4 months). The average surgical time was 130.5 minutes (range, 90 - 210 minutes), with the average intraoperative blood loss of 560 ml (range, 300 - 1000 ml). During the follow-up period, the VAS grade reduced from 6.3 ± 1.1 to 2.5 ± 1.0 (t = 8.48, P < 0.05). There were 8 patients had neurological function improved and 3 remained no change which was evaluated by McCormick scale for spinal function status at final follow-up. CONCLUSIONS Spinal osteoblastoma has its own specific radiographic feature. There are some recurrence in simple curettage of tumor lesion. The thoroughly en-bloc resection of tumor or spondylectomy, bone fusion and strong in ter fixation are the key points for successful surgical treatment.
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Affiliation(s)
- Zhong-hai Li
- Department of Orthopaedics, Changhai Hospital, Shanghai 200433, China
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Kaner T, Sasani M, Oktenoglu T, Aydin S, Ozer AF. Osteoid osteoma and osteoblastoma of the cervical spine: the cause of unusual persistent neck pain. Pain Physician 2010; 13:549-554. [PMID: 21102967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The most important symptom in patients with osteoid osteoma and osteoblastoma is a resistant localized neck pain and stiffness in the spine. OBJECTIVE To evaluate and analyze 6 cases of osteoid osteoma and osteoblastoma of the cervical spine that were surgically treated over a 7-year period and to emphasize the unusual persistent neck pain associated with osteoid osteoma and osteoblastoma of the cervical spine. STUDY DESIGN Retrospective study. METHODS Six patients, 3 male and 3 female, with a mean age of 21 years (range 16-31) diagnosed with osteoid osteoma or osteoblastoma during 2003 to 2009 were analyzed retrospectively. The preoperative neurological and clinical symptoms, neck pain duration, preoperative deformity, location of lesion, radiological findings, surgical technique and clinical follow-up outcomes of each patient were evaluated. RESULTS The average follow-up duration was 40.5 months (range, 19 to 83 months). Three patients had osteoid osteoma (2 female and one male), and 3 patients had osteoblastoma (one female and 2 male). Two male patients had recurrent osteoblastoma. The locations of the lesions were as follows: C7 (2 patients), C3 (one patient), C2 (one patient), C3-C4 (one patient) and C5-C6 (one patient). The most common symptom was local neck pain in the region of the tumor. Among all patients, only one patient, who had osteoblastoma, had neurological deficits (right C5-C6 root symptoms). The other patients had no neurological deficits. All patients were treated with surgical resection using microsurgery. Two patients underwent only tumor resection, one patient underwent tumor resection and fusion, and the other 3 patients underwent tumor resection, fusion and spinal instrumentation. No perioperative complications developed in any of our patients. There was no tumor recurrence during the follow-up period. LIMITATIONS A retrospective study with 6 analyses of cases. CONCLUSION Surgical treatment of osteoid osteoma and osteoblastoma of the spine has been standardized. The most common symptom of osteoid osteoma and osteoblastoma of the cervical spine is local persistent neck pain in the region of the tumor. This symptom can be significant in the diagnosis of these tumors.
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28
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Noujeim M, Nasseh I. [Unusual mandibular osteolysis]. Rev Stomatol Chir Maxillofac 2010; 111:241-243. [PMID: 20817201 DOI: 10.1016/j.stomax.2010.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 09/15/2009] [Accepted: 07/12/2010] [Indexed: 05/29/2023]
Affiliation(s)
- M Noujeim
- Programme de spécialité en radiologie orale et maxillofaciale, Health Science Center at San Antonio, University of Texas, San Antonio, Texas, USA.
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29
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Affiliation(s)
- Frank Kandziora
- Berufsgenossenschaftliche Unfallklinik Frankfurt, Frankfurt, Germany.
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30
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Abolghasemian M, Rezaie M, Behgoo A, Shoushtarizadeh T, Ghazavi MT. Exostosis-like intra-articular periosteal osteoblastoma: a rare case. Am J Orthop (Belle Mead NJ) 2010; 39:E50-E53. [PMID: 20631934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Osteoblastoma is a relatively rare benign bone tumor, most often located in the vertebral column or metaphysis of the long bones, particularly the femur and the tibia. Periosteal osteoblastoma is the least common type. Exostosis-like appearance is not common even in periosteal osteoblastoma, a very rare type of this tumor. In addition, an intraarticular location is uncommon for osteoblastomas. Here we report the case of a 25-year-old man with intra-articular exostosis-like periosteal osteoblastoma of the hip that resulted in impingement and osteoarthritis.
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Affiliation(s)
- Mansour Abolghasemian
- Division of Hip Surgery, Shafa Rehabilitation Hospital, Iran University of Medical Sciences, Tehran, Iran. mn.abolghasemi@ yahoo.com
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Abstract
Osteoblastoma is a rare bone tumor that usually affects the vertebrae. We present the first known case of osteoblastoma arising in the hyoid bone, in a patient who presented with a neck mass and dysphagia. The radiographic appearance of the tumor is similar to that of low-grade chondrosarcoma, with well-defined expansion of the bone and central chondroid matrix.
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Affiliation(s)
- C M Rivera-Serrano
- Department of Otolaryngology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15215, USA
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33
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Arpino L, Gragnaniello C, Nina P, Franco A. Limited approach to a thoracic spine osteoblastoma. J Neurosurg Sci 2008; 52:123-125. [PMID: 18981987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Osteoblastoma (OB) is a rare primary benign bone tumor. It generally occurs in the axial skeleton, where it preferentially involves the neural arch. The peak incidence of this neoplasm is in the first two decades of life. Female/male ratio is 2:1. It is important to differentiate OB from osteoid osteoma, a very similar bone tumor. Neuroradiological imaging are diagnostics in most of the cases. This article describes a 18-year-old female affected from a thoracic osteoblastoma stemming from T9 lamina and extending to T11, with a diameter of about 2.5 cm. The patient complained of dorsal pain with progressive weakness to lower limbs. A dorsal approach was performed with a right partial T9 and T11 right laminectomy with total T10 right laminectomy. The mass was totally removed by a limited approach, with no consequent instability and no reason for any stabilization. OB is rare benign bone neoplasm that generally affect the posterior elements of the spine. Surgery is the treatment of choice in this kind of lesions: total removal is effective with no recurrence. When the lesion is placed in the cervical and thoracic spine the goal is to decompress spinal cord and reach the stability of the spine.
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Affiliation(s)
- L Arpino
- Department of Neurosurgery, San Giovanni Bosco Hospital, and Second University of Naples, Naples, Italy.
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34
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Smith ER, Loeffler J, Misra M, Pomerantz SR, Stemmer-Rachamimov A, Post MD. Case records of the Massachusetts General Hospital. Case 37-2008. A 17-year-old boy with a pituitary tumor and skull abnormalities. N Engl J Med 2008; 359:2367-77. [PMID: 19038883 DOI: 10.1056/nejmcpc0806983] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Edward R Smith
- Department of Neurosurgery, Children's Hospital of Boston, USA
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35
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Saglik Y, Atalar H, Yildiz Y, Basarir K, Gunay C. Surgical treatment of osteoblastoma : a report of 20 cases. Acta Orthop Belg 2007; 73:747-753. [PMID: 18260488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Osteoblastoma is a locally aggressive osteoblastic lesion of bone with rare malignant transformation. We retrospectively evaluated 20 patients who were diagnosed and surgically treated for osteoblastoma in our institution. Their mean age was 22.5 years (range: 10 to 34). The most frequent location was in the posterior elements of the spine, followed by the long bones of the extremities and the talus. Intralesional curettage was the most common modality of treatment; it was used in 11 patients, with a 13% recurrence rate. This series demonstrates that osteoblastoma may be locally aggressive and may recur after removal. Although it is usually treated successfully with curettage, wide excision should be considered along with careful follow-up over the long term owing to the possibility of recurrence or malignant transformation.
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Affiliation(s)
- Yener Saglik
- Department of Orthopaedic Surgery and Traumatology, Ankara University School of Medicine, Ankara, Turkey
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Abstract
We describe the clinical, radiologic, and pathologic features of 26 osteoblastomas with a multinodular growth pattern (defined as multiple nidi in a single tumor) and primarily epithelioid-appearing cells. Clinical information and histologic slides for all 26 patients and radiologic studies for 9 were examined. Follow-up information was obtained from medical charts at our institution and from correspondence with pathologists who submitted cases in consultation. Of the 23 patients with osteoblastoma whose sex had been recorded, 18 were male and 5 were female (median age, 17.8 y). The most common site was the jawbones, although long bones were also involved. Radiologic studies suggested a benign lesion in 5 patients, a malignant lesion in 2, and indeterminate features in 2. Histologically, the tumors appeared to be multiple nodules of epithelioid cells, most with a lacy, blue-bone matrix. Frequently, there were sheets of cells with no matrix. Follow-up information was obtained for 14 of the 23 patients. One patient died in an automobile accident; all others were alive as long as 29 years after treatment. Epithelioid osteoblastomas mimic osteosarcoma because of similar cellularity and cytologic features. Although follow-up is limited, we are cautiously optimistic that these are benign lesions.
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Affiliation(s)
- Renée Zon Filippi
- Division of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905, USA
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Jolette J, Wilker CE, Smith SY, Doyle N, Hardisty JF, Metcalfe AJ, Marriott TB, Fox J, Wells DS. Defining a noncarcinogenic dose of recombinant human parathyroid hormone 1-84 in a 2-year study in Fischer 344 rats. Toxicol Pathol 2007; 34:929-40. [PMID: 17178693 DOI: 10.1080/01926230601072301] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The carcinogenic potential of human parathyroid hormone 1-84 (PTH) was assessed by daily subcutaneous injection (0, 10, 50, 150 microg/kg/day) for 2 years in Fischer 344 rats. Histopathological analyses were conducted on the standard set of soft tissues, tissues with macroscopic abnormalities, selected bones, and bones with abnormalities identified radiographically. All PTH doses caused widespread osteosclerosis and significant, dose-dependent increases in femoral and vertebral bone mineral content and density. In the mid-and high-dose groups, proliferative changes in bone increased with dose. Osteosarcoma was the most common change, followed by focal osteoblast hyperplasia, osteoblastoma, osteoma and skeletal fibrosarcoma. The incidence of bone neoplasms was comparable in control and low-dose groups providing a noncarcinogenic dose for PTH of 10 microg/kg/day at a systemic exposure to PTH that is 4.6-fold higher than for a 100 microg dose in humans. The ability of PTH to interact with and balance the effects of both the PTH-1 receptor and the putative C-terminal PTH receptor, may lead to the lower carcinogenic potential observed with PTH than reported previously for teriparatide.
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Affiliation(s)
- Adonios Zanglis
- St. Savas Oncology Hospital, Nuclear Medicine Department, Athens, Greece.
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Trübenbach J, Nägele T, Bauer T, Ernemann U. Preoperative embolization of cervical spine osteoblastomas: report of three cases. AJNR Am J Neuroradiol 2006; 27:1910-2. [PMID: 17032864 PMCID: PMC7977911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Our aim was to describe the technique and clinical results of preoperative embolization of cervical spine osteoblastomas. We treated 3 patients with these tumors with transarterial embolization and subsequent surgical excision. In all 3 patients, distal access to the tumor-supplying vessels was gained with a microcatheter and embolization was performed with polyvinyl alcohol particles. No complications occurred. Surgical resection was performed in all patients without relevant bleeding. The postoperative course was uneventful in all patients. Preoperative embolization is a valuable adjunct to the surgical treatment of osteoblastomas of the cervical spine.
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Affiliation(s)
- J Trübenbach
- Department of Neuroradiology, University Hospital, Tübingen, Germany.
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Abstract
PURPOSE This study was conducted to evaluate the diagnostic usefulness of gray level parameters in order to distinguish healthy bone from osteoblastic metastases on digitized radiographs. MATERIALS AND METHODS Skeletal radiographs of healthy bone (n = 144) and osteoblastic metastases (n = 35) were digitized using pixels 0.175 mm in size and 4,096 gray levels. We obtained an optimized healthy bone classification to compare with pathological bone: cortical, trabecular, and flat bone. The osteoblastic metastases (OM) were classified in nonflat and flat bone. These radiological images were analyzed by using a computerized method. The parameters (gray scale) calculated were: mean, standard deviation, and coefficient of variation (MGL, SDGL, and CVGL, respectively) based on gray level histogram analysis. Diagnostic utility was quantified by measurement of parameters on healthy and pathological bone, yielding quantification of area under the receiver operating characteristic (ROC) curve, AUC. RESULTS All three image parameters showed high and significant values of AUC when comparing healthy trabecular bone and nonflat bone OM, showing MGL the best discriminatory ability (0.97). As for flat bones, MGL showed no ability to distinguish between healthy and flat bone OM (0.50). This could be achieved by using SDGL or CVGL, with both showing a similar diagnostic ability (0.85 and 0.83, respectively). CONCLUSION Our results show that the use of gray level parameters quantify healthy bone and osteoblastic metastases zones on digitized radiographs. This may be helpful as a complementary method for differential diagnosis. Moreover, our method will allow us to study the evolution of osteoblastic metastases under medical treatment.
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Affiliation(s)
- Angel González-Sistal
- Department of Physiological Sciences II, Faculty of Medicine, University of Barcelona, C/ Feixa Llarga s/n Pavelló de Govern, Lab. 41.57, 08907 Hospitalet de Llobregat, Barcelona, Spain.
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Abstract
We describe a unique case of an osteoblastoma in the cricoid cartilage of a 50-year-old man who presented with hoarseness and progressive dyspnea. Panendoscopic examination revealed a reddish tumor at the left side of the cricoid cartilage. Computed tomography (CT) imaging showed a sclerotic lesion involving the cricoid cartilage, protruding in the airway lumen. The tumor was removed via an external procedure. Histology confirmed the diagnosis of osteoblastoma.
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Takahashi T, Oguchi M, Kuga G, Higashi K, Tonami H, Yamamoto I, Segami N, Nojima T. Osteoblastic Osteosarcoma of the Mandible: Findings on Tc-99m HMDP Bone and Ga-67 Citrate Scintigraphy. Clin Nucl Med 2005; 30:608-9. [PMID: 16100479 DOI: 10.1097/01.rlu.0000174201.42679.0c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 25-year-old woman presented with a disturbance in the opening of her mouth 5 months before admission. On admission, painful swelling of the right preauricular region was revealed. Computed tomography (CT) demonstrated a soft tissue density mass around the right condylar process of the mandible. Tc-99m hydroxymethylene diphosphonate (HMDP) bone scintigraphy and Ga-67 citrate scintigraphy showed avid uptake in the mass. The tumor was histologically identified as an osteoblastic osteosarcoma of the right mandible. There are few reports of Ga-67 citrate scintigraphy findings of osteoblastic osteosarcoma of the mandible. The accumulation patterns on Tc-99m HMDP bone scintigraphy and Ga-67 citrate scintigraphy are possibly characteristic of osteoblastic osteosarcoma of the mandible.
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Affiliation(s)
- Tomoko Takahashi
- Department of Radiology, Kanazawa Medical University, Ishikawa, Japan.
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Rawal YB, Angiero F, Allen CM, Kalmar JR, Sedghizadeh PP, Steinhilber AM. Gnathic osteoblastoma: clinicopathologic review of seven cases with long-term follow-up. Oral Oncol 2005; 42:123-30. [PMID: 16129654 DOI: 10.1016/j.oraloncology.2005.04.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2005] [Accepted: 04/25/2005] [Indexed: 11/16/2022]
Abstract
The clinical, radiographic and histopathologic features of seven cases of osteoblastoma of the jaw bones were analyzed. The mandible was involved in six cases and a periosteal presentation of the tumor was noted in three cases. Six tumors were symptomatic with pain being the common presentation. The radiographic appearance of the intraosseous tumors varied from well-defined radiolucencies to poorly-defined mixed lesions. A small periosteal tumor was undetectable radiographically. Histopathologically, the tumors exhibited variation in woven bone formation, osteoblastic rimming, lesional maturation as well as interaction of the tumor with surrounding host tissue. Intraosseous tumors were managed with aggressive surgical curettage and periosteal tumors were resected and the underlying bone was curetted down to normal host bone. Follow-up of cases ranged from 2 years to 18 years with no recorded recurrences. Gnathic osteoblastomas offer a unique diagnostic challenge as they resemble other tumors of the jaws including the cementoblastoma, cemento-ossifying fibroma, cemento-osseous dysplasia and most importantly the gnathic osteosarcoma. We stress on the need to correlate the histopathologic findings with clinical and radiographic features to reach an accurate diagnosis.
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Affiliation(s)
- Yeshwant B Rawal
- Department of Oral and Maxillofacial Pathology, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
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Papagelopoulos PJ, Savvidou OD, Mavrogenis AF, Galanis EC, Shaughnessy WJ, Unni KK, Sim FH. Lateral malleolus en bloc resection and ankle reconstruction for malignant tumors. Clin Orthop Relat Res 2005:209-18. [PMID: 16056051 DOI: 10.1097/01.blo.0000164356.99795.a2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
UNLABELLED Four children and six adults required en bloc resection of the lateral malleolus for malignant tumors. There were four osteosarcomas, three chondrosarcomas, two Ewing's sarcomas, and one adamantinoma. Surgical margins were wide in seven patients, marginal in two, and intralesional in one. A primary ankle arthrodesis was done in four adults and bracing without any reconstruction was done in four children and two adults. During a mean followup of 14.5 years (range, 3-30 years), there were two local recurrences (two of 10 patients) after a marginal excision and an intralesional excision. One patient had reoperation for a skip osteosarcoma lesion in the proximal fibula. Other complications included chronic osteomyelitis, a lateral talus subluxation and cavovarus deformity, and recurrent ankle instability and degenerative changes of the ankle. At the latest followup, all 10 patients showed no evidence of disease. Five patients who had primary or late ankle arthrodesis had a Musculoskeletal Tumor Society and International Society of Limb Salvage functional score of 28 points (92%), and two adolescents who had postoperative bracing alone had a functional score of 24 points (80%). The three remaining patients had a salvage amputation. LEVEL OF EVIDENCE Therapeutic study, Level IV (case series--no, or historical control group). See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Eun Ja Lee
- Myongji Hospital, Kwandong University, Koyang-City 412-270, Korea
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47
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Klonowski S, Klatka J, Szymański M. [Giant osteoma of the ethmoid and frontal sinuses]. Otolaryngol Pol 2005; 59:899-901. [PMID: 16521461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The authors present a case of a huge osteoma of the ethmoid and frontal sinuses. An operative technique enabling radical removal without fragmentation of the tumor with preservation of the bony margins of the fronto-orbital region was presented.
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Affiliation(s)
- Stanisław Klonowski
- Katedra i Klinika Otolaryngologii i Onkologii Laryngologicznej AM w Lublinie
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Alvares Capelozza AL, Gião Dezotti MS, Casati Alvares L, Negrão Fleury R, Sant'Ana E. Osteoblastoma of the mandible: systematic review of the literature and report of a case. Dentomaxillofac Radiol 2005; 34:1-8. [PMID: 15709098 DOI: 10.1259/dmfr/24385194] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Benign osteoblastoma is a bone tumour that seldom occurs in the facial bones. The objective of this article is to add one more case of this rare lesion to the academic literature and to provide a systematic review of previously published cases. A new case of benign osteoblastoma is presented and clinical, radiographic and microscopic aspects, as well as differential diagnosis, treatment and follow-up are discussed. The importance of the correct diagnosis of this type of lesion is stressed, since it presents a clinical, radiographic and microscopic similarity to other bone lesions, including malignant tumours, which may lead the professional into conducting the case in an improper manner.
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Affiliation(s)
- A L Alvares Capelozza
- Stomatology Department, Bauru Dentistry School, University of São Paulo, Bauru, São Paulo, Brazil
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Capodiferro S, Maiorano E, Giardina C, Lacaita MG, Lo Muzio L, Favia G. Osteoblastoma of the mandible: Clinicopathologic study of four cases and literature review. Head Neck 2005; 27:616-21. [PMID: 15880408 DOI: 10.1002/hed.20192] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Osteoblastoma is a benign bone tumor accounting for 1% of all bone tumors; it commonly involves the spine and the sacrum of young individuals, with less than 5% being localized to the posterior mandible. In view of its rarity in the maxilla and mandible, osteoblastoma is rarely diagnosed as such in the absence of interdisciplinary cooperation. METHODS A retrospective study of four benign osteoblastomas was performed based on a review of the clinical, radiographic, and histopathologic features of all cases. RESULTS The tumors involved the posterior mandible of young patients (age range, 10-21 years; two male and two female patients) and appeared as painful bone expansions. Radiologically, they were poorly defined, radiolucent/radiopaque lesions containing calcifications and not showing sclerotic borders or periosteal reactions. Histologically, they were composed of osteoid and woven bone surrounded by plump osteoblast-like cells with interposed fibroblasts, inflammatory cells, and red blood cells. All patients were disease free after prolonged follow-up. CONCLUSIONS Osteoblastomas may be distinguished from other bone tumors, fibro-osseous lesions, and odontogenic neoplasms on the basis of integrated clinical, radiologic, and histologic features and usually manifest an indolent clinical course.
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Abstract
BACKGROUND CONTEXT Osseous spinal tumors are an uncommon cause of persistent axial pain and muscle spasm, but even benign lesions may grow to cause deformity or neurological signs. Traditional treatment approaches to resection can be debilitating even when the tumor is benign. PURPOSE Emerging technologies allow surgeons to diagnose and treat osseous neoplasms while minimizing the collateral damage caused by surgical exposure and tumor excision. STUDY DESIGN Technical considerations are presented through two cases of benign osseous neoplasm occurring in the cervicothoracic spine of competitive athletes, demonstrating the meth-ods used to provide effective treatment while maintaining maximal functional capacity. METHODS Stereotactic imaging and intraoperative guidance was used as an adjunct to tumor care in these patients. Used in combination with minimally invasive, microsurgical techniques,stereotactic guidance localized and verified excision margins of benign vertebral lesions, minimizing soft tissue trauma and collateral damage. RESULTS Computer-assisted stereotactic localization allowed us to successfully ablate these lesions from their anatomically challenging locations, without disrupting the shoulder girdle or neck musculature, and without extensive bony resection. CONCLUSIONS Image guidance can accurately localize and guide excision of benign vertebral lesions while minimizing soft tissue trauma and collateral damage, allowing patients a rapid and complete return to high-demand function.
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Affiliation(s)
- Timothy Moore
- Department of Orthopedic Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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