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Medical Science Monitor : International... Jun 2023BACKGROUND This retrospective study aims to compare the efficacy of computed tomography-guided percutaneous excision and radiofrequency ablation in the treatment of...
BACKGROUND This retrospective study aims to compare the efficacy of computed tomography-guided percutaneous excision and radiofrequency ablation in the treatment of osteoid osteoma. MATERIAL AND METHODS We evaluated 40 patients with osteoid osteoma who underwent either percutaneous excision or radiofrequency ablation between 2012 and 2015. The cohort consisted of 10 female and 30 male patients, with a mean age of 15.1 years (range: 4-27 years) and a mean follow-up time of 19.02 months (range: 11-39 months). Percutaneous excision was performed in 20 patients, while radiofrequency ablation was performed in the remaining 20 patients. RESULTS The success rates of percutaneous excision and radiofrequency ablation were comparable, with unsuccessful outcomes observed in 10% and 5% of patients, respectively. The reasons for failure in the percutaneous excision group were attributed to a marking error and incomplete excision of the wide-based nidus. Complications were limited to pathological fracture (n=1) and deep infection (n=1) in the percutaneous excision group, while no complications were encountered in the radiofrequency ablation group. CONCLUSIONS Both percutaneous excision and radiofrequency ablation demonstrate high success rates in treating osteoid osteoma. However, radiofrequency ablation offers the advantage of a quicker return to daily activities without the need for activity restrictions or splints. While being a more cost-effective option, percutaneous excision should be considered cautiously to minimize potential complications.
Topics: Humans; Male; Female; Adolescent; Bone Neoplasms; Retrospective Studies; Osteoma, Osteoid; Catheter Ablation; Radiofrequency Ablation
PubMed: 37349982
DOI: 10.12659/MSM.940292 -
The Journal of Craniofacial SurgeryOsteoid osteomas are benign bony overgrowths that can occur in any region of the body. However, they have a predilection to occur in the craniofacial region. Because of...
IMPORTANCE
Osteoid osteomas are benign bony overgrowths that can occur in any region of the body. However, they have a predilection to occur in the craniofacial region. Because of the rarity of this entity, there is a lack of literature detailing the management and prognosis of craniofacial osteoid osteomas.
OBSERVATIONS
Craniofacial osteomas have a predilection to involve the paranasal sinuses, but can also be found within the jaw, skull base, and facial bones. Because of their slow-growing nature, craniofacial osteomas are often incidentally discovered on routine imaging or after they compress nearby structures or distort nearby anatomy. Osteoid osteomas of the face can be treated with resection via various approaches. Recent advancements describe minimally invasive endoscopic techniques and adjuvant therapy with radiofrequency ablation guided by cone biopsy computed tomography. Osteoid osteomas have an excellent prognosis with complete resection. They demonstrate a low incidence of recurrence when compared with other osteoblastic lesions of the craniofacial structures.
CONCLUSIONS AND RELEVANCE
Craniofacial osteoid osteomas remain a developing topic within the field of craniofacial surgery. Their removal may be trending toward minimally invasive techniques. However, all treatment modalities appear to result in improved cosmetic outcomes and low recurrence rates.
Topics: Humans; Osteoma, Osteoid; Osteoma; Paranasal Sinuses; Endoscopy; Treatment Outcome; Bone Neoplasms
PubMed: 37253237
DOI: 10.1097/SCS.0000000000009395 -
Virchows Archiv : An International... Jan 2020Bone tumours are difficult to diagnose and treat, as they are rare and over 60 different subtypes are recognised. The emergence of next-generation sequencing has partly... (Review)
Review
Bone tumours are difficult to diagnose and treat, as they are rare and over 60 different subtypes are recognised. The emergence of next-generation sequencing has partly elucidated the molecular mechanisms behind these tumours, including the group of bone forming tumours (osteoma, osteoid osteoma, osteoblastoma and osteosarcoma). Increased knowledge on the molecular mechanism could help to identify novel diagnostic markers and/or treatment options. Osteoid osteoma and osteoblastoma are bone forming tumours without malignant potential that have overlapping morphology. They were recently shown to carry FOS and-to a lesser extent-FOSB rearrangements suggesting that these tumours are closely related. The presence of these rearrangements could help discriminate these entities from other lesions with woven bone deposition. Osteosarcoma is a malignant bone forming tumour for which different histological subtypes are recognised. High-grade osteosarcoma is the prototype of a complex karyotype tumour, and extensive research exploring its molecular background has identified phenomena like chromothripsis and kataegis and some recurrent alterations. Due to lack of specificity, this has not led to a valuable novel diagnostic marker so far. Nevertheless, these studies have also pointed towards potential targetable drivers of which the therapeutic merit remains to be further explored.
Topics: Bone Neoplasms; Gene Rearrangement; Genes, p53; Genetic Predisposition to Disease; Humans; Osteoblastoma; Osteoma; Osteoma, Osteoid; Osteosarcoma; Retinoblastoma Protein
PubMed: 31741049
DOI: 10.1007/s00428-019-02683-w -
European Journal of Orthopaedic Surgery... Dec 2020Intra- and juxta-articular osteoid osteoma (OO) is rare and can result in irreversible joint damage. Recently, arthroscopic surgery is being used more and more to avoid... (Review)
Review
BACKGROUND
Intra- and juxta-articular osteoid osteoma (OO) is rare and can result in irreversible joint damage. Recently, arthroscopic surgery is being used more and more to avoid complications associated with other treatment modalities.
METHODS
On October 13, 2019, we conducted a systematic review of the literature available in PubMed and EMBASE regarding the arthroscopic management of OO involving the joints of the upper extremity. Predetermined inclusion criteria were used to include any relevant article published on and before that date for further analysis. Treatment success rate and tumor recurrence rate were considered the primary outcomes in our analysis.
RESULTS
Out of 113 studies, 19 met our inclusion criteria. Of the 32 reported cases in these 19 articles, ten involved the shoulder joint, 19 involved the elbow joint and three involved the wrist joint. Overall treatment success rate was 93.8%. Tumor recurrence rate was 0.0%. No postoperative complications (0.0%) were reported among cases involving the shoulder joint. Two out of 24 (8.3%) patients with elbow OO failed arthroscopic treatment due to incomplete excision, and two (4%) experienced minor complications. Among the three cases of wrist OO, two (66.7%) patients had residual postoperative pain and decreased hand grip strength.
CONCLUSION
Arthroscopic management of OO of the upper extremity joints is highly successful and results in no tumor recurrence; however, there is a risk of incomplete resection in areas more difficult to access by arthroscopy.
Topics: Arthroscopy; Bone Neoplasms; Elbow; Hand Strength; Humans; Neoplasm Recurrence, Local; Osteoma, Osteoid
PubMed: 32504238
DOI: 10.1007/s00590-020-02710-6 -
La Revue Du Praticien May 2018
Topics: Bone Neoplasms; Humans; Osteoma, Osteoid; Tomography, X-Ray Computed
PubMed: 30869419
DOI: No ID Found -
The Journal of Bone and Joint Surgery.... Mar 2019The etiology of hip pain in pediatric and adolescent patients can be unclear. Osteoid osteoma (OO) about the hip in children has only been described in case reports or...
BACKGROUND
The etiology of hip pain in pediatric and adolescent patients can be unclear. Osteoid osteoma (OO) about the hip in children has only been described in case reports or small studies. The present study assessed the clinical presentation and diagnostic course, imaging, and treatment approaches in a large cohort of pediatric cases of OO about the hip.
METHODS
Medical record and imaging results were reviewed for all cases of OO identified within or around the hip joint in patients <20 years old between January 1, 2003, and December 31, 2015, at a tertiary-care pediatric center. Demographic, clinical, and radiographic data were analyzed.
RESULTS
Fifty children and adolescents (52% female; mean age, 12.4 years; age range, 3 to 19 years) were identified. Night pain (90%) and symptom relief with nonsteroidal anti-inflammatory drugs (NSAIDs) (88%) were common clinical findings. Sclerosis/cortical thickening was visible in 58% of radiographs, although a radiolucent nidus was visible in only 42%. Diagnostic imaging findings included perilesional edema and a radiolucent nidus on 100% of available magnetic resonance imaging (MRI) and computed tomography (CT) scans, respectively. Initial alternative diagnoses were given in 23 cases (46%), the most common of which was femoroacetabular impingement (FAI). Delay in diagnosis of >6 months occurred in 43% of patients. Three patients underwent operative procedures for other hip diagnoses, but all had persistent postoperative pain until the OO was treated. Of the 41 patients (82%) who ultimately underwent radiofrequency ablation (RFA), 38 (93%) achieved complete post-RFA symptom resolution.
CONCLUSIONS
Initial misdiagnosis, the most common of which was FAI, and delayed correct diagnosis are common in pediatric OO about the hip. Presenting complaints were variable and nonspecific MRI findings were frequent. Night pain and relief with NSAIDs were present in the vast majority of cases. CT scans provided definitive diagnosis in all patients who received them. As increasing numbers of young, active patients are being evaluated for various causes of hip pain, such as FAI, OO should not be overlooked in the differential diagnosis.
LEVEL OF EVIDENCE
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Topics: Adolescent; Arthralgia; Bone Neoplasms; Child; Child, Preschool; Female; Humans; Magnetic Resonance Imaging; Male; Osteoma, Osteoid; Pelvic Bones; Radiofrequency Ablation; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 30893229
DOI: 10.2106/JBJS.18.00888 -
Acta Bio-medica : Atenei Parmensis Jan 2018Osteoid osteoma is a benign bone neoplasm with a reported incidence of 2-3% among all bone primary tumors. Although it is a small and benign lesion, it is often cause of... (Review)
Review
Osteoid osteoma is a benign bone neoplasm with a reported incidence of 2-3% among all bone primary tumors. Although it is a small and benign lesion, it is often cause of patient complaint and discomfort. It is generally characterized by a long lasting, unremitting pain that typically exacerbates at night, often leading to sleep deprivation and functional limitation of the skeletal segment involved, with a significant reduction of patient daily life activities and consequent worsening of the overall quality of life. Over decades, complete surgical resection has represented the only curative treatment for symptomatic patients. In the last years, new percutaneous ablation techniques, especially radiofrequency ablation, have been reported to be a safe and effective alternative to classical surgery, with a low complication and recurrence rate, and a significant reduction in hospitalization cost and duration. The aim of this article is to provide an overview about the radiofrequency thermal ablation procedure in the treatment of osteoid osteoma.
Topics: Bone Neoplasms; Humans; Imaging, Three-Dimensional; Magnetic Resonance Imaging, Interventional; Osteoma, Osteoid; Radiofrequency Ablation; Radiography, Interventional
PubMed: 29350646
DOI: 10.23750/abm.v89i1-S.7021 -
Journal of Orthopaedic Surgery and... Dec 2022Scoliosis behavior after curettage of spinal osteoid osteoma has been not clarified as most studies regarding scoliosis secondary to osteoid osteoma (OO) were case...
BACKGROUND
Scoliosis behavior after curettage of spinal osteoid osteoma has been not clarified as most studies regarding scoliosis secondary to osteoid osteoma (OO) were case reports. The aims of this study were to investigate (1) clinical and radiographic features of scoliosis secondary to OO; (2) scoliosis behavior after Curettage of OO.
METHODS
A retrospective study was performed at patients who were diagnosed as OO clinically or pathologically from July 1998 to December 2019 in a single institution. Age, gender, location of pain, location of lesion and curve pattern of scoliosis were collected preoperatively. Intraoperative blood loss, operation time and surgical complications were documented. VAS scores and curve magnitude were collected pre- and postoperatively and at last follow-up.
RESULTS
The mean operation time was 124 ± 32 min and the average intraoperative blood loss was 274 ± 134 ml. The mean preoperative VAS score was 6.2 ± 2.7, and the mean postoperative VAS score was 2.1 ± 1.8. Thoracic scoliosis was improved from 22.7 ± 10.6° to 6.2 ± 4.3° after operation, and to 4.1 ± 4.3° at last follow-up. Lumbar scoliosis was improved from 18.1 ± 7.4° to 6.7 ± 5.2° after operation, and to 5.3 ± 3.9° at last follow-up. Trunk shift was improved from 34.7 ± 12.4 to 10.5 ± 7.2 mm after operation, and to 8.4 ± 5.6 mm at last follow-up. There was no significant differences as to sagittal radiographic parameters (P > 0.05).
CONCLUSION
Patients with spinal OO had a significantly high incidence of scoliosis. Patients could get rapid relief of pain and scoliosis with low occurrence. Night pain, pain at the concave side of curve, normal sagittal alignment could help differentiate it from scoliosis associated with lumbar disc herniation.
Topics: Humans; Retrospective Studies; Blood Loss, Surgical; Scoliosis; Osteoma, Osteoid; Pain; Bone Neoplasms
PubMed: 36503626
DOI: 10.1186/s13018-022-03423-8 -
Journal of Clinical Medicine Jun 2021Pediatric benign osteocytic tumors include osteoma, enostosis, osteoid osteoma, and osteoblastoma. In pediatric populations, benign bone tumors are more common than... (Review)
Review
Pediatric benign osteocytic tumors include osteoma, enostosis, osteoid osteoma, and osteoblastoma. In pediatric populations, benign bone tumors are more common than malignancies. Benign osteocytic tumors may have a unique clinical presentation that helps narrow the differential diagnosis. A systemic imaging approach should be utilized to reach the diagnosis and guide clinicians in management. Radiographs are the most prevalent and cost-effective imaging modality. Cross-sectional imaging can be utilized for tissue characterization and for evaluation of lesions involving complex anatomical areas such as the pelvis and spine. Computed Tomography (CT) is the modality of choice for diagnosis of osteoid osteoma. CT scan can also be utilized to guide radiofrequency ablation, which has been found to be highly effective in treating osteoid osteoma and osteoblastoma. Enostosis is a no-touch lesion. Osteoma is commonly located in the paranasal sinuses. Osteoma needs an excision if it causes complications due to a mass effect.
PubMed: 34206870
DOI: 10.3390/jcm10132823 -
The American Journal of Surgical... Dec 2019Osteoblastoma and osteoid osteoma together are the most frequent benign bone-forming tumor, arbitrarily separated by size. In some instances, it can be difficult to...
Osteoblastoma and osteoid osteoma together are the most frequent benign bone-forming tumor, arbitrarily separated by size. In some instances, it can be difficult to differentiate osteoblastoma from osteosarcoma. Following our recent description of FOS gene rearrangement in these tumors, the aim of this study is to evaluate the value of immunohistochemistry in osteoid osteoma, osteoblastoma, and osteosarcoma for diagnostic purposes. A total of 337 cases were tested with antibodies against c-FOS: 84 osteoblastomas, 33 osteoid osteomas, 215 osteosarcomas, and 5 samples of reactive new bone formation. In all, 83% of osteoblastomas and 73% of osteoid osteoma showed significant expression of c-FOS in the osteoblastic tumor cell component. Of the osteosarcomas, 14% showed c-FOS expression, usually focal, and in areas with severe morphologic atypia which were unequivocally malignant: 4% showed more conspicuous expression, but these were negative for FOS gene rearrangement. We conclude that c-FOS immunoreactivity is present in the vast majority of osteoblastoma/osteoid osteoma, whereas its expression is usually focal or patchy, in no more than 14% of osteosarcoma biopsies. Therefore, any bone-forming tumor cases with worrying histologic features would benefit from fluorescence in situ hybridization analysis for FOS gene rearrangement. Our findings highlight the importance of undertaking a thorough assessment of expression patterns of antibodies in the light of morphologic, clinical, and radiologic features.
Topics: Adolescent; Adult; Biomarkers, Tumor; Bone Neoplasms; Child; Child, Preschool; Diagnosis, Differential; England; Female; Gene Rearrangement; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Male; Middle Aged; Osteoblastoma; Osteoma, Osteoid; Predictive Value of Tests; Proto-Oncogene Proteins c-fos; Switzerland; Young Adult
PubMed: 31490237
DOI: 10.1097/PAS.0000000000001355