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Medicine Dec 2023Recently, cone-beam computed tomography (CBCT)-guided surgeries have been developed for bone and soft tissue tumors. The present study aimed to evaluate the efficacy of...
Recently, cone-beam computed tomography (CBCT)-guided surgeries have been developed for bone and soft tissue tumors. The present study aimed to evaluate the efficacy of CBCT-guided curettage for osteoid osteoma. Our study population included 13 patients who underwent primary curettage for osteoid osteoma using intraoperative CBCT in a hybrid operating room between April 2019 and November 2022. We collected the following data: sex, age, follow-up period, symptom onset to time of surgery, tumor size and location, length of skin incision, operating time, radiation dose, recurrence, postoperative complications, and visual analog scale for pain during the last follow-up. There were 10 male and 3 female patients, and the mean age was 25.0 years (range, 9-49 years). The mean follow-up period was 10.6 months (range, 0.4-24.0 months). The locations of the tumors were the proximal femur in 6 patients, the acetabular region in 2 patients, and the ilium, tibial shaft, calcaneus, cuboid, and talus in 1 patient each. The mean time of symptoms onset to surgery was 18.7 months (range, 2.3-69.9 months). The mean maximum diameter of the tumor was 5.9 mm (range, 3.5-10.0 mm). The mean length of the skin incision was 2.2 cm (range, 1.5-3.5 cm). The mean operating time was 96.9 minutes (range, 64-157 minutes). The mean dose of radiation was 193.2 mGy (range, 16.3-484.0 mGy). No recurrences, postoperative complications, and reoperation were observed in this study. All the patients reported 0 mm on the visual analogue scale for pain on the last follow-up. CBCT-guided curettage for osteoid osteoma was minimally invasive and reliable. This procedure can be effective for the treatment of lesions found in deep locations such as the pelvic bone and proximal femur or an invisible lesion that cannot be detected by regular fluoroscopy.
Topics: Humans; Male; Female; Adult; Osteoma, Osteoid; Tomography, X-Ray Computed; Radiography, Interventional; Bone Neoplasms; Cone-Beam Computed Tomography; Pain; Talus; Postoperative Complications; Calcaneus; Treatment Outcome
PubMed: 38134085
DOI: 10.1097/MD.0000000000036747 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2024To investigate the criteria for selecting surgical approaches for frontal and ethmoid sinus osteomas of different locations and sizes on CT imaging. Using sagittal and...
To investigate the criteria for selecting surgical approaches for frontal and ethmoid sinus osteomas of different locations and sizes on CT imaging. Using sagittal and coronal CT images, the following lines were delineated: the F-line(a horizontal line passing nasofrontal beak), the M-line(a vertical line passing paries medialis orbitae), and the P-line(a vertical line passing the center of the pupil). Classification of frontal and ethmoid sinus osteomas was based on their relationship with these lines. Appropriate surgical approaches were selected, including pure endoscopic approaches, endoscopic combined with eyebrow incision approach, and endoscopic combined with coronal incision approach. This method was applied to a single center at the Third Affiliated Hospital of Sun Yat-sen University for endoscopic resection of frontal and ethmoid sinus osteoma. Case Data: Sixteen cases of ethmoid sinus osteomas were treated from January 2020 to September 2023. Among these cases, there were 9 males and 7 females, with ages ranging from 18 to 69 years, and a median age of 48 years. Thirteen cases underwent pure endoscopic resection of the osteoma, while in three cases, a combined approach was utilized. Among the combined approach cases, two exceeded both the M-line and the F-line but did not cross the P-line; therefore, they underwent endoscopic combined with eyebrow incision approach. One case exceeded all three lines and thus underwent endoscopic combined with coronal incision. In all cases, complete resection of the osteoma was achieved as per preoperative planning, and none of the patients experienced significant postoperative complications. For frontal and ethmoid sinus osteomas, it is advisable to perform a thorough preoperative radiological assessment. Based on the size of the osteoma and its relationship to the three lines, an appropriate surgical approach should be chosen to optimize the diagnostic and treatment plan.
Topics: Humans; Osteoma; Male; Female; Middle Aged; Adult; Aged; Frontal Sinus; Ethmoid Sinus; Adolescent; Tomography, X-Ray Computed; Paranasal Sinus Neoplasms; Endoscopy; Young Adult
PubMed: 38858119
DOI: 10.13201/j.issn.2096-7993.2024.06.013 -
International Journal of Surgery Case... Jun 2024Osteoid osteoma is a benign primary bone tumor with a predilection for the long bones and vertebrae, presenting a unique challenge when occurring in rare locations such...
INTRODUCTION AND IMPORTANCE
Osteoid osteoma is a benign primary bone tumor with a predilection for the long bones and vertebrae, presenting a unique challenge when occurring in rare locations such as the talus, accounting for 5 to 8 % of cases. Early imaging struggles to detect its nidus, leading to diagnostic delays, especially when atypical symptoms and previous trauma complicate clinical presentations. This case report illustrates the diagnostic challenges and emphasizes the importance of targeted computed tomography (CT) guided by scintigraphy in diagnosing osteoid osteoma of the talus.
CASE PRESENTATION
A 23-year-old male presented with chronic left ankle pain spanning three years, with a history of previous trauma. Initial evaluations including standard radiology and magnetic resonance imaging (MRI) suggested algodystrophy of the talus and tenosynovitis, but failed to identify the osteoma. Persistent pain led to further investigation with bone scintigraphy, revealing hyperfixation indicative of partial algodystrophy. Targeted CT scans focused on the scintigraphy-identified area ultimately revealed an osteoid osteoma's nidus, enabling successful surgical intervention and symptomatic relief.
DISCUSSION
The diagnosis of osteoid osteoma in the talus is frequently delayed due to its atypical presentation and rare occurrence. Traditional imaging techniques may overlook the tumor's nidus, underscoring the necessity for targeted diagnostic approaches. This case demonstrates the value of integrating scintigraphy with targeted CT to enhance early diagnosis and treatment planning, contrasting with the limited diagnostic yield of MRI and underscoring CT's superiority for nidus detection.
CONCLUSION
Osteoid osteoma of the talus poses significant diagnostic challenges. This case report highlights the utility of scintigraphy-guided targeted CT in identifying the nidus and facilitating prompt surgical management, advocating for a multidisciplinary approach to atypical ankle pain, especially in patients with a history of trauma.
PubMed: 38735215
DOI: 10.1016/j.ijscr.2024.109745 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Nov 2023To investigate short-term effectiveness and clinical application advantages of orthopedic robot-assisted resection for osteoid osteoma compared with traditional open...
OBJECTIVE
To investigate short-term effectiveness and clinical application advantages of orthopedic robot-assisted resection for osteoid osteoma compared with traditional open surgery.
METHODS
A retrospective analysis was conducted on clinical data of 48 osteoid osteoma patients who met the selection criteria between July 2022 and April 2023. Among them, 23 patients underwent orthopedic robot-assisted resection (robot-assisted surgery group), and 25 patients received traditional open surgery (traditional surgery group). There was no significant difference ( >0.05) in gender, age, disease duration, lesion location and size, and preoperative visual analogue scale (VAS) score, and musculoskeletal tumor society (MSTS) score between the two groups. The surgical time, intraoperative blood loss, intraoperative lesion localization time, initial localization success rate, infection, and recurrence were recorded and compared. VAS scores before surgery and at 24 hours, 1, 3, 6, and 9 months after surgery and MSTS score before surgery and at 3 months after surgery were assessed.
RESULTS
All patients completed the surgery successfully, with no significant difference in surgical time between the two groups ( >0.05). Compared to the traditional surgery group, the robot-assisted surgery group had less intraoperative blood loss, shorter lesion localization time, and shorter hospitalization time, with significant differences ( <0.05). The initial localization success rate was higher in the robot-assisted surgery group than in the traditional surgery group, but the difference between the two groups was not significant ( >0.05). All patients in both groups were followed up, with the follow-up time of 3-12 months in the robot-assisted surgery group (median, 6 months) and 3-14 months in the traditional surgery group (median, 6 months). The postoperative MSTS scores of both groups improved significantly when compared to those before surgery ( <0.05), but there was no significant difference in the changes in MSTS scores between the two groups ( >0.05). The postoperative VAS scores of both groups showed a gradually decreasing trend over time ( <0.05), but there was no significant difference between the two groups after surgery ( >0.05). During follow-up, except for 1 case of postoperative infection in the traditional surgery group, there was no infections or recurrences in other cases. There was no significant difference in the incidence of postoperative infection between the two groups ( >0.05).
CONCLUSION
Orthopedic robot-assisted osteoid osteoma resection achieves similar short-term effectiveness when compared to traditional open surgery, with shorter lesion localization time.
Topics: Humans; Robotics; Blood Loss, Surgical; Osteoma, Osteoid; Retrospective Studies; Treatment Outcome; Postoperative Complications; Bone Neoplasms
PubMed: 37987039
DOI: 10.7507/1002-1892.202308032 -
Musculoskeletal Surgery Mar 2024Osteoid osteoma is one of the most frequent benign musculoskeletal neoplasm. Radiofrequency ablation is the method of choice for non-conservative treatment of osteoid... (Review)
Review
Osteoid osteoma is one of the most frequent benign musculoskeletal neoplasm. Radiofrequency ablation is the method of choice for non-conservative treatment of osteoid osteoma. Recently, high-intensity focused ultrasound (HIFU) has been proposed as a safer option. The objective of this study is to review the efficacy and side effects of HIFU in the management of osteoid osteoma. A comprehensive search was conducted in PubMed, Science Direct, and Clinical Key until June 30, 2022. Demographic data, baseline characteristics, success rates, pre- and post-procedure pain scores, recurrences, and complications were recorded. Eleven studies were included in this systematic review. Pooled analysis that involved 186 subjects resulted in an overall success rate of 91.94%. Recurrence was reported in two studies, in which it occurred in 4/177 (2.26%) subjects. Skin burn was found in 1 (0.54%) patients. No major or other complications were reported. Three studies compared the success rate of HIFU and RFA. Success rate was slightly higher in the RFA group with insignificant difference (p = 0.15). High-intensity focused ultrasound showed promising results. It offers a safer treatment approach for osteoid osteoma, especially in children, and can be considered for recalcitrant cases after RFA. Nonetheless, more studies are expected in the future.
Topics: Child; Humans; Osteoma, Osteoid; Treatment Outcome; Bone Neoplasms; Musculoskeletal Diseases
PubMed: 38150115
DOI: 10.1007/s12306-023-00801-1 -
Medicine Aug 2023Osteoid osteoma is a relatively common benign bone-forming lesion that often occurs in young adults with a predilection for the lower limbs and spine. It is...
RATIONALE
Osteoid osteoma is a relatively common benign bone-forming lesion that often occurs in young adults with a predilection for the lower limbs and spine. It is characterized by the formation of osteoid tissue, a precursor to bone, and can cause pain and restricted mobility in affected areas. Osteoid osteoma of the hand and fingers is rare, thus representing a diagnostic challenge. A written informed consent was provided from the patient's father for the publication and sharing all images and clinical data concerning the patient.
PATIENT CONCERNS
We are reporting a case of an 11-year-old girl who presented with persistent pain and swelling in her left index finger, as well as limited mobility, over the course of 1 year. Nonsteroidal anti-inflammatory drugs eased the pain, but it resurfaced once the medication was discontinued.
DIAGNOSES
A series of investigations, showed a lytic lesion at the second proximal phalangeal neck, with features indicative of osteoid osteoma.
INTERVENTIONS
Excision with bone grafting was performed as definitive therapy with pathological confirmation of the osteoid osteoma diagnosis. Nevertheless, the patient returned 2 years later with a recurrence of her previous symptoms, and further tests suggested a recurrence of osteoid osteoma. To address the recurrence, a modified open thermoablation technique was used. Thermoablation is a minimally invasive procedure that uses heat to destroy the tumor cells, and it has been shown to be effective in treating osteoid osteoma. The modified open approach involves making a small incision to access the tumor and delivering heat directly through a previously CT-guided inserted Kirschner wire to the affected area.
OUTCOMES
The patient reported no pain at 1 month and 1 year after the surgery, with no radiological signs of recurrence, indicating complete excision of the lesion.
LESSONS
Overall, this case highlights the challenges of diagnosing and treating osteoid osteoma in the hands and fingers. Further research is needed to better understand the underlying causes, potential risk factors, and optimal treatment for osteoid osteoma recurrence.
Topics: Humans; Female; Young Adult; Child; Osteoma, Osteoid; Bone Neoplasms; Pain; Radiography; Fingers
PubMed: 37543830
DOI: 10.1097/MD.0000000000034490 -
Pediatric Radiology Nov 2023The location and proximity to the spinal cord in spinal osteoid osteoma can increase the likelihood of an incomplete resection. Intraoperative bone scintigraphy (IOBS)...
BACKGROUND
The location and proximity to the spinal cord in spinal osteoid osteoma can increase the likelihood of an incomplete resection. Intraoperative bone scintigraphy (IOBS) can be used to verify location and complete surgical resection.
OBJECTIVE
To review our experience using IOBS for resection of intraspinal osteoid osteoma.
METHODS
IRB approved, retrospective review of IOBS-guided resection over 10 years. Patients underwent injection of 200 uCi/kg (1-20 mCi) Tc-MDP 3-4 h prior surgery. Portable single-headed gamma camera equipped with a pinhole collimator (3- or 4-mm aperture) was used. Images were obtained pre-operatively, at the start of the procedure, and intraoperatively. Operative notes were reviewed. Evaluation of recurrence and clinical follow-up was performed.
RESULTS
Twenty IOBS-guided resections were performed in 18 patients (median age 13.5 years, 6-22 years, 12 males). Size ranged 5-16 mm, with 38.9% (7/18) cervical, 22.2% (4/18) thoracic, 22.2% (4/18) lumbar, and 16.7% (3/18) sacral. In all cases, IOBS was able to localize the lesion. After suspected total excision, IOBS altered the surgical plan in 75% of cases (15/20), showing residual activity prompting further resection. Median length of follow-up was 6 months (range 1-156 months) with 90% (18/20) showing complete resection without recurrence. Two patients had osteoid osteoma recurrence at 7 and 10 months following the original resection, requiring re-intervention.
CONCLUSIONS
IOBS is a useful tool for real-time localization and assessment of spinal osteoid osteoma resection. In all cases, IOBS was able to localize the lesion and changed surgical planning in 75% of cases. Ninety percent of patients achieved complete resection and remain recurrence free.
Topics: Adolescent; Humans; Male; Bone Neoplasms; Osteoma, Osteoid; Radionuclide Imaging; Retrospective Studies; Spinal Neoplasms; Female; Child; Young Adult
PubMed: 37740781
DOI: 10.1007/s00247-023-05773-9 -
Turkish Journal of Physical Medicine... Sep 2023Osteoid osteoma is a benign bone tumor that commonly arises from the metaphyseal and diaphyseal regions of long bones. Pain is often the first symptom, and it can mimic...
Osteoid osteoma is a benign bone tumor that commonly arises from the metaphyseal and diaphyseal regions of long bones. Pain is often the first symptom, and it can mimic many diseases. Herein, we report a 36-year-old male patient who presented with complaints of lower back pain radiating to the right extremity for a year. In the patient's history, physical therapy, platelet-rich plasma, pregabalin, and duloxetine were used, with the only benefit from indomethacin. An X-ray of the femur was requested, and the diagnosis of osteoid osteoma was confirmed by magnetic resonance imaging. Osteoid osteoma should be kept in mind as a differential diagnosis of persistent pain despite treatment.
PubMed: 37674793
DOI: 10.5606/tftrd.2023.10653 -
Cureus Oct 2023Giant osteomas of the frontoethmoidal region often manifest early with ocular symptoms and intracranial complications. The management involves careful surgical planning...
Giant osteomas of the frontoethmoidal region often manifest early with ocular symptoms and intracranial complications. The management involves careful surgical planning of both the approach and reconstruction. In the present case report, a case of giant frontoethmoid osteoma presented with ocular symptoms and cosmetic deformity. The case was managed by a combined endoscopic and open surgical approach along with reconstruction of the sinus wall defect using a pericranial flap and titanium mesh. The outcome was found to be satisfactory with the resolution of ocular symptoms and good cosmesis.
PubMed: 38021510
DOI: 10.7759/cureus.47046 -
Archives of Orthopaedic and Trauma... Aug 2023Osteoid osteoma (OO) is a common benign bone tumor. OO is observed most frequently in the long bones, especially in the tibia and femur. When occurring in the bones of...
INTRODUCTION
Osteoid osteoma (OO) is a common benign bone tumor. OO is observed most frequently in the long bones, especially in the tibia and femur. When occurring in the bones of the hand, OO can be a diagnostic and therapeutic challenge. The aim of this study was to provide a systematic review of occurrence, symptoms, diagnosis and treatment options regarding OO in hand bones.
MATERIALS AND METHODS
We performed a systematic review of the literature. All studies from the online databases PubMed and SpringerLink, which reported cases of osteoid osteomas in the bones of the hand, were included. By summarizing the literature, we evaluated the localization within the hand as well as diagnostic and therapeutic options.
RESULTS
We included 133 studies reporting 401 cases. OO was mostly common in the phalanges. The diagnosis was mostly made by CT (computed tomography) scan. Most of the OO were treated surgically by open curettage or en bloc resection.
CONCLUSIONS
Osteoid osteomas in the bones of the hand are rare and a delayed diagnosis is common. In cases of pain combined with particular symptoms such as nail hypertrophy and swelling OO should be considered. Of the most used imaging methods, CT scans have the highest sensitivity.
Topics: Humans; Osteoma, Osteoid; Hand; Pain; Finger Phalanges; Bone Neoplasms
PubMed: 36939892
DOI: 10.1007/s00402-023-04839-5