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Current Medical Imaging 2021This article represents a review of the use of image-guided cryotherapy in the treatment of musculoskeletal tumor lesions. Cryotherapy is able to induce a lethal effect... (Review)
Review
BACKGROUND
This article represents a review of the use of image-guided cryotherapy in the treatment of musculoskeletal tumor lesions. Cryotherapy is able to induce a lethal effect on cancer cells through direct and indirect mechanisms. In this manuscript, we combined our experience with that of other authors who have published on this topic in order to provide indications on when to use cryotherapy in musculoskeletal oncology.
DISCUSSION
Image-Guided percutaneous cryotherapy is a therapeutic method now widely accepted in the treatment of patients with musculoskeletal tumors. It can be used both for palliative treatments of metastatic bone lesions and for the curative treatment of benign bone tumors, such as osteoid osteoma or osteoblastoma. In the treatment of bone metastases, cryotherapy plays a major role in alleviating or resolving disease-related pain, but it has also been demonstrated that it can have a role in local disease control. In recent years, the use of cryotherapy has also expanded for the treatment of both benign and malignant soft tissue tumors.
CONCLUSION
Percutaneous cryotherapy can be considered a safe and effective technique in the treatment of benign and malignant musculoskeletal tumors. Cryotherapy can be considered the first option in benign tumor lesions, such as osteoid osteoma, and a valid alternative to radiofrequency ablation. In the treatment of painful bone metastases, it must be considered secondarily to other standard treatments (radiotherapy, bisphosphonate therapy, and chemotherapy) when they are no longer effective in controlling the disease or when they cannot be repeated (for example, radiotherapy).
Topics: Bone Neoplasms; Cryotherapy; Humans; Osteoblastoma; Osteoma, Osteoid; Soft Tissue Neoplasms
PubMed: 32842945
DOI: 10.2174/1573405616666200825162712 -
World Neurosurgery Aug 2022Benign tumors that grow in the spinal canal are heterogeneous neoplasms with low incidence; from these, meningiomas and nerve sheath tumors (neurofibromas and... (Review)
Review
Benign tumors that grow in the spinal canal are heterogeneous neoplasms with low incidence; from these, meningiomas and nerve sheath tumors (neurofibromas and schwannomas) account for 60%-70% of all primary spinal tumors. Benign spinal canal tumors provoke nonspecific clinical manifestations, mostly related to the affected level of the spinal cord. These tumors present a challenge for the patient and healthcare professionals, for they are often difficult to diagnose and the high frequency of posttreatment complications. In this review, we describe the epidemiology, risk factors, clinical features, diagnosis, histopathology, molecular biology, and treatment of extramedullary benign meningiomas, osteoid osteomas, osteoblastomas, aneurysmal bone cysts, osteochondromas, neurofibromas, giant cell tumors of the bone, eosinophilic granulomas, hemangiomas, lipomas, and schwannomas located in the spine, as well as possible future targets that could lead to an improvement in their management.
Topics: Humans; Meningeal Neoplasms; Meningioma; Neurilemmoma; Neurofibroma; Neurofibromatoses; Spinal Canal; Spinal Cord Neoplasms; Spinal Neoplasms
PubMed: 35552036
DOI: 10.1016/j.wneu.2022.04.135 -
Pathologie (Heidelberg, Germany) Nov 2023Osseous lesions are rare; however, their incidence is increased in childhood and adolescence. The spectrum of osseous processes in this age group is limited, with benign... (Review)
Review
Osseous lesions are rare; however, their incidence is increased in childhood and adolescence. The spectrum of osseous processes in this age group is limited, with benign lesions being much more prevalent than malignant tumors. For the differential diagnosis, it is essential to have in-depth knowledge of the more frequent bone diseases in children and adolescents. The current review presents these diseases based on the morphologic approach of the WHO classification, including giant cell-rich and cystic lesions, chondrogenic and bone-forming lesions [7]. Small round cell sarcomas which are now summarized in a separate chapter of the WHO classification have been described previously [12, 20].
Topics: Humans; Adolescent; Child; Bone Neoplasms; Giant Cells
PubMed: 37828376
DOI: 10.1007/s00292-023-01235-z -
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 -
Foot (Edinburgh, Scotland) Dec 2021Bone tumors and tumor-like lesions (pseudotumors) are not uncommonly encountered as asymptomatic findings on imaging, or as symptomatic lesions clinically. Radiographic... (Review)
Review
Bone tumors and tumor-like lesions (pseudotumors) are not uncommonly encountered as asymptomatic findings on imaging, or as symptomatic lesions clinically. Radiographic imaging is the first diagnostic tool for their management strategy, since the symptoms are commonly non-specific, such as pain, swelling, and redness. Image findings must be analyzed with attention to the specific features such as lesion location, margination, zone of transition, mineralization, size and multifocality, soft tissue component and/or loco-regional extent. Cross-sectional imaging including CT and MRI serve as complementary methods, providing additional information with respect to the lesion characterization, mineralization, extent and involvement of the adjoining soft tissues. Clinical and/or key imaging features aid in limiting the differential diagnostic possibilities and serve as a guide in determining the benignity or malignancy of the tumor as well as to exclude pseudotumors. This article reviews the key imaging features of foot and ankle lesions. Benign bone lesions include simple and aneurysmal bone cysts, lipoma, hemangioma, chondroblastoma, enchondroma, osteoid osteoma, osteoblastoma, and giant cell tumor. Locally aggressive intermediate category lesion includes hemangioendothelioma. Malignant lesions include osteosarcoma, Ewing's sarcoma, chondrosarcoma. Pseudotumors such as fibrous dysplasia, hemophilic pseudotumor, gout and Madura foot are also discussed with illustrative case examples.
Topics: Ankle; Bone Neoplasms; Chondroblastoma; Diagnosis, Differential; Humans; Osteoblastoma; Osteoma, Osteoid
PubMed: 34560430
DOI: 10.1016/j.foot.2021.101845 -
Journal of Clinical Medicine Dec 2021Osteoblastoma (OB) and osteoid osteoma (OO) are benign bone-forming tumors, with nearly identical basic microscopic features. The main difference is dimension (OO has... (Review)
Review
Osteoblastoma (OB) and osteoid osteoma (OO) are benign bone-forming tumors, with nearly identical basic microscopic features. The main difference is dimension (OO has usually a nidus measuring <2 cm in diameter). In addition, OB is biologically more active than OO, with a tendency to grow in size. Historically, treatments have included surgical resection and analgesics, although invasiveness and poor tolerance have led to the current standard of care moving toward interventional radiology, where radiofrequency ablation (RFA) represents the most diffuse technique. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) has recently emerged as another innovative alternative treatment, providing tumor ablation through a needleless and ionizing radiation-free modality. In addition, this technique has the ability to guarantee a very precise and controlled increase in temperature, delivering small amounts of energy that can accurately destroy only the lesion, avoiding healthy surrounding tissues. The present review focuses on MRgFUS as the less invasive, safe, effective, and durable treatment option for the management of osteoid osteoma and osteoblastoma, including a description of technical details, indications and outcomes.
PubMed: 35011867
DOI: 10.3390/jcm11010128 -
Multimodal Imaging Evaluation and Clinical Progress of Spinal Osteoblastoma: A Comprehensive Review.World Neurosurgery Feb 2023Spinal osteoblastoma is rare clinically, with insidious onset, atypical symptoms, and various imaging manifestations, which can easily lead to misdiagnosis and delayed... (Review)
Review
Spinal osteoblastoma is rare clinically, with insidious onset, atypical symptoms, and various imaging manifestations, which can easily lead to misdiagnosis and delayed diagnosis. It can cause severe neurological dysfunction in patients with intermediate to advanced stages and may easily recur after surgery. Imaging examinations such as radiography, computed tomography, magnetic resonance imaging, and positron emission tomography have different value for the diagnosis of spinal osteoblastoma, but they lack specificity. The preferred treatment is surgical resection, which is technically difficult, and in some cases, osteoblastoma cannot be completely removed. New clinical approaches such as radiofrequency ablation, radiotherapy, targeted chemotherapy, and other comprehensive treatments have emerged and are progressing rapidly, but no unified norms have yet been developed. This manuscript provides a systematic review of the literature and provides an extensive and comprehensive review of this rare tumor in terms of multimodality imaging manifestations and clinical progress.
Topics: Humans; Osteoblastoma; Neoplasm Recurrence, Local; Spine; Magnetic Resonance Imaging; Multimodal Imaging; Bone Neoplasms; Spinal Neoplasms
PubMed: 36455846
DOI: 10.1016/j.wneu.2022.11.118 -
Insights Into Imaging Jul 2021To review the safety and efficacy of percutaneous cryoablation for the treatment of chondroblastoma and osteoblastoma in the pediatric and adolescent population.
BACKGROUND
To review the safety and efficacy of percutaneous cryoablation for the treatment of chondroblastoma and osteoblastoma in the pediatric and adolescent population.
MATERIALS AND METHODS
A retrospective review from 2016 to 2020 was performed to evaluate clinical and imaging response to percutaneous cryoablation in 11 symptomatic patients with diagnosis of chondroblastoma and osteoblastoma treated from two pediatric hospitals with at least 12-month follow-up. Technical success (correct needle placement and potential full coverage of the tumor with the planned ablation zone) and clinical success (relief of the symptoms) were evaluated. The primary objective was to alleviate pain related to the lesion(s). Immediate and late complications were recorded. Patients were followed in clinic and with imaging studies such as MRI or CT for a minimum of 6 months.
RESULTS
A total of 11 patients were included (mean 14 years, age range 9-17; male n = 8). Diagnoses were osteoblastoma (n = 4) and chondroblastoma (n = 7). Locations were proximal humerus (n = 1), femur condyle (n = 1), and proximal femur (n = 1) tibia (n = 3), acetabulum (n = 3), thoracic vertebra (n = 1) and lumbar vertebra (n = 1). Cryoablation was technically successful in all patients. Clinical success (cessation of pain) was achieved in all patients. No signs of recurrence were observed on imaging follow-up in any of the patients. One of the patients developed periprocedural right L2-L3 transient radiculopathy as major immediate complication.
CONCLUSIONS
Percutaneous image-guided cryoablation can be considered potentially safe and effective treatment for chondroblastoma and osteoblastoma in children and adolescents.
PubMed: 34313884
DOI: 10.1186/s13244-021-01036-z -
The Journal of Hand Surgery Apr 2022Osteoblastomas are rare, benign, bone-forming neoplasms that represent less than 1% of all bone tumors and occur mostly in people aged 10 to 30 years. In long bones, the...
Osteoblastomas are rare, benign, bone-forming neoplasms that represent less than 1% of all bone tumors and occur mostly in people aged 10 to 30 years. In long bones, the metadiaphyseal region tends to be most commonly affected. However, to the best of our knowledge, only 11 cases have been reported to occur in the distal radius. We present the clinical, radiological, and histopathological findings of an osteoblastoma of the right distal radius in a 42-year-old woman for whom an open excisional biopsy with nidus removal comprised the treatment and produced a good outcome.
Topics: Adult; Biopsy; Bone Neoplasms; Female; Humans; Osteoblastoma; Radius; Wrist Joint
PubMed: 33840569
DOI: 10.1016/j.jhsa.2021.02.003