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Der Pathologe May 2022Osteoclastic giant cells represent a common cellular component of lesions arising in bone. Highlighting this morphological finding, the current WHO classification of... (Review)
Review
Osteoclastic giant cells represent a common cellular component of lesions arising in bone. Highlighting this morphological finding, the current WHO classification of bone tumors defines a diagnostic group comprising aneurysmal bone cyst, giant cell tumor of bone and non-ossifying fibroma, which may display morphologic similarities while being distinct with regard to molecular and biological features. Starting with these tumors - putting a focus on lesions arising in bone - this article gives a survey of other (chondrogenic and osteogenic) tumors that frequently contain osteoclastic giant cells, which may, particularly in small biopsies, enter differential diagnosis. Overlapping features with selected giant cell-containing soft tissue tumors, which may be of differential diagnostic relevance in daily routine, are discussed.
Topics: Bone Cysts, Aneurysmal; Bone Neoplasms; Bone and Bones; Diagnosis, Differential; Giant Cells; Humans
PubMed: 35467097
DOI: 10.1007/s00292-022-01069-1 -
Revista Brasileira de Ortopedia Apr 2024Carpal bone tumors must be investigated in clinical cases of chronic wrist pain with no previous trauma. Intraosseous ganglion, enchondroma, osteoid osteoma, and, less...
Carpal bone tumors must be investigated in clinical cases of chronic wrist pain with no previous trauma. Intraosseous ganglion, enchondroma, osteoid osteoma, and, less commonly, osteoblastoma are potential causes of osteolytic lesions affecting the carpal bones. In most cases, the clinical presentation alone is not enough to differentiate such lesions. Knowledge of certain characteristics, including the radiological and histopathological aspects of each of these tumors, is critical in order to make the differential diagnosis. We present a rare case of osteoblastoma of the capitate bone and review the literature on the subject.
PubMed: 38606137
DOI: 10.1055/s-0041-1724084 -
Journal of the Korean Association of... Feb 2023Osteoblastoma is a rare benign neoplasm formed by osteoid tissue and well-vascularized bone that occurs mainly in children and adolescents. It appears primarily in the...
Osteoblastoma is a rare benign neoplasm formed by osteoid tissue and well-vascularized bone that occurs mainly in children and adolescents. It appears primarily in the long bones, vertebral column, and small bones of the hands and feet, and not typically in the skull and maxillary bones. The purpose of this study is to present the case of an 8-year-old girl with a diagnosis of right mandibular osteoblastoma and a review of the relevant literature. The goals of treatment were to preserve dental occlusion, masticatory function and facial symmetry while minimizing the effects on patient body image and quality of life. Osteoblastoma, although it is benign, can be aggressive, and its treatment will depend on the timing of diagnosis, size and location. Early diagnosis is essential to avoid not only radical surgery as in the case presented, but also to help minimize the risk of possible relapse and potential malignancy of a benign osteoblastoma.
PubMed: 36859375
DOI: 10.5125/jkaoms.2023.49.1.49 -
Osteoblastoma and Osteoid Osteoma of the Mandible: Review of the Literature and Report of Two Cases.Case Reports in Dentistry 2022Osteoblastoma and osteoid osteoma are rare benign neoplasms of the jaws. We reviewed current literature surrounding the ongoing debate over similarities and differences...
Osteoblastoma and osteoid osteoma are rare benign neoplasms of the jaws. We reviewed current literature surrounding the ongoing debate over similarities and differences of osteoblastoma and osteoid osteoma and present two cases. Both cases are well-demarcated mixed radiodensity mandibular lesions with histological features of osteoblastoma. They exhibit, however, distinctly unique and contrasting clinical and imaging characteristics suggesting that the first case is osteoblastoma and the second is osteoid osteoma. The first case of a 37-year-old male presents with a large, expansile lesion at posterior mandible, surrounded by a thick sclerotic band. Unusual features include significant buccal/lingual expansion, extensive new bone apposition, and soft tissue edema in the masseter muscle. This is in contrast to the second case of a much smaller lesion in a 17-year-old male with history of recent third molar extraction in the left posterior mandible. In this case, CT imaging revealed a circular, nonexpansile lesion with a sclerotic border surrounded by a radiolucent rim. Both patients underwent surgical excision of the lesion with extraction of the adjacent tooth. We discuss herein the distinct clinical and imaging features.
PubMed: 35300290
DOI: 10.1155/2022/7623855 -
Anaesthesia Reports 2023Myoclonus is a known side effect of propofol and can interfere with surgery and possibly precipitate patient injury. Here, we report a 23-year-old patient undergoing an...
Myoclonus is a known side effect of propofol and can interfere with surgery and possibly precipitate patient injury. Here, we report a 23-year-old patient undergoing an L5 osteoblastoma resection with a predominantly propofol-based anaesthetic who developed intra-operative myoclonus. Other adjuncts included ketamine, lidocaine and fentanyl infusions. The myoclonus did not improve after deepening the anaesthetic with propofol, opioid boluses or discontinuation of the lidocaine infusion. The myoclonus ceased after reducing the propofol infusion and increasing the ketamine and opioid infusions. The remainder of the intra-operative course was uneventful. This report details our intra-operative management of propofol-induced cortical reflex myoclonus and discusses our institution's experience with treating this phenomenon.
PubMed: 37937281
DOI: 10.1002/anr3.12253 -
BioMed Research International 2019To explore the incidence and significance of intra- and extra-osseous edema associated with benign tumors and tumor-like diseases.
OBJECTIVE
To explore the incidence and significance of intra- and extra-osseous edema associated with benign tumors and tumor-like diseases.
METHODS
Magnetic resonance imaging (MRI) data from 300 benign osseous tumors and tumor-like diseases diagnosed by pathology were retrospectively reviewed. Borderline tumors, cases associated with pathological fractures, and skull lesions were excluded from the study. Bone marrow and soft tissue edema were defined on T2WI with fat suppression on MRI in all cases. The incidence rate of edema in benign tumors and tumor-like diseases was determined using the test. The preoperative diagnoses were reviewed, and the effect of edema on the differential diagnosis of benign and malignant tumors was analyzed.
RESULTS
The incidence rate of bone marrow and soft tissue edema associated with benign tumors and tumor-like diseases was 35.7% (107/300), including 84.4% (27/32) Langerhans cell histiocytosis, 86.4% (19/22) osteoblastoma, 93.9% (31/33) osteoid osteoma, and 85.2% (23/27) chondroblastoma cases. There was no statistically significant difference in the incidence of edema among the four diseases ( = 1.7, > 0.05). Of 107 cases associated with edema, 49 (45.8%) were misdiagnosed as malignant tumors by MRI preoperatively.
CONCLUSION
Bone marrow and soft tissue edema are a common finding associated with benign bone tumors and tumor-like diseases, and they are frequently detected in Langerhans cell histiocytosis, osteoblastoma, osteoid osteoma, and chondroblastoma.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Marrow; Bone Neoplasms; Child; Child, Preschool; Chondroblastoma; Diagnosis, Differential; Edema; Female; Fractures, Bone; Histiocytosis, Langerhans-Cell; Humans; Incidence; Infant; Magnetic Resonance Imaging; Male; Middle Aged; Osteoblastoma; Osteoma, Osteoid; Retrospective Studies; Young Adult
PubMed: 31781646
DOI: 10.1155/2019/8206913 -
Skeletal Radiology Mar 2022Epithelioid osteoblastoma, sometimes equated with aggressive osteoblastoma, is a variant of osteoblastoma that typically demonstrates more worrisome imaging and...
Epithelioid osteoblastoma, sometimes equated with aggressive osteoblastoma, is a variant of osteoblastoma that typically demonstrates more worrisome imaging and pathological features compared to conventional osteoblastoma. These more aggressive features can overlap with those seen in osteosarcoma, creating a diagnostic challenge for radiologists and pathologists. Recent identification of FOS and FOSB gene rearrangements in osteoid osteoma and osteoblastoma has allowed for greater diagnostic confidence following biopsy, but careful radiological-pathological correlation remains a key component for guiding appropriate management. Although the imaging features of conventional osteoblastoma have been previously described, there are limited examples in the literature of the imaging appearance of epithelioid osteoblastoma, and none with secondary aneurysmal bone cyst. In this case report, we detail the clinical, imaging, and histological characteristics of a proximal femoral epithelioid osteoblastoma which was pathologically confirmed by FOS and FOSB genetic testing. The initial imaging impression favored a malignancy, but when the biopsy results were correlated in a multidisciplinary fashion with the imaging, epithelioid osteoblastoma became the leading diagnosis which was subsequently genetically confirmed. This case emphasizes the value of multidisciplinary radiology-pathology correlation in routine practice.
Topics: Bone Cysts, Aneurysmal; Bone Neoplasms; Gene Rearrangement; Humans; Osteoblastoma; Osteoma, Osteoid
PubMed: 34448010
DOI: 10.1007/s00256-021-03895-5 -
Advances in Experimental Medicine and... 2023Benign osseocartilaginous tumors of the spine are overall uncommon, representing between 1 and 13% of all primary bone tumors and less than 10% of all spinal tumors....
Benign osseocartilaginous tumors of the spine are overall uncommon, representing between 1 and 13% of all primary bone tumors and less than 10% of all spinal tumors. Tumors in this category include osteoblastic lesions such as the related osteoid osteoma and osteoblastoma, and cartilage-forming lesions including osteochondroma, chondroma, and chondroblastoma. Aneurysmal bone cysts, giant cell tumors of bone, and eosinophilic granulomas also comprise benign tumors of the spine arising from bone. There is significant heterogeneity in the epidemiology, molecular biology, imaging features, and optimal treatment of these lesions. For example, osteoid osteoma is characterized by high expression of the cyclooxygenase enzymes, making it amenable to treatment with anti-inflammatory drugs initially, whereas other lesions such as osteoblastoma may require intralesional curettage or en bloc resection sooner. Generally, en bloc resection is preferred when possible to minimize risk of recurrence. Further, some tumors may arise in the setting of syndromic conditions, such as multiple chondromas arising in Ollier disease or Maffucci syndrome, or as part of genetic disorders, such as osteochondromas in the context of hereditary multiple exostosis. These lesions may present with local pain, cause neurological compromise or be discovered incidentally on routine imaging. The Enneking classification and Weinstein-Boriani-Biagini system are routinely used to classify lesions and assist in surgical planning. More novel techniques such as radiofrequency ablation and laser photocoagulation have been applied for the treatment of osteoid osteoma and may have utility in the treatment of other lesion types. A multidisciplinary approach is critical in the management of benign lesions of the spine, and both chemotherapeutic and surgical approaches are routinely used.
Topics: Humans; Spinal Neoplasms; Osteoma, Osteoid; Osteoblastoma; Bone Neoplasms; Cartilage; Osteochondroma; Spinal Cord Neoplasms; Brain
PubMed: 37452949
DOI: 10.1007/978-3-031-23705-8_17 -
Osteoblastoma-Like Osteosarcoma of the Cuboid and Skull: A Case Report and Review of the Literature.The Journal of Foot and Ankle Surgery :... 2020Osteoblastoma-like osteosarcoma is a rare form of osteosarcoma that shares similar clinical and pathological characteristics with osteoblastoma. We describe a... (Review)
Review
Osteoblastoma-like osteosarcoma is a rare form of osteosarcoma that shares similar clinical and pathological characteristics with osteoblastoma. We describe a 12-year-old boy with osteoblastoma-like osteosarcoma of the cuboid and skull without lung involvement. Despite inadequate primary surgical treatment, the patient recovered well after wide excision and postoperative chemotherapy. We report the case for the rarity of the sites and the misleading clinical and pathological manifestation.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Child; Follow-Up Studies; Frontal Bone; Humans; Male; Neoplasm Recurrence, Local; Osteosarcoma; Reoperation; Skull Neoplasms; Tarsal Bones
PubMed: 31753571
DOI: 10.1053/j.jfas.2019.05.007 -
Surgical Neurology International 2022Establishing the proper diagnosis and rendering appropriate treatment of spinal primary bone tumors (SPBT) can result in definitive cures. Notably, malignant, or benign...
BACKGROUND
Establishing the proper diagnosis and rendering appropriate treatment of spinal primary bone tumors (SPBT) can result in definitive cures. Notably, malignant, or benign SPBT (i.e., with aggressive local behavior) generally require resection. Osteotomies of the vertebral body in more than 1 plane may avoid critical structures, preserve nerve functions, and reduce the volume of healthy bone resected. Here, our objective was to report how we planned and performed navigated multiplanar osteotomies for resection of 14 SPBT.
METHODS
We performed a retrospective analysis of 14 patients with malignant or locally aggressive benign SPBT operated on consecutively between 2014 and 2019 utilizing preoperative 3D planning/navigation. Tumors were resected in an fashion utilizing multiplanar osteotomies. Patients were followed for a minimum of 12 postoperative months.
RESULTS
Diagnoses included three benign but locally aggressive bone tumors (i.e., all osteoblastomas) and 11 primary sarcomas (i.e., six chordomas and five chondrosarcomas). Eleven tumors involved the sacrum and the other three, the thoracic spine. In 12 patients, the margins were classified as marginal (<1 cm), and in two patients, as wide (>1 cm). Intraoperative navigation facilitated the performance of 40 osteotomies in 14 patients (median = 2.9, range = 2-6).
CONCLUSION
Navigated multiplanar osteotomies increased the precision and safety of resections for 14 primary spinal bone tumors SPBT that included 11 malignant and three benign/locally aggressive lesions.
PubMed: 35242424
DOI: 10.25259/SNI_1232_2021