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Diagnostics (Basel, Switzerland) Apr 2023Vertebra plana is a rare radiologic condition characterized by a uniform loss of height of a vertebral body that represents a diagnostic challenge for surgeons. The... (Review)
Review
Vertebra plana is a rare radiologic condition characterized by a uniform loss of height of a vertebral body that represents a diagnostic challenge for surgeons. The purpose of this study was to review all possible differential diagnoses that may present with a vertebra plana (VP) described in the current literature. For that purpose, we performed a narrative literature review in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, analyzing 602 articles. Patient demographics, clinical presentation, imaging characteristics and diagnoses were investigated. VP is not a pathognomonic feature of Langerhans cell histiocytosis, but other oncologic and non-oncologic conditions should be considered. The list of differential diagnoses, based on our literature review, can be recalled with the mnemonic HEIGHT OF HOMO: H-Histiocytosis; E-Ewing's sarcoma; I-Infection; G-Giant cell tumor; H-Hematologic neoplasms; T-Tuberculosis; O-Osteogenesis imperfecta; F-Fracture; H-Hemangioma; O-Osteoblastoma; M-Metastasis; O-Osteomyelitis, chronic.
PubMed: 37189540
DOI: 10.3390/diagnostics13081438 -
Journal of Neurosurgery Jan 2023Concerns about the approach-related morbidity of the extradural anterior petrosal approach (EAPA) have been raised, especially regarding temporal lobe and venous...
OBJECTIVE
Concerns about the approach-related morbidity of the extradural anterior petrosal approach (EAPA) have been raised, especially regarding temporal lobe and venous injuries, hearing impairment, facial nerve palsy, cerebrospinal fluid fistula, and seizures. There is lack in the literature of studies with detailed analysis of surgical complications. The authors have presented a large series of patients who were treated with EAPA, focusing on complications and their avoidance.
METHODS
The authors carried out a retrospective review of patients who underwent EAPA at their institution between 2012 and 2021. They collected preoperative clinical characteristics, operative reports, operative videos, findings on neuroimaging, histological diagnosis, postoperative course, and clinical status at last follow-up. For pathologies without petrous bone invasion, the amount of petrous apex drilling was calculated and classified as low (< 70% of the volume) or high (≥ 70%). Complications were dichotomized as approach related and resection related.
RESULTS
This study included 49 patients: 26 with meningiomas, 10 brainstem cavernomas, 4 chondrosarcomas, 4 chordomas, 2 schwannomas, 1 epidermoid cyst, 1 cholesterol granuloma, and 1 osteoblastoma. The most common approach-related complications were temporal lobe injury (6.1% of patients), seizures (6.1%), pseudomeningocele (6.1%), hearing impairment (4.1%), and dry eye (4.1%). Approach-related complications occurred most commonly in patients with a meningioma (p = 0.02) and Meckel's cave invasion (p = 0.02). Gross-total or near-total resection was correlated with a higher rate of tumor resection-related complications (p = 0.02) but not approach-related complications (p = 0.76). Inferior, lateral, and superior tumoral extension were not correlated with a higher rate of tumor resection-related complications. No correlation was found between high amount of petrous bone drilling and approach- or resection-related complications.
CONCLUSIONS
EAPA is a challenging approach that deals with critical neurovascular structures and demands specific skills to be safely performed. Contrary to general belief, its approach-related morbidity seems to be acceptable at dedicated skull base centers. Morbidity can be lowered with careful examination of the preoperative neuroradiological workup, appropriate patient selection, and attention to technical details.
Topics: Humans; Meningeal Neoplasms; Meningioma; Neurosurgical Procedures; Facial Paralysis; Petrous Bone
PubMed: 35561692
DOI: 10.3171/2022.3.JNS212962 -
Cancer Genomics & Proteomics 2020Osteoblastoma is a rare benign tumor of the bones in which recurrent rearrangements of FOS have been found. Our aim was to investigate two osteoblastomas for possible...
BACKGROUND/AIM
Osteoblastoma is a rare benign tumor of the bones in which recurrent rearrangements of FOS have been found. Our aim was to investigate two osteoblastomas for possible genetic aberrations.
MATERIALS AND METHODS
Cytogenetic, RNA sequencing, and molecular analyses were performed.
RESULTS
A FOS-ANKH transcript was found in the first tumor, whereas a FOS-RUNX2 was detected in the second. Exon 4 of FOS fused with sequences either from intron 1 of ANKH or intron 5 of RUNX2. The fusion events introduced a stop codon and removed sequences involved in the regulation of FOS.
CONCLUSION
Rearrangements and fusions of FOS show similarities with those of HMGA2 (a feature of leiomyomas and lipomas) and CSF1 (tenosynovial giant cell tumors). The replacement of a 3'-untranslated region, controlling the gene's expression, by a new sequence is thus a common pathogenetic theme shared by FOS, HMGA2, and CSF1 in many benign connective tissue tumors.
Topics: Base Sequence; Bone Neoplasms; Child; Core Binding Factor Alpha 1 Subunit; Female; Gene Expression; Humans; Karyotype; Male; Oncogene Proteins, Fusion; Osteoblastoma; Phosphate Transport Proteins
PubMed: 32108038
DOI: 10.21873/cgp.20176 -
Cureus Dec 2020The critical biomechanical importance of talus and nonspecific clinical features of talus lesion warrants a meticulous diagnostic work-up for specific management,...
The critical biomechanical importance of talus and nonspecific clinical features of talus lesion warrants a meticulous diagnostic work-up for specific management, particularly when the talus lesion is associated with concomitant soft tissue and joint abnormalities. We present a rare case of osteoblastoma of talus with concomitant tenosynovitis of tibialis anterior, ankle joint effusion, varicose vein and moderate distal arterial stenosis.
PubMed: 33409078
DOI: 10.7759/cureus.11838 -
Histology and Histopathology Jul 2022Hydrogen sulfide (H₂S) is a novel gas transmitter signaling molecule. H₂S is synthesized by cystathionine β-synthase (CBS), cystathionine γ-lyase (CSE), and...
BACKGROUND
Hydrogen sulfide (H₂S) is a novel gas transmitter signaling molecule. H₂S is synthesized by cystathionine β-synthase (CBS), cystathionine γ-lyase (CSE), and 3-mercaptopyruvate sulfurtransferase (MST). There have been no reports about the roles of these enzymes in osteosarcoma and its metastases. We detected H₂S synthase expression levels in human primary osteosarcoma and lung metastatic osteosarcoma.
METHODS
Immunohistochemistry was performed in primary osteosarcoma (n=19), lung metastatic osteosarcoma (n=11), osteoblastoma (n=10) and bony callus (n=2). The expression of CBS, CSE, and MST was defined as negative, moderately positive and strongly positive.
RESULTS
MST staining was moderately to strongly positive in all cases. CSE staining was negative in 94.7% (18/19) of primary osteosarcoma cases and 90.9% (10/11) of lung metastatic osteosarcoma cases. CBS staining was strongly positive in 68.4% (13/19) of primary osteosarcoma cases, moderately positive in 15.8% (3/19) of cases, and negative in 15.8% (3/19) of cases. In lung metastatic osteosarcoma, the proportions of negative, moderately positive and strongly positive cases were 63.6% (7/11), 18.2% (2/11) and 18.2% (2/11), respectively.
CONCLUSIONS
CBS and CSE expression, especially CSE expression, decreased in both primary osteosarcoma and lung metastatic osteosarcoma, which may suggest that CBS and CSE play roles in osteoblast cell malignant transformation and osteosarcoma progression. These enzymes could be used as new prognostic assessment factors and may represent new therapeutic targets for osteosarcoma and metastasis prevention.
Topics: Cystathionine beta-Synthase; Cystathionine gamma-Lyase; Humans; Hydrogen Sulfide; Lung; Osteosarcoma
PubMed: 35174476
DOI: 10.14670/HH-18-438 -
Frontiers in Oncology 2023Nasal osteoblastoma (OB) is a rare and locally aggressive osteogenic tumor that has rarely been reported, and there is a lack of effective evidence data for its...
Nasal osteoblastoma (OB) is a rare and locally aggressive osteogenic tumor that has rarely been reported, and there is a lack of effective evidence data for its diagnosis and treatment. In this study, we report a 31-year-old female patient who presented with nasal congestion and associated progressive painless swelling of the left maxillofacial region. A preoperative computed tomography (CT) examination of the paranasal sinuses was performed, and based on the imaging presentation, the surgeon was unable to differentiate between OB, osteoid osteoma (OO), fibrous dysplasia of bone (FDB) and osteoblastic fibroma (OF). After excluding contraindications to surgery, the patient underwent nasal endoscopic excision of the left nasal mass, which was found to be gravel-like and difficult to remove cleanly during the operation. The mass was brittle and bled easily, resulting in inadequate exposure of the operative field, prolonged operation time, and substantial intraoperative blood loss. This indicates that definite preoperative diagnosis (biopsy of deeper parts of the mass is recommended) and appropriate preoperative preparations (e.g., preoperative angiography and embolization, adequate blood preparation) are very important. The intraoperative frozen and postoperative pathological results clearly identified the tumor as OB. No local recurrence of the tumor was observed at the 11-month postoperative follow-up.
PubMed: 37519816
DOI: 10.3389/fonc.2023.1168777 -
Radiology Case Reports Jul 2024An osteoblastoma is a benign bone tumor characterized by osteoblast proliferation that is more commonly diagnosed in young men during adolescence and youth. The...
An osteoblastoma is a benign bone tumor characterized by osteoblast proliferation that is more commonly diagnosed in young men during adolescence and youth. The condition mainly occurs in the posterior regions of the spine and sacrum, but in rare cases, the patella as well. We present a case of patellar osteoblastoma successfully managed through intralesional curettage and grafting, highlighting the need for comprehensive imaging and pathological studies to ensure an accurate diagnosis. A 26-year-old male with a history of knee plica excision presented with persistent knee pain over 1 year. Radiographic and CT evaluations revealed an osteolytic lesion in the patella, further characterized by MRI. An incisional biopsy confirmed the diagnosis of osteoblastoma. Intralesional curettage and grafting were performed. Later, subsequent follow-up demonstrated complete pain relief, restoration of knee function, and optimal graft incorporation. As shown in this case, precise diagnosis and effective management are key to improving the quality of life of patients. Furthermore, it illustrates that intralesional curettage and grafting are effective treatments for patellar osteoblastomas. Given the rarity of this condition, further research and comprehensive case studies are imperative to establish standardized guidelines for improved healthcare and patient outcomes. In summary, while the clinical characteristics of patellar osteoblastoma resemble those of osteoblastomas in general, its unique presentation warrants specific attention. Individualized consideration of adjuvant measures, graft selection, and preventive fixation is vital to ensure optimal outcomes in patellar osteoblastoma management.
PubMed: 38666146
DOI: 10.1016/j.radcr.2024.03.035 -
Medicina (Kaunas, Lithuania) Oct 2020Bone islands (BI; enostoses) may be solitary or occur in the setting of osteopoikilosis (multiple bone islands) and are sometimes associated with Gardner's Syndrome... (Review)
Review
Bone islands (BI; enostoses) may be solitary or occur in the setting of osteopoikilosis (multiple bone islands) and are sometimes associated with Gardner's Syndrome (osteopoikilosis and colonic polyposis). Characteristic features of bone islands are (1) absence of pain or local tenderness, (2) typical radio dense central appearance with peripheral radiating spicules (rose thorn), (3) Mean CT (computerized tomography) attenuation values above 885 Hounsfield units (HU) (4) absence of uptake on bone scan and (5) radiographic stability over time. However, when enostoses display atypical features of pain, unusual radiographic appearance, aberrant HU, increased radiotracer uptake, and/or enlargement, they can be difficult to differentiate from more sinister bony lesions such as osteoblastic metastasis, low grade central osteosarcoma, osteoid osteoma and osteoblastoma. In this retrospective case series, the demographic, clinical, radiographic, treatment and outcome for ten patients with eleven atypical bone islands (ABI) are presented, some showing associated pain (5), some with atypical radiographic appearance (3), some with increased activity on BS (4), some with documented enlargement over time (7), one with abnormal CT attenuation value, some in the setting of osteopoikilosis (2), one in the setting of Gardner's Syndrome and one osteoid osteoma simulating a bone island. This series represents the spectrum of presentations of ABI. Comprehensive review of the literature reveals that the previous largest series of ABI showing enlargement as the atypical feature was in younger patients with jaw BI. Hence, this represents one of the largest series reported of ABI of all types in adults.
Topics: Adult; Bone Diseases; Bone Neoplasms; Humans; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 33065973
DOI: 10.3390/medicina56100534 -
Life Sciences Jan 2022To study the proapoptotic effect of ligustilide on osteoblastoma (OS) and the relative related molecular mechanism.
OBJECTIVE
To study the proapoptotic effect of ligustilide on osteoblastoma (OS) and the relative related molecular mechanism.
METHODS AND MATERIALS
An MTT was used to examine the proliferation of OS cells, and Flow cytometry was used to analyze apoptosis and the cell cycle. Western blotting was used to detect the signaling pathway of apoptosis, and immunohistochemical (IH) staining was used to detect the apoptosis status of OS cells. A TLR4 inhibitor was used to study the effect of ligustilide on OS.
RESULTS
Ligustilide inhibited OS cell proliferation but had no inhibitory effect on normal bone marrow cells. Flow cytometry results showed that ligustilide induced apoptosis in OS cells, and the cell cycle was arrested at the M/G2 phase. Western blot results showed that ERK, P53, P21, Caspase 9, Caspase 8 and Caspase 3 were all activated; cytochrome C and Bax increased; and Bcl-2 decreased when OS was treated with ligustilide. When an ERK or Caspase inhibitor was added to the culture medium, the apoptosis of OS cells decreased to some degree. When OS cells were pretreated with CLI-095, which is a TLR4 inhibitor, the percentage of apoptotic cells and cell cycle arrest were both reversed. IH results also showed that ligustilide induced apoptosis in OS cells, and the effect was blocked by the TLR4 inhibitor.
CONCLUSION
Ligustilide selectively inhibited the proliferation of OS cells by inducing apoptosis, which possibly included endogenous and exogenous apoptosis through TLR4.
Topics: 4-Butyrolactone; Apoptosis; Bone Neoplasms; Caspases; Cell Cycle Checkpoints; Cell Movement; Cell Proliferation; Gene Expression Regulation, Neoplastic; Humans; MAP Kinase Signaling System; Osteoblastoma; Toll-Like Receptor 4; Tumor Cells, Cultured
PubMed: 33545202
DOI: 10.1016/j.lfs.2020.118993 -
Seminars in Musculoskeletal Radiology Feb 2021Interventional radiology procedures have been proven to be as effective as traditional surgery but usually are characterized by lower morbidity rates. In this article,...
Interventional radiology procedures have been proven to be as effective as traditional surgery but usually are characterized by lower morbidity rates. In this article, the most diffuse IR treatments for pediatric lesions are reviewed with the aim of describing main advantages and drawbacks. Ablation procedures (in particular RFA and MRgFUS) are widely used for the management of osteoid osteoma and osteoblastoma whereas intracystic injection of methylprednisolone acetate is performed for simple bone cysts. Sclerosing agents and where possible, selective arterial embolization are used for treatment of aneurysmal bone cysts and other vascular malformations. In the management of malignant muscoloskeletal tumors, the role interventional radiology is mainly represented by percutaneous biopsies, and by adiuvant selective embolizations in presence of hypervascular lesions to be submitted to surgery.
Topics: Bone Neoplasms; Child; High-Intensity Focused Ultrasound Ablation; Humans; Magnetic Resonance Imaging; Osteoma, Osteoid; Radiology, Interventional
PubMed: 34020477
DOI: 10.1055/s-0041-1730326