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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 -
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 -
International Journal of Surgery Case... May 2022Osteoid osteoma (OO) is a type of benign bone tumor that usually affects long bones of the lower extremities. In this case report, we describe a successful surgical...
INTRODUCTION
Osteoid osteoma (OO) is a type of benign bone tumor that usually affects long bones of the lower extremities. In this case report, we describe a successful surgical resection of an OO located in the rib which is an extremely rare location.
CASE PRESENTATION
This is a 23-year-old man, referred to our thoracic surgery department for a very intense nocturnal right chest pain for over two months, the physical examination was normal without clinically palpable chest mass. The CT scan showed an osteocondensing lesion at the junction of the middle and posterior arches of the right 6th rib suggesting Ewing's sarcoma, a PET CT was then requested showed an appearance of a regular non-hypermetabolic inhomogeneous condensation at the junction of the middle and posterior arcs of the 6th right rib. After multidisciplinary concertation, a CT-guided biopsy of the lesion was performed, the histological examination of which revealed an osteoid osteoma, then a complete resection of the lesion was performed under posterolateral thoracotomy which histology confirmed a costal osteoid osteoma. The patient is currently in good health condition with complete disappearance of chest pain after one month of the operation and does not present any complications for the long-term follow-up.
DISCUSSION
Osteoid osteoma (OO) is a benign primary bone tumor with unknown pathogenesis. That occurs in patients during the first two decades of life in about 60 to 75% of cases with a strong predilection for long bones, in 60 to 70% of cases. Flat bones, such as the skull, jawbones, innominate bones, and ribs are rarely described (McDermott et al., 1996 [1]). The standard treatment for OO is complete surgical excision, which is offered to the patient when the pain is chronic and not relieved by medical treatment (Osteoid osteoma: the results of surgical treatment [Internet] [2]).
CONCLUSION
The osteoid osteoma of the rib is a very rare entity of bone neoplasms, this is the first case in our department that demonstrates that the OO of the rib must be suspected affront any painful rib and that complete surgical excision when it's possible, is a safe and effective treatment.
PubMed: 35658306
DOI: 10.1016/j.ijscr.2022.107139 -
Virchows Archiv : An International... Mar 2020Osteoid osteoma and osteoblastoma are bone-forming tumors shown to harbor FOS (87%) and FOSB (3%) rearrangements. The aim was to evaluate the immunohistochemical...
Osteoid osteoma and osteoblastoma are bone-forming tumors shown to harbor FOS (87%) and FOSB (3%) rearrangements. The aim was to evaluate the immunohistochemical expression of FOS and FOSB in these tumors in comparison to other bone tumors, to evaluate the influence of decalcification, and to correlate immunohistochemical findings with the underlying genetic alteration using fluorescence in situ hybridization (FISH). Immunohistochemistry using whole sections was performed on osteoid osteoma (n=23), osteoblastoma (n=22), osteoblastoma-like osteosarcoma (n=3), reactive (n=3), and proliferative (n=11) bone lesions. Immunoreactivity in giant cell tumor of bone (n=74), aneurysmal bone cyst (n=6), chondromyxoid fibroma (n=20), osteosarcoma (n=85), chondroblastoma (n=17), and clear cell chondrosarcoma (n=20) was assessed using tissue micro arrays. Strong nuclear expression of FOS in > 50% of the tumor cells was observed in all osteoid osteomas (22/22), in 57% of osteoblastomas (12/21) and in 3/197 control cases. FOS immunoreactivity disappeared after > 3 days decalcification. FOS rearrangements were present in 94% of osteoid osteomas and osteoblastomas, with a concordance of 86% between FISH and immunohistochemistry. Two osteoblastomas (5%) were positive for FOSB, as opposed to 8/177 control cases. Additional FISH revealed no FOSB rearrangements in these cases. To conclude, in short decalcified biopsies, FOS immunohistochemistry can be used to diagnose osteoid osteoma and osteoblastoma, as overexpression is seen in the majority, being rare in their mimics. FOS immunohistochemistry should not be used after long decalcification. Moreover, low level of focal expression found in other lesions and tissues might cause diagnostic problems, in which case FISH could be employed.
Topics: Adolescent; Adult; Biomarkers, Tumor; Bone Neoplasms; Child; Child, Preschool; Female; Humans; Male; Middle Aged; Osteoblastoma; Osteoma, Osteoid; Proto-Oncogene Proteins c-fos; Young Adult
PubMed: 31768625
DOI: 10.1007/s00428-019-02684-9 -
Acta Chirurgiae Orthopaedicae Et... 2020PURPOSE OF THE STUDY Osteoid osteoma is a benign tumor that forms in bone, which accounts for 3% of all primary bone tumors. The classical clinical finding is...
PURPOSE OF THE STUDY Osteoid osteoma is a benign tumor that forms in bone, which accounts for 3% of all primary bone tumors. The classical clinical finding is substantial nocturnal pain and imaging findings. The management of osteoid osteomas include open surgical excision or minimally invasive percutaneous interventions. Why and which treatment modality should be considered between CT-guided radiofrequency ablation and open surgical excision for osteoid osteomas in unusual locations? MATERIAL AND METHODS We retrospectively reviewed 17 patients with osteoid osteomas in unusual locations included cuboid, triquetrum, coronoid process, and proximal phalanx. We evaluated the duration from symptoms to diagnosis, activity related pain, clinical findings, and possible recurrence or complications. The minimum clinical follow-up was 51 ± 34.8 months. RESULTS CT-guided radiofrequency ablation was applied to 3 patients and open surgical excision procedures to 14. All the complaints of patients gone after treatment. No major complications were observed following CT-guided radiofrequency ablation or surgical excision. Transient weakness/paresthesia was determined in 1 patient in the treated shoulder after CT-guided radiofrequency ablation, which resolved spontaneously in the 6th week. There was only recurrence seen in 1 patient, who had 2nd proximal phalangeal osteoid osteoma. Proximal interphalangeal joint arthrodesis was performed after recurred lesion. DISCUSSION The main challenge in management of the osteoid osteomas of the unusual locations are the diagnosis. When we examined the literature, the interval from the beginning of the symptoms to accurate diagnosis did not change over the past decades. Techniques for management of these lesions should be chosen with consideration of the location of the lesion. CONCLUSIONS If there is long-term complaint of undiagnosed limb pain, the physician should suspect osteoid osteoma. However, the selection of treatment modality should be considered according to the location of the lesion. Which management modality is superior may change depending on the location of the lesion between CT-guided radiofrequency ablation and surgical excision. Key words: osteoid osteoma, unusual locations, CT guided, radiofrequency ablation, benign bone tumor.
Topics: Bone Neoplasms; Catheter Ablation; Humans; Neoplasm Recurrence, Local; Osteoma, Osteoid; Retrospective Studies; Treatment Outcome
PubMed: 32940225
DOI: No ID Found -
Frontiers in Oncology 2022Osteoid osteoma (OO) comprises approximately 11%-14% of benign bone tumors. The main symptom of OO is localized pain accompanied by nighttime aggravation. Surgical...
BACKGROUND
Osteoid osteoma (OO) comprises approximately 11%-14% of benign bone tumors. The main symptom of OO is localized pain accompanied by nighttime aggravation. Surgical treatment is frequently used in clinic, including open surgery and percutaneous ablation, the latter including radiofrequency ablation, cryoablation, and microwave ablation, but there is no consensus on when and how to choose the best treatment for OO.
PURPOSE
We did a systematic review of the literature on existing surgical treatments of OO to assess the safety and efficacy of surgical treatments of OO and to evaluate the surgical options for different locations of OO.
METHODS
The inclusion criteria in the literature are 1. Patients diagnosed with osteoid osteoma and treated surgically; 2. Include at least five patients; 3. Perioperative visual analogue scale (VAS), postoperative complications, and recurrence were recorded; 4. Literature available in PubMed from January 2014 to December 2021.
RESULTS
In the cohort, 1565 patients (mainly adolescents) with OO received 1615 treatments. And there are 70 patients with postoperative recurrence and 93 patients with postoperative complications (minor: major=84:9). The results of Kruskal-Wallis examination of each experimental index in this experiment were clinical success rate H=14.818, p=0.002, postoperative short-term VAS score H=212.858, p<0.001, postoperative long-term VAS score H=122.290, p<0.001, complication rate H=102.799, p<0.001, recurrence rate H=17.655, p<0.001, the technical success rate was H=45.708, p<0.001, according to the test criteria of α=0.05, H was rejected. The overall means of the outcome index in each group were not completely equal.
CONCLUSION
Percutaneous ablation and open surgery are safe and reliable for OOs, and the technical success rate of percutaneous ablation is higher than that of open surgery. Open surgery and cryoablation can be selected for OOs close to the nerve and atypical sites, while radiofrequency ablation and microwave ablation can be selected for OOs in most other sites.
PubMed: 35936708
DOI: 10.3389/fonc.2022.935640 -
Radiographics : a Review Publication of... Jul 2024Osteoid osteoma (OO) is the third most prevalent benign bone neoplasm in children. Although it predominantly affects the diaphysis of long bones, OO can assume an... (Review)
Review
Osteoid osteoma (OO) is the third most prevalent benign bone neoplasm in children. Although it predominantly affects the diaphysis of long bones, OO can assume an intra-articular location in the epiphysis or the intracapsular portions of bones. The most common location of intra-articular OO is the hip joint. The presentation of intra-articular OOs often poses a diagnostic enigma, both from clinical and radiologic perspectives. Initial symptoms are often vague and nonspecific, characterized by joint pain, stiffness, and limited range of motion, which frequently contributes to a delayed diagnosis. Radiographic findings range from normal to a subtle sclerotic focus, which may or may not have a lucent nidus. In contrast to their extra-articular counterparts, intra-articular lesions have distinct features at MRI, including synovitis, joint effusion, and bone marrow edema-like signal intensity. While CT remains the standard for identifying the nidus, even CT may be inadequate in visualizing it in some cases, necessitating the use of bone scintigraphy or fluorine 18-labeled sodium fluoride PET/CT for definitive diagnosis. Radiologists frequently play a pivotal role in suggesting this diagnosis. However, familiarity with the unique imaging attributes of intra-articular OO is key to this endeavor. Awareness of these distinctive imaging findings of intra-articular OO is crucial for avoiding diagnostic delay, ensuring timely intervention, and preventing unnecessary procedures or surgeries resulting from a misdiagnosis. The authors highlight and illustrate the different manifestations of intra-articular OO as compared with the more common extra-articular lesions with respect to clinical presentation and imaging findings. RSNA, 2024 Supplemental material is available for this article.
Topics: Humans; Osteoma, Osteoid; Bone Neoplasms; Diagnosis, Differential; Child; Magnetic Resonance Imaging; Hip Joint; Tomography, X-Ray Computed
PubMed: 38843097
DOI: 10.1148/rg.230208 -
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