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The British Journal of Radiology Oct 2020Osteoid osteoma is a painful benign bone tumour of children and young adults with characteristic clinico-radiological features depending upon the location of the lesion.... (Review)
Review
Osteoid osteoma is a painful benign bone tumour of children and young adults with characteristic clinico-radiological features depending upon the location of the lesion. Intraoperative visualisation of the nidus is difficult and therefore curative surgery is often associated with excessive bone removal, significant perioperative morbidity and potential need of bone grafting procedures. With advancement in cross-sectional imaging and radiofrequency ablation (RFA) technology, CT-guided RFA has emerged as the treatment of choice for the osteoid osteoma. This procedure involves accurate cannulation of the nidus and subsequent thermocoagulation-induced necrosis.Multidisciplinary management approach is the standard of care for patients with osteoid osteoma. Appropriate patient selection, identification of imaging pitfalls, pre-anaesthetic evaluation and a protocol-based interventional approach are the cornerstone for a favourable outcome. Comprehensive patient preparation with proper patient position and insulation is important to prevent complications. Use of spinal needle-guided placement of introducer needle, namely, "rail-road technique" is associated with fewer needle trajectory modifications, reduced radiation dose and patient morbidity and less intervention time. Certain other procedural modifications are employed in special situations, for example, intra-articular osteoid osteoma and osteoid osteoma of the subcutaneous bone in order to reduce complications. Treatment follow-up generally includes radiographic assessment and evaluation of pain score. Dynamic contrast-enhanced MRI has been recently found useful for demonstrating post-RFA healing.
Topics: Bone Neoplasms; Catheter Ablation; Humans; Osteoma, Osteoid; Radio Waves; Surgery, Computer-Assisted; Tomography, X-Ray Computed
PubMed: 32520586
DOI: 10.1259/bjr.20200266 -
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 -
Cureus Sep 2023Paranasal osteomas are rare benign bone tumours originating within the paranasal sinuses. Despite their benign nature, these slow-growing osseous lesions can lead to a...
Paranasal osteomas are rare benign bone tumours originating within the paranasal sinuses. Despite their benign nature, these slow-growing osseous lesions can lead to a spectrum of symptoms ranging from asymptomatic discovery to nasal obstruction, headache, facial deformity, and ophthalmological complications. We present the case of a 52-year-old female who initially presented with chronic sinusitis-like symptoms in 2008 and was incidentally found to have a small right-sided paranasal sinus osteoma on CT. Eleven years later, in 2019, she re-presented with new symptoms of unilateral nasal obstruction, epiphora, and restriction in her lateral gaze and was diagnosed with a large osteoma causing structural and ophthalmological issues (proptosis and epiphora). Endoscopic removal of the osteoma successfully alleviated her symptoms. This case emphasises the importance of surveillance of paranasal osteomas as there are no formal guidelines to support clinicians, as even though they grow slowly, they can eventually lead to significant "mass-effect" symptoms and impact local structures. Thus, monitoring and consideration of surgical intervention are crucial to managing these lesions effectively.
PubMed: 37674766
DOI: 10.7759/cureus.44696 -
Archives of Craniofacial Surgery Oct 2021A 65-year-old woman presented with a solid mass on the right temporal area. The mass had grown for over 2 years without any initiating event of trauma or inflammation....
A 65-year-old woman presented with a solid mass on the right temporal area. The mass had grown for over 2 years without any initiating event of trauma or inflammation. Before excision, the patient went through a computed tomography scan, revealing a calcified mass without bony connection. Under general anesthesia, an excisional biopsy was performed. Microscopic examination confirmed a diagnosis of soft tissue osteoma. Soft tissue osteoma is rare, especially in the head and neck region. Osteomas in the temporal region have not been reported yet. Due to its rarity, osteoma might be misdiagnosed as another soft tissue or bone origin tumor. Its treatment of choice is simple excision. In this review, we present an unusual clinical form of soft tissue osteoma.
PubMed: 34732040
DOI: 10.7181/acfs.2021.00388 -
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 -
Indian Journal of Otolaryngology and... Dec 2023Solid primary tumors of the hyoid bone are extremely rare. Osteomas are benign, slow-growing, usually asymptomatic, and well-circumscribed tumors broadly attached to the...
Solid primary tumors of the hyoid bone are extremely rare. Osteomas are benign, slow-growing, usually asymptomatic, and well-circumscribed tumors broadly attached to the bone surface composed of mature lamellar/cortical-type bone with unknown etiology. Osteomas commonly occur in bones formed by membranous ossification, almost exclusively occurring in the head and commonly involving the paranasal sinus, skull vault, mandible, and nasal bone. We discuss a rare case of osteoma involving the hyoid bone.
PubMed: 37974889
DOI: 10.1007/s12070-023-04024-5 -
European Journal of Orthopaedic Surgery... Dec 2021Osteoid osteoma is the third most common benign bone tumor, with well-known clinical presentation and radiological features. Although surgical excision has been the only... (Review)
Review
Osteoid osteoma is the third most common benign bone tumor, with well-known clinical presentation and radiological features. Although surgical excision has been the only therapeutic option for a long time, to date it has been replaced by minimally invasive techniques, which proved satisfactory success rates and low complication occurrence. Therefore, the purpose of this literature review was to describe the main updates of these recent procedures in the field of interventional radiology, with particular attention paid to the results of the leading studies relating to the efficacy, complications, and recurrence rate. Nevertheless, this study aimed to analyze the peculiarities of each reported technique, with specific focus on the possible improvements and pitfalls. Results proved that all mininvasive procedures boast a high success rate with slight number of complications and a low recurrence rate. Radiofrequency ablation is still considered the gold standard procedure for percutaneous treatment of osteoid osteoma, and it has the possibility to combine treatment with a biopsy. Interstitial laser ablation's advantages are the simplicity of use and a lower cost of the electrodes, while cryoablation allows real-time visualization of the ablated zone, increasing the treatment safety. Magnetic resonance-guided focused ultrasound surgery is the most innovative non-invasive procedure, with the unquestionable advantage to be radiation free.
Topics: Bone Neoplasms; Catheter Ablation; High-Intensity Focused Ultrasound Ablation; Humans; Neoplasm Recurrence, Local; Osteoma, Osteoid; Radiology, Interventional; Treatment Outcome
PubMed: 33839926
DOI: 10.1007/s00590-021-02946-w -
Seminars in Musculoskeletal Radiology Dec 2021Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive therapy that uses focused sound energy to thermally ablate focal pathology within the body.... (Review)
Review
Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive therapy that uses focused sound energy to thermally ablate focal pathology within the body. In the United States, MRgFUS is approved by the Food and Drug Administration for the treatment of uterine fibroids, palliation of painful bone metastases, and thalamotomy for the treatment of essential tremor. However, it has also demonstrated utility for the treatment of a wide range of additional musculoskeletal (MSK) conditions that currently are treated as off-label indications. Advantages of the technology include the lack of ionizing radiation, the completely noninvasive technique, and the precise targeting that offer unprecedented control of the delivery of the thermal dose, as well as real-time monitoring capability with MR thermometry. In this review, we describe the most common MSK applications of MRgFUS: palliation of bone metastases, treatment of osteoid osteomas, desmoid tumors, facet arthropathy, and other developing indications.
Topics: Bone Neoplasms; Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Musculoskeletal System; Osteoma, Osteoid; United States
PubMed: 34937113
DOI: 10.1055/s-0041-1735472 -
Seminars in Musculoskeletal Radiology Aug 2022Regarding osseous tumors of the spine, characteristic morphology is encountered in hemangioma of the vertebral body, osteoid osteoma (OO), osteochondroma, Paget's... (Review)
Review
Regarding osseous tumors of the spine, characteristic morphology is encountered in hemangioma of the vertebral body, osteoid osteoma (OO), osteochondroma, Paget's disease, and bone islands. In these cases, radiologic imaging can make a specific diagnosis and thereby avoid biopsy, especially when the radiologist has chosen the correct imaging modality to establish the diagnosis, such as thin-slice computed tomography in suspected OO. A benign lesion is suggested by a high amount of fat within the lesion, the lack of uptake of the contrast agent, and a homogeneous aspect without solid parts in a cystic tumor. Suspicion of malignancy should be raised in spinal lesions with a heterogeneous disordered matrix, distinct signal decrease in T1-weighted magnetic resonance imaging, blurred border, perilesional edema, cortex erosion, and a large soft tissue component. Biopsy is mandatory in presumed malignancy, such as any Lodwick grade II or III osteolytic lesion in the vertebral column. The radiologist plays a crucial role in determining the clinical pathway by choosing the imaging approach wisely, by narrowing the differential diagnosis list, and, when characteristic morphology is encountered, by avoiding unnecessary biopsies.
Topics: Biopsy; Humans; Osteoma, Osteoid; Spinal Neoplasms; Spine; Tomography, X-Ray Computed
PubMed: 36103887
DOI: 10.1055/s-0042-1753506 -
Ear, Nose, & Throat Journal Dec 2022Osteomas are rare benign bony tumors located in the tongue area. In most cases, patients presenting with a lingual osteoma are asymptomatic but may complain of the... (Review)
Review
Osteomas are rare benign bony tumors located in the tongue area. In most cases, patients presenting with a lingual osteoma are asymptomatic but may complain of the sensation of having a foreign body. Fewer than 100 cases of lingual osteoma have been reported worldwide. Here, we present 2 cases of tongue base osteoma that were treated with excision under a laryngoscope.
Topics: Humans; Tongue Neoplasms; Osteoma; Tongue Diseases; Tongue
PubMed: 33263414
DOI: 10.1177/0145561320977469