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Seminars in Ultrasound, CT, and MR Oct 2020Osteoid osteoma (OO) is a benign bone neoplasm consisting of a central prostaglandin-secreting nidus surrounded by a zone of reactive sclerosis. The diagnosis is... (Review)
Review
Osteoid osteoma (OO) is a benign bone neoplasm consisting of a central prostaglandin-secreting nidus surrounded by a zone of reactive sclerosis. The diagnosis is suspected in children and young adults with longstanding nighttime pain that is relieved by salicylates or nonsteroidal anti-inflammatory drugs. Early studies suggested that computed tomography had a higher sensitivity and specificity in the diagnosis of OO compared to magnetic resonance imaging (MRI). More recent literature suggests MRI done with dynamic postcontrast imaging to be equal to or slightly better at detecting the nidus of OOs, particularly the ones in atypical locations. Being able to evaluate for OO utilizing MRI is important given that the majority of these lesions occur in younger patients, in whom there is greater concern to limit ionizing radiation. Furthermore, patients with atypical OOs often receive an MRI if radiographs are not suggestive of the diagnosis. Therefore, it is important for radiologists to be aware of the imaging features that can help make the diagnosis on MRI.
Topics: Adolescent; Bone Neoplasms; Bone and Bones; Child; Child, Preschool; Female; Humans; Magnetic Resonance Imaging; Male; Osteoma, Osteoid
PubMed: 32980095
DOI: 10.1053/j.sult.2020.05.013 -
FP Essentials Jun 2020Primary benign bone tumors are uncommon and most often affect children and young adults. They typically are detected incidentally on imaging, though some patients...
Primary benign bone tumors are uncommon and most often affect children and young adults. They typically are detected incidentally on imaging, though some patients present with pain, swelling, or other symptoms. The four main categories of benign bone tumor are: bone-forming (eg, osteoid osteoma, osteoblastoma, fibrous dysplasia, enostosis), cartilage-forming (eg, osteochondroma, enchondroma), connective tissue, and vascular; the latter two are rare. A fifth category is idiopathic (eg, giant cell tumor, aneurysmal bone cyst, simple bone cyst). Osteochondromas are the most common, accounting for 30% to 35% of benign bone tumors. Giant cell tumors account for 20%, osteoblastomas for 14%, and osteoid osteomas for 12%. All others are less common. Diagnosis mainly is via imaging; biopsy rarely is required. Management varies with tumor type, location, symptoms, and risk of recurrence. Some (eg, enchondroma, osteochondroma, fibrous dysplasia, enostosis) typically are asymptomatic, and generally require no intervention. Others (eg, osteoid osteoma, aneurysmal bone cyst, simple bone cyst) can cause symptoms and require percutaneous ablation or surgery. Still others (eg, giant cell tumor, osteoblastoma) can be aggressive and require surgery and other therapies. Malignant transformation is rare for all benign bone tumors, but patients with these tumors should be monitored with serial imaging.
Topics: Biopsy; Bone Neoplasms; Child; Diagnosis, Differential; Humans; Osteoblastoma; Osteoma, Osteoid; Young Adult
PubMed: 32573182
DOI: No ID Found -
International Journal of Molecular... Jan 2023Choroidal neovascularizations are historically associated with exudative macular degeneration, nonetheless, they have been observed in nevus, melanoma, osteoma, and... (Review)
Review
Choroidal neovascularizations are historically associated with exudative macular degeneration, nonetheless, they have been observed in nevus, melanoma, osteoma, and hemangioma involving the choroid and retina. This review aimed to elucidate the possible origins of neovascular membranes by examining in vivo and in vitro models compared to real clinical cases. Among the several potential mechanisms examined, particular attention was paid to histologic alterations and molecular cascades. Physical or biochemical resistance to vascular invasion from the choroid offered by Bruch's membrane, the role of fibroblast growth factor 2 and vascular endothelial growth factor, resident or recruited stem-like/progenitor cells, and other angiogenic promoters were taken into account. Even if the exact mechanisms are still partially obscure, experimental models are progressively enhancing our understanding of neovascularization etiology. Choroidal neovascularization (CNV) over melanoma, osteoma, and other tumors is not rare and is not contraindicative of malignancy as previously believed. In addition, CNV may represent a late complication of either benign or malignant choroidal tumors, stressing the importance of a long follow-up.
Topics: Humans; Choroid Neoplasms; Vascular Endothelial Growth Factor A; Macular Degeneration; Choroidal Neovascularization; Retina; Choroid; Retinal Neovascularization; Melanoma; Osteoma
PubMed: 36674579
DOI: 10.3390/ijms24021064 -
Retina (Philadelphia, Pa.) May 2020To evaluate the outcome of photodynamic therapy (PDT) in the management of extrafoveolar choroidal osteoma.
PURPOSE
To evaluate the outcome of photodynamic therapy (PDT) in the management of extrafoveolar choroidal osteoma.
METHODS
The authors performed a retrospective chart review of all patients with choroidal osteoma that did not involve the foveola and were treated with standard-fluence PDT.
RESULTS
Nine eyes with extrafoveolar choroidal osteoma were studied. Mean logarithm of the minimum angle of resolution best-corrected visual acuity at initial examination was 0.07 (Snellen ∼20/25). The osteoma was treated with 1 (8/9) or 2 (1/9) PDT sessions using 50 J/cm. After a mean follow-up of 49 months, the treated area of osteoma demonstrated complete (4/9) or partial (5/9) regression, with a mean of 73% regression in the PDT-treated areas. Tumor growth in the region of PDT was noted in 3 cases (3/9) (one tumor toward the foveola and two tumors at the margin away from the foveola), but in no case did the tumor reach the foveola. Therefore, PDT controlled tumor growth in 8 of 9 cases with only 1 of 9 cases showing growth through the PDT scar into foveola. Mean logarithm of the minimum angle of resolution visual acuity at last follow-up was 0.04 (Snellen ∼20/20) (P = 0.59).
CONCLUSION
Photodynamic therapy is an effective modality for the management of extrafoveolar choroidal osteoma, minimizing tumor growth toward the foveola and preserving visual acuity.
Topics: Adolescent; Adult; Choroid; Choroid Neoplasms; Female; Humans; Male; Osteoma; Photochemotherapy; Photosensitizing Agents; Retrospective Studies; Tomography, Optical Coherence; Verteporfin; Visual Acuity; Young Adult
PubMed: 30950971
DOI: 10.1097/IAE.0000000000002534 -
European Journal of Ophthalmology Jul 2022To report a case of macular choroidal osteoma treated with photodynamic therapy.
PURPOSE
To report a case of macular choroidal osteoma treated with photodynamic therapy.
OBSERVATIONS
A 34-years old woman with decreased visual acuity in her left eye came to our observation for assessment of an amelanotic choroidal tumor in the left eye. On the basis of ophthalmoscopic and echographic features the tumor was diagnosed as choroidal osteoma. Imaging examination revealed subretinal fluid involving the foveal area associated with alterations of outer neuroepithelial layers and photoreceptors without evidence of choroidal neovascularization. Foveal sparing standard fluence rate photodynamic therapy was performed. After treatment, subretinal fluid reabsorption and visual acuity recovery was noted with progressive restoration of foveal architecture. Due to the relapse of fluid and visual impairment, 1 year after treatment, a second PDT session was made using the same parameters and protocol of treatment. Despite a complete subretinal fluid reabsorption and visual acuity recovery the second treatment was complicated by the development of subretinal fibrosis.
CONCLUSIONS
PDT is effective to induce subretinal fluid reabsorption and visual recovery in choroidal osteoma located in the macular area. However, the risk of possible complications related to the treatment have to be considered.
Topics: Adult; Choroidal Neovascularization; Female; Fluorescein Angiography; Humans; Neoplasm Recurrence, Local; Osteoma; Photochemotherapy; Tomography, Optical Coherence
PubMed: 33715490
DOI: 10.1177/11206721211000639 -
World Journal of Clinical Cases Mar 2021Intradural osteoma is very rarely located in the subdural or subarachnoid space. Unfortunately, intradural osteoma lacks specificity in clinical manifestations and...
BACKGROUND
Intradural osteoma is very rarely located in the subdural or subarachnoid space. Unfortunately, intradural osteoma lacks specificity in clinical manifestations and imaging features and there is currently no consensus on its diagnosis method or treatment strategy. Moreover, the pathogenesis of osteoma without skull structure involvement remains unclear.
CASE SUMMARY
We describe two cases of intradural osteomas located in the subdural and subarachnoid spaces, respectively. The first case involved a 47-year-old woman who presented with a 3-year history of intermittent headache and dizziness. Intraoperatively, a bony hard mass was found in the left frontal area, attached to the inner surface of the dura mater and compressing the underlying arachnoid membrane and brain. The second case involved a 56-year-old woman who had an intracranial high-density lesion isolated under the right greater wing of the sphenoid. Intraoperatively, an arachnoid-covered bony tumor was found in the sylvian fissure. The pathological diagnosis for both patients was osteoma.
CONCLUSION
Surgery and pathological examination are required for diagnosis of intradural osteomas, and craniotomy is a safe and effective treatment.
PubMed: 33748235
DOI: 10.12998/wjcc.v9.i8.1863 -
European Archives of... Sep 2020The purpose of this study was to describe our experience in the surgical treatment of frontal sinus osteomas.
OBJECTIVE
The purpose of this study was to describe our experience in the surgical treatment of frontal sinus osteomas.
METHODS
This study involved 18 patients who underwent surgery for frontal sinus osteoma between January 2016 and December 2019. Demographic characteristics, site and size of osteoma, presenting symptoms, frontal sinus osteoma grading system, presence of frontal sinusitis, surgical methods, treatment outcome, operation time, and complications were reviewed.
RESULTS
The endoscopic approach was performed in all patients except one. Among patients who underwent an endoscopic approach, endoscopic sinus surgery was performed in ten patients and endoscopic-modified Lothrop procedure was performed in seven patients. The mean size of the frontal sinus osteoma was 1.5 ± 0.7 cm. According to the frontal sinus osteoma grading system, grade III (n = 9, 50.0%) was the most common, followed by grade II (n = 4), grade I (n = 3), and grade IV (n = 2). The size of the osteoma and frontal osteoma grading system exhibited statistical significance with the operation time (p < 0.05). There were no major surgical complications or recurrence.
CONCLUSION
The operation time was prolonged when the frontal sinus osteomas were more than 1.5 cm or in grade III and IV frontal osteomas.
Topics: Endoscopy; Frontal Sinus; Humans; Neoplasm Recurrence, Local; Osteoma; Paranasal Sinus Neoplasms
PubMed: 32367154
DOI: 10.1007/s00405-020-06021-8 -
The Israel Medical Association Journal... Aug 2022
Topics: Bone Neoplasms; Fingers; Humans; Osteoma, Osteoid; Upper Extremity
PubMed: 35972009
DOI: No ID Found -
Journal of Neurosurgery. Case Lessons Dec 2023Trigeminal neuralgia (TN) is a common neurosurgical issue that has a detrimental impact on patients' quality of life. Osteoma at the petrous apex is a rare etiology of...
BACKGROUND
Trigeminal neuralgia (TN) is a common neurosurgical issue that has a detrimental impact on patients' quality of life. Osteoma at the petrous apex is a rare etiology of TN. Here, the authors present a case involving the co-occurrence of petrous osteoma and a vascular loop around the trigeminal nerve. Both exerted pressure or compression on the exit of the trigeminal nerve.
OBSERVATIONS
A 46-year-old male presented with a 3-year history of persistent severe pain in the right side of his face. Magnetic resonance tomographic angiography of the trigeminal nerve revealed an abnormal signal in the right prepontine cistern, along with a vascular loop accompanying the right trigeminal nerve. A computed tomography scan of the skull indicated a nodular calcified density. The combined anterior transpetrosal approach for petrous osteoma and microvascular decompression (MVD) for the offending vessel were successfully performed. The patient was discharged without any complications or facial pain.
LESSONS
Although extremely rare, TN simultaneously secondary to petrous osteoma and offending vessels should be considered in the diagnosis. In this case, the combined surgical removal of petrous osteoma and MVD for the offending vessels proved to be an effective treatment for TN secondary to osteoma and vascular compression.
PubMed: 38048567
DOI: 10.3171/CASE23518 -
Surgical Oncology May 2022We sought to systematically assess and summarize the available literature on the clinical outcomes and complications following radiofrequency ablation (RFA) for painful... (Review)
Review
AIM
We sought to systematically assess and summarize the available literature on the clinical outcomes and complications following radiofrequency ablation (RFA) for painful spinal osteoid osteoma (OO).
METHODS
PubMed, Scopus, and CENTRAL databases were searched in accordance with PRISMA guidelines. Studies with available data on safety and clinical outcomes following RFA for spinal OO were included.
RESULTS
In the 14 included studies (11 retrospective; 3 prospective), 354 patients underwent RFA for spinal OO. The mean ages ranged from 16.4 to 28 years (Females = 31.3%). Lesion diameters ranged between 3 and 20 mm and were frequently seen in the posterior elements in 211/331 (64%) patients. The mean distance between OO lesions and neural elements ranged between 1.7 and 7.4 mm. The estimated pain reduction on the numerical rating scale was 6.85/10 (95% confidence intervals [95%CI] 4.67-9.04) at a 12-24-month follow-up; and 7.29/10 (95% CI 6.67-7.91) at a >24-month follow-up (range 24-55 months). Protective measures (e.g., epidural air insufflation or neuroprotective sterile water infusion) were used in 43/354 (12.1%) patients. Local tumor progression was seen in 23/354 (6.5%) patients who were then successfully re-treated with RFA or open surgical resection. Grade I-II complications such as temporary limb paresthesia and wound dehiscence were reported in 4/354 (1.1%) patients. No Grade III-V complications were reported.
CONCLUSION
RFA demonstrated safety and clinical efficacy in most patients harboring painful spinal OO lesions. However, further prospective studies evaluating these outcomes are warranted.
Topics: Adolescent; Adult; Bone Neoplasms; Catheter Ablation; Female; Humans; Osteoma, Osteoid; Prospective Studies; Radiofrequency Ablation; Retrospective Studies; Spinal Neoplasms; Treatment Outcome; Young Adult
PubMed: 35358911
DOI: 10.1016/j.suronc.2022.101747