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Case Reports in Dentistry 2022. Osteoid osteoma is a benign osseous tumor characterized by an excessive formation of unmineralized bone matrix. The aim of this study was to present, through a case...
. Osteoid osteoma is a benign osseous tumor characterized by an excessive formation of unmineralized bone matrix. The aim of this study was to present, through a case report, the clinical and radiological manifestations of osteoid osteoma affecting the left basilar border of the mandible. . A 30-year-old male patient presented with left mandibular pain of unknown etiology. The chief complaint was mandibular pain accentuating mainly at night, originating in the left basilar border, and radiating to the whole mandibular hemi-arch. Extraoral examination revealed a small, bone-consistent, and slightly painful swelling. Computed tomography scan revealed a well-limited, infracentimetric, and mixed osteolytic image with central nidus and peripheral osteocondensation. Histological examination revealed osteoid osteoma. Surgical excision of the lesion was performed, and the pain stopped immediately. . This benign tumor presents many clinical and radiological features similar to other lesions. To differentiate osteoid osteoma from these other bone pathoses, practitioners should have a clear concept and keen observation skills. Confrontation of the clinical, radiological, and anatomopathological data is therefore essential to establish the correct diagnosis and to determine the appropriate treatment plan.
PubMed: 36569572
DOI: 10.1155/2022/2179877 -
RoFo : Fortschritte Auf Dem Gebiete Der... Apr 2020While ostoeid osteomas (OO) are typically located in long tubular bones, OO occurring elsewhere are referred to as "atypical". Aim of our study was to review the... (Observational Study)
Observational Study
PURPOSE
While ostoeid osteomas (OO) are typically located in long tubular bones, OO occurring elsewhere are referred to as "atypical". Aim of our study was to review the characteristics of atypically located OO, course of symptoms and therapy, as well as clinical outcome, safety, and patient satisfaction of radiofrequency ablation (RFA).
MATERIALS AND METHODS
In the period from 04/01 to 07/13, 33 patients were treated using thermal ablation (RFA or laser), partly with low temperature and short duration technique. Clinical records were analyzed. Additionally, 23 patients were interviewed via telephone. Primary endpoints were technical success, clinical success (recurrence rates), and adverse events. Secondary endpoints were course of symptoms and therapy as well as patient satisfaction.
RESULTS
Mean follow-up was 22.1 ± 21.5 months. Average patient age was 31.7 ± 16.3 years. Localization: Most atypical OO (61 %) were located in the lower extremity, followed by axial skeleton (26 %) and upper extremity (13 %). Pain anamnesis: 74 % of patients stated that their pain occured predominantly at night and responded to NSAID, as typical for OO. Diagnostics: Patients consulted on average 4 different doctors and in 52 % patients, ≥ 3 different radiologic imaging techniques where used before the diagnosis "OO" was made.
OUTCOME
Technical success of thermal ablation was 100 %. Primary clinical success was 91 %. Patient satisfaction was 100 %. No major complications occurred.
CONCLUSION
In ¼ of cases, atypical OO did not show the typical pain characteristics of OO. Image-guided thermal ablation is a promising and safe therapy also for patients with atypical OO.
KEY POINTS
· Atypical OO are challenging regarding diagnostics and therapy. · Image-guided thermal ablation is a safe and effective procedure also for patients with atypical OO. · Image-guided thermal ablation shows high patient satisfaction.
CITATION FORMAT
· Seemann RJ, Märdian S, Schwabe P et al. Atypically Located Osteoid Osteoma: Characteristics and Therapeutic Success After Image-Guided Thermal Ablation. Fortschr Röntgenstr 2020; 192: 335 - 342.
Topics: Adolescent; Adult; Bone Neoplasms; Child; Female; Follow-Up Studies; Humans; Laser Therapy; Male; Middle Aged; Neoplasm Recurrence, Local; Osteoma, Osteoid; Patient Satisfaction; Prospective Studies; Radiofrequency Ablation; Surgery, Computer-Assisted; Tomography, X-Ray Computed; Young Adult
PubMed: 31747706
DOI: 10.1055/a-1012-2143 -
Journal of Radiology Case Reports Jun 2022A radiographically lucent patellar lesion may represent a variety of etiologies, ranging from more commonly seen degenerative, metabolic, infectious, developmental,...
A radiographically lucent patellar lesion may represent a variety of etiologies, ranging from more commonly seen degenerative, metabolic, infectious, developmental, posttraumatic, postoperative causes to rarer benign and malignant neoplasms. Clinical symptoms, surgical history, laboratory values, and radiographic features may help narrow the differential. In addition, radiographic features such as circumscribed borders and sharply delineated margins favor benign lesions while ill-defined margins suggest malignant etiologies. This case series illustrates the imaging findings and explores relevant clinical findings in a variety of interesting lucent patellar lesions.
Topics: Bone Neoplasms; Humans; Patella
PubMed: 35875365
DOI: 10.3941/jrcr.v16i6.4484 -
Indian Journal of Orthopaedics Jan 2023We aimed to evaluate the midterm functional and clinical outcomes of the patients who underwent arthroscopic excision of hip osteoid osteoma (OO).
PURPOSE
We aimed to evaluate the midterm functional and clinical outcomes of the patients who underwent arthroscopic excision of hip osteoid osteoma (OO).
METHODS
We reviewed records of patients diagnosed with intra-articular hip OO, treated with hip arthroscopic excision procedure, and a minimum of 1-year postoperative between 2011 and 2020. Clinical outcomes were assessed range of motion (ROM) pre and postoperatively, and functional outcomes were evaluated with a modified Harris hip score (modified HHS) and Visual analog scale test. All patients were assessed by hip radiography, and three radiological measurements, including lateral center-edge angle (LCEA), alpha angle, and Tönnis angle, were measured. These parameters were compared with unaffected hips.
RESULTS
Fifteen (5 female and 10 male) patients were included in the study, with a mean age of 32.6 ± 12.7 (range 12-53). The average postoperative follow-up period was 59.1 ± 28 (range 13-106) months. The functional and clinical scores were significantly improved at the final visit compared to the preoperative values. No differences were found between the operated and unaffected sides with respect to the radiological parameters. The preoperative alpha was significantly higher on the operated side than on the unaffected side ( = 0.007).
CONCLUSION
In this study, within an average of 5 years after surgery, hip arthroscopy provided successful clinical outcomes in the treatment of OO of the hip joint without recurrence. The modified HHS, VAS, and HOS values improved significantly at the final follow-up; 14 of 15 patients had satisfactory outcomes after hip arthroscopy for hip OO.
LEVEL OF EVIDENCE
Prognostic Level IV study.
PubMed: 36660482
DOI: 10.1007/s43465-022-00772-8 -
Orthopaedic Surgery Sep 2023Osteoid osteoma is a benign osteogenic tumor that occurs mostly in the femoral stem, while osteoid osteoma occurring in the lumbar vertebral body is a relatively rare...
BACKGROUND
Osteoid osteoma is a benign osteogenic tumor that occurs mostly in the femoral stem, while osteoid osteoma occurring in the lumbar vertebral body is a relatively rare case. To minimize treatment-related complications, a computer-assisted navigation fully visualized spinal endoscopy was used. Ultimately, the pathology was diagnosed as osteoid osteoma.
CASE PRESENTATION
We report a 19-year-old adult male with low back pain that worsened at night and CT, MRI imaging showed an abnormal signal shadow at the posterior margin of the lumbar vertebral body. Due to the proximity of the lesion to the spinal canal and adjacent to the nerve roots, it was difficult to precisely localize the lesion by purely endoscopic or open procedures, and if necessary, the resection of surrounding tissues had to be expanded, causing unnecessary damage to the surrounding tissues. Therefore, we choose computer-assisted navigation fully visualized spinal endoscopy to perform the treatment.
CONCLUSION
In this case, we report an osteoid osteoma that occurs less frequently in the lumbar vertebral body. Using computer-assisted navigation with fully visualized spinal endoscopy, we successfully resected the osteoid osteoma at the posterior margin of the L3 vertebral body preoperatively by computer-planned path with intraoperative visualization endoscopy, minimizing the damage to spinal stability. Computer-assisted navigation with visualization endoscopy provides a more precise and minimally invasive approach to the treatment of osteoid osteoma of the spine.
Topics: Adult; Humans; Male; Young Adult; Osteoma, Osteoid; Spinal Neoplasms; Treatment Outcome; Lumbar Vertebrae; Endoscopy; Surgery, Computer-Assisted
PubMed: 37344980
DOI: 10.1111/os.13801 -
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 -
Radiology Case Reports Nov 2021Atypical intra-articular osteoid osteoma can be difficult to diagnose and challenging to treat. We report a case of a right acetabular subchondral intra-articular...
Atypical intra-articular osteoid osteoma can be difficult to diagnose and challenging to treat. We report a case of a right acetabular subchondral intra-articular osteoid osteoma in a young male patient which was initially diagnosed as femoroacetabular impingement due to its atypical clinical and radiological presentations. After fully working up the patient the lesion was successfully treated with percutaneous CT-guided low-power bipolar radiofrequency ablation using several per procedural articular cartilage thermal protective measures including intra-articular thermocouple, and continuous per procedural joint space cooling with Dextrose 5% solution. A precise RFA electrode placement, using the No-touch technique, and applying different passive and active thermal protective measures were helpful in avoiding collateral damage of the hip joint articular cartilages. atypical intra-articular osteoid osteomas necessitate pertinent correlation between the clinical and radiological presentations. As far as intra-articular or subchondral nidus ablation is concerned, thermal protective measures should be considered.
PubMed: 34484539
DOI: 10.1016/j.radcr.2021.07.072 -
European Journal of Radiology Sep 2023Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive interventional technique for osteoid osteoma (OO). The purpose of this study was to evaluate... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive interventional technique for osteoid osteoma (OO). The purpose of this study was to evaluate the efficacy and safety of MRgFUS in the treatment of OO through a systematic review and meta-analysis of pain scores and post-treatment adverse events before and after MRgFUS treatment.
MATERIALS AND METHODS
A comprehensive literature search of PubMed, Embase, Web of science, and Cochrane Library databases was conducted to screen the study literature based on inclusion and exclusion criteria to extract and analyze pre- and post-treatment pain score data, success rates (complete pain relief with no recurrence until the last follow-up), recurrence rates, secondary intervention rates, and complications to evaluate the efficacy and/or safety of MRgFUS for OO.
RESULTS
A total of 113 studies published between 2012 and 2022were collected, resulting in a total sample size of 353 patients. The majority of the studies were prospective and had a follow-up period of 4 weeks or more, and overall, the quality of evidence ranged from low to high. Pain scores at 1 week and 1 month after the merger were 0.62 (9.5% CI:0.28-0.96) and 0.37 (9.5% CI:0.07-0.68), respectively. The success rate of the combination was 92.8% (95% CI: 89.8%-95.7%), the incidence of minor complications (thermal injury at the ablation site) was 0.85%, and no major complications were recorded in any of the included literature.
CONCLUSION
MRgFUS is an effective procedure that is able to treat pain for patients with OO with satisfying efficacy and safety.
PROSPERO
No.CRD42023415573.
Topics: Humans; Osteoma, Osteoid; Prospective Studies; Pain; Bone Neoplasms; Magnetic Resonance Spectroscopy; Treatment Outcome
PubMed: 37523874
DOI: 10.1016/j.ejrad.2023.111006 -
Current Approaches to Osteoid Osteoma and Minimally Invasive Surgery-A Minireview and a Case Report.Journal of Clinical Medicine Sep 2022Osteoid osteoma is a benign bone tumor typically affecting the long bones of the lower limbs in young male patients. The lesion can be asymptomatic but, in most cases,...
Osteoid osteoma is a benign bone tumor typically affecting the long bones of the lower limbs in young male patients. The lesion can be asymptomatic but, in most cases, patients present with characteristic nocturnal pain that is very responsive to the administration of non-steroidal anti-inflammatory drugs. Although osteoid osteomas can regress spontaneously over time, surgical therapy is often indicated in cases of long-lasting resistant pain. Apart from a traditional open resection, the modalities of minimally invasive surgery, such as radiofrequency ablation or cryoablation, have gradually become the option of choice in most cases. The first part of this manuscript is a minireview of the contemporary literature on the pathogenesis, diagnosis, and current trends in the treatment of osteoid osteoma. The second part is a case report of our own experience with a conventional C-arm-guided radiofrequency ablation of an osteoid osteoma located in the femoral neck in an adolescent patient. The aim was to prove that, even when more sophisticated guiding devices (CT, O-arm, etc.) are not available, the safe and reliable ablation of the lesion using a C-arm is still possible even in hard-to-reach areas. The case was a success, with no perioperative or postoperative complications.
PubMed: 36233673
DOI: 10.3390/jcm11195806 -
Radiology Case Reports Aug 2023Phosphaturic mesenchymal tumor is a rare tumor characterized by paraneoplastic osteomalacia. The diagnosis is often delayed because of nonspecific symptoms and...
Phosphaturic mesenchymal tumor is a rare tumor characterized by paraneoplastic osteomalacia. The diagnosis is often delayed because of nonspecific symptoms and difficulty to localize the tumor. In this study we report a case of PMT of the left femur detected by Ga-68-DOTATATE PET-CT with radiological features mimicking osteoid osteoma. We report a 31-year-old female patient who presented to our hospital for evaluation due to progressive bone pain and muscle weakness. Her laboratory data showed hypophosphatemia and increased fibroblast growth factor 23 (FGF-23) together with reduced bone mineral density on bone densitometry. The diagnosis of PMT was suspected and the tumor was identified on Ga-68-DOTATATE PET-CT as a focal uptake in a lucent lesion of the left femoral head with a central sclerotic dot mimicking a nidus as seen in osteoid osteoma. The lesion was treated with percutaneous radiofrequency ablation. Laboratory tests and bone densitometry rapidly improved post-treatment. The present case emphasizes the difficulty to diagnose PMT due to its nonspecific biochemical and clinical presentation and the relevance of functional imaging for locating these tumors despite different radiological presentation.
PubMed: 37304318
DOI: 10.1016/j.radcr.2023.05.008