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Cureus Feb 2024Osteoblastoma, an uncommon bone neoplasm characterized by the formation of osteoid tissue, constitutes a rare subset of bone tumors, representing only a negligible...
Osteoblastoma, an uncommon bone neoplasm characterized by the formation of osteoid tissue, constitutes a rare subset of bone tumors, representing only a negligible percentage of cases. While extensive research on the condition has identified a predilection for long bones and vertebrae, occurrences in facial bones are infrequent. This case report discusses a unique presentation in a nine-year-old female diagnosed with a tumor located in the mandibular parasymphysis region. Radiological examination revealed distinctive irregular contours surrounding the lesion, prompting a comprehensive investigation involving biopsy and subsequent histological analysis. The ensuing evaluation definitively confirmed the diagnosis of a typical benign osteoblastoma. This report highlights the novelty of an unresected benign osteoblastoma situated in the mandible, currently undergoing periodic review, with the option of surgery also on the table.
PubMed: 38465192
DOI: 10.7759/cureus.53900 -
Oral and Maxillofacial Surgery Clinics... Aug 2024This article provides a comprehensive overview of benign non-odontogenic pathologies. Bone-derived lesions like osteoma, osteoid osteoma, osteoblastoma, and... (Review)
Review
This article provides a comprehensive overview of benign non-odontogenic pathologies. Bone-derived lesions like osteoma, osteoid osteoma, osteoblastoma, and osteochondroma are discussed in detail, emphasizing their radiographic features, locations, and treatment strategies. Cartilage-derived lesions such as chondroma, chondroblastoma, and chondromyxoid fibroma are also examined, noting their typical presentation and management approaches. The article then delves into fibroconnective tissue lesions. Mesenchymal and vascular lesions are detailed regarding their clinical and radiographic characteristics and treatment options. Lastly, nerve-derived lesions like schwannoma and neurofibroma are covered, providing insights into their association with diseases like neurofibromatosis and preferred management strategies.
Topics: Humans; Child; Bone Neoplasms
PubMed: 38402139
DOI: 10.1016/j.coms.2024.01.007 -
Surgical Neurology International 2024Osteoblastomas, although rare, are benign primary bone tumors, with cervical spine involvement being exceptionally uncommon. Late diagnosis, especially in aggressive...
BACKGROUND
Osteoblastomas, although rare, are benign primary bone tumors, with cervical spine involvement being exceptionally uncommon. Late diagnosis, especially in aggressive cases, can lead to surgical challenges. Oxidized regenerated cellulose (ORC) used for hemostasis may result in complications if left in the surgical field.
CASE DESCRIPTION
An 8-year-old female presented with six months of intractable neck pain accompanied by swelling, hindering proximal right upper extremity evaluation. Motor strength was intact distally, with normal reflexes and no hypoesthesia. Imaging revealed a C4-5 facet joint lesion necessitating surgery. Intraoperative hemorrhage prompted ORC application, which led to postoperative arm pain and C5-6 radiculopathy. Subsequent surgery alleviated these symptoms.
CONCLUSION
Osteoblastomas, despite their benign classification, may exhibit aggressive characteristics, warranting resection. Cervical spine osteoblastomas, due to their vascular nature and proximity to vital structures, complicate surgical interventions. ORC, a commonly used hemostatic agent, may induce compression complications, and early intervention is critical for patient recovery. This case underscores the intricacies of managing aggressive osteoblastomas in the cervical spine and highlights potential ORC-related complications. Surgeons must exercise caution when using ORC and consider postoperative risks. Prompt intervention and meticulous planning are paramount for favorable outcomes in such cases.
PubMed: 38344086
DOI: 10.25259/SNI_854_2023 -
The British Journal of Radiology Mar 2024We retrospectively reviewed the CT and MRI features of patients with benign osteoblastoma in the calvarium and skull base (CSBOB).
OBJECTIVE
We retrospectively reviewed the CT and MRI features of patients with benign osteoblastoma in the calvarium and skull base (CSBOB).
METHODS
Nine cases of pathologically confirmed benign CSBOB were analysed retrospectively. The patients had undergone CT and/or MRI. Tumour location, size, and imaging features were reviewed and recorded.
RESULTS
The patients included four males and five females with a mean age of 27.0 years (age 14-40 years). The tumours were located in the frontal bone in 3 patients, the occipital bone in 3 patients, and in the parietal bone, sphenoid bone, and skull base in 1 patient each. On CT, the tumours measured 5.1 ± 3.3 (1.8-8.4) cm. Seven tumours were shown to have caused expansile bony destruction with an eggshell appearance and varying degrees of calcification or matrix mineralization. Multiple septa were observed in 5 tumours. Intracranial growth was observed in 5 tumours. On MRI, 7 tumours showed heterogeneous hypo- to isointensity on T1WI. Heterogeneous high signal patterns with low signal rims and septa were observed in 6 tumours on T2WI, and 4 showed a fluid-fluid level. On contrast-enhanced imaging, 6 tumours showed peripheral and septal enhancement, and 2 showed the dural tail sign.
CONCLUSIONS
Benign CSBOB is a rare tumour characterized by expansile bony destruction, septa, a sclerotic rim and calcification or matrix mineralization on CT and MRI.
ADVANCES IN KNOWLEDGE
The findings from this study contribute to a better understanding of benign CSBOB and provide valuable imaging features that can aid in its diagnosis and differentiation from other tumours in the calvarium and skull base.
Topics: Male; Female; Humans; Adult; Adolescent; Young Adult; Osteoblastoma; Retrospective Studies; Tomography, X-Ray Computed; Magnetic Resonance Imaging; Skull Base; Bone Neoplasms
PubMed: 38310336
DOI: 10.1093/bjr/tqae027 -
Journal of Orthopaedic Case Reports Jan 2024Osteoblastoma is a rare, benign, bone-forming tumor accounting for <1% of all primary bone tumors. It has a predilection for the posterior elements of the spine and...
INTRODUCTION
Osteoblastoma is a rare, benign, bone-forming tumor accounting for <1% of all primary bone tumors. It has a predilection for the posterior elements of the spine and metaphysis and diaphysis of long bones. The occurrence of this tumor in the metatarsal region is rare. We report such the case of a metatarsal osteoblastoma which was treated with wide excision and non-vascularized fibular autograft: a reliable method of reconstruction.
CASE REPORT
A 25-year-old woman presented with progressive pain and swelling over the right foot for 4 years. On examination, there was a gross swelling over the fourth metatarsal region over the dorsum of the foot. Radiographs revealed a osteoblastic lesion of the fourth metatarsal bone expanding into the intermetatarsal region. Magnetic resonance imaging (MRI) revealed an expansile altered signal intensity lesion which was hypointense on both T1 and T2 - weighted images with no soft-tissue component. With a working diagnosis of locally aggressive bone-forming tumor, she underwent wide excision of the tumor with reconstruction using a non-vascularized fibular autograft. Intraoperative samples sent for histopathological examination confirmed the diagnosis of osteoblastoma. After 2 years of follow-up, the patient is able to weight bear with no pain and imaging shows graft incorporation with no signs of recurrence.
CONCLUSION
Osteoblastoma of the metatarsal region can present a diagnostic conundrum to the treating clinician due to its rare nature. Proper evaluation and reconstruction at an early stage with wide excision and reconstruction with non-vascularized fibular autograft are a reliable treatment option.
PubMed: 38292114
DOI: 10.13107/jocr.2024.v14.i01.4130 -
BMJ Case Reports Jan 2024Osteoblastoma is a primary bone-forming tumour that usually occurs in the second decade with an affinity to the posterior elements when found in the spine. Its...
Osteoblastoma is a primary bone-forming tumour that usually occurs in the second decade with an affinity to the posterior elements when found in the spine. Its occurrence in the early first decade is uncommon and often causes a diagnostic dilemma. It usually has a late presentation and the symptoms may be non-specific which may lead the clinician to overlook this particular entity. We present a case of osteoblastoma of the posterior elements of the C5 vertebra in a pre-adolescent child who was diagnosed and successfully managed with surgical resection in a timely fashion that led to favourable recovery postoperatively.
Topics: Child; Humans; Cervical Vertebrae; Neck Pain; Osteoblastoma; Spinal Neoplasms
PubMed: 38286577
DOI: 10.1136/bcr-2023-257171 -
Zhongguo Gu Shang = China Journal of... Jan 2024
Topics: Humans; Osteoblastoma; Neck; Spinal Neoplasms; Cervical Vertebrae
PubMed: 38286459
DOI: 10.12200/j.issn.1003-0034.20220079 -
Annals of Medicine and Surgery (2012) Dec 2023Osteoblastoma (OB) is a rare benign bone tumor, representing less than 1% of all bone neoplasms. In contrast to the typical OB, a smaller subset known as 'epithelioid...
INTRODUCTION AND IMPORTANCE
Osteoblastoma (OB) is a rare benign bone tumor, representing less than 1% of all bone neoplasms. In contrast to the typical OB, a smaller subset known as 'epithelioid osteoblastoma (EO)' exhibits a distinctive inclination for local invasion and recurrence. This rare variant can pose diagnostic challenges, particularly due to its unclear clinical and radiological presentation.
CASE PRESENTATION
This study details a clinical case of a 12-year-old boy experiencing pain from a lytic bone tumor located in the thoracic vertebrae (T3-T4), initially suggesting malignancy. Following extensive curettage, histopathological analysis confirmed the diagnosis of EO through immunohistochemical staining. Subsequent follow-up at 3 months revealed the absence of no pain or recurrence of the lesion.
CLINICAL DISCUSSION
Distinguishing EO from a malignant tumor requires a multidisciplinary approach, considering clinical, radiographic, and histological features that differentiate the two entities.
CONCLUSION
The goal of this case presentation is to increase awareness regarding this recurrent tumor variant, which poses diagnostic challenges, particularly in distinguishing it from malignant tumors, including osteosarcoma.
PubMed: 38098609
DOI: 10.1097/MS9.0000000000001430 -
Cureus Nov 2023Osteoblastoma is a benign bone tumor that can spread aggressively and is commonly found in the spine and long bones. When present in other areas of the body, it can be...
Osteoblastoma is a benign bone tumor that can spread aggressively and is commonly found in the spine and long bones. When present in other areas of the body, it can be difficult to diagnose. While this tumor is rarely found in the hand, in reported cases, it typically presents with pain. Treatment is usually curettage and marginal excision. We report a rare case of osteoblastoma in the fifth proximal phalanx of the left hand in a 14-year-old right-handed female, presenting as a painless, progressively growing mass with associated flexion contracture over a seven-month period, with no history of trauma. An excision biopsy with curettage was performed, and histopathologic examination confirmed the diagnosis of osteoblastoma. This is a rare case of osteoblastoma of the proximal phalanx presenting as a painless mass in the finger with a progressive flexion contracture. Histopathologic examination is important in diagnosing osteoblastoma to determine the appropriate treatment and surgery. Post-operatively, close monitoring is important due to the high recurrence rates in these tumors.
PubMed: 38074054
DOI: 10.7759/cureus.48409 -
Journal of Children's Orthopaedics Dec 2023The growing spine differs from the adult spine in several ways. Although tumors and infections cause only a small percentage of pediatric back pain incidences, delayed... (Review)
Review
The growing spine differs from the adult spine in several ways. Although tumors and infections cause only a small percentage of pediatric back pain incidences, delayed proper diagnosis and treatment may be disastrous. Benign lesions, such as osteoid osteoma, osteoblastoma, and aneurysmal bone cyst in the spine, are predominant during the first two decades of life, whereas malignant bony spinal tumors are rare. In the pediatric population, malignant spine tumors include osteosarcoma, Ewing's sarcoma, lymphoma, and metastatic neuroblastoma. Infections of the growing spine are rare, with the incidence of discitis peaking in patients under the age of 5 years and that of vertebral osteomyelitis peaking in older children. Spondylodiscitis is often a benign, self-limiting condition with low potential for bone destruction. Conservative treatments, including bedrest, immobilization, and antibiotics, are usually sufficient. Spinal tuberculosis is a frequently observed form of skeletal tuberculosis, especially in developing countries. Indications for surgical treatment include neurologic deficit, spinal instability, progressive kyphosis, late-onset paraplegia, and advanced disease unresponsive to nonoperative treatment. Spinal tumors and infections should be considered potential diagnoses in cases with spinal pain unrelated to the child's activity, accompanied by fever, malaise, and weight loss. In spinal tumors, early diagnosis, fast and adequate multidisciplinary management, appropriate en bloc resection, and reconstruction improve local control, survival, and quality of life. Pyogenic, hematogenous spondylodiscitis is the most common spinal infection; however, tuberculosis-induced spondylodiscitis should also be considered. level 4.
PubMed: 38050596
DOI: 10.1177/18632521231215857