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Frontiers in Surgery 2022Osteoblastoma is quite rare in the oromaxillo-facial region, while the mandible is always the predilection. However, in our case, the lesion was located in the left...
BACKGROUND
Osteoblastoma is quite rare in the oromaxillo-facial region, while the mandible is always the predilection. However, in our case, the lesion was located in the left temporal articular tubercle, involving the adjacent skull base, which is extremely rare in the literature.
CASE REPORTS
It had been diagnosed as the most common temporomandibular joint disorder in the local hospital before the patient came to our department, mainly due to the primary symptom, that was, the patient got pain in the left temporomandibular joint area while opening the mouth. However, we found a mass of bone lesions at the left temporal articular tubercle in MRI and cone beam CT, and it turned out to be an osteoblastoma after surgery. The patient's primary symptom disappeared after recovering from the surgery, and there have been no indications of complication or recurrence up to now.
CONCLUSION
Osteoblastoma is very rare in the temporomandibular joint region. It could easily miss the possibility of a benign tumor due to its unusual location and confusing chief complaint in this case. Our report provides experience in the identification of osteoblastoma in rare sites.
PubMed: 36684216
DOI: 10.3389/fsurg.2022.1033342 -
Journal of Orthopaedic Case Reports 2022Intraosseous hemangiomas (IH) are one of the rarest bone tumors that an orthopedic surgeon comes across, more so in the long bones. It most often affects adult females,...
INTRODUCTION
Intraosseous hemangiomas (IH) are one of the rarest bone tumors that an orthopedic surgeon comes across, more so in the long bones. It most often affects adult females, severely blunting their activities of daily living, coupled with potential debilitating complications such as pathological fracture.
CASE PRESENTATION
We present a case of a 38-year-old female who presented with long standing pain and swelling in the left knee. Radiology, in the form of plain radiographs and magnetic resonance imaging, narrowed the diagnosis down to a benign form of osteoblastoma or hemangioma. With this in mind, the patient underwent radical excision of the lytic lesion, along with a margin of the surrounding normal bone. The defect was filled with impaction bone grafting and supplemented by a hydroxyapatite block and a poly ethyl ether ketone plate. The patient had excellent clinical, functional, and radiological outcomes at 6 months follow-up.
CONCLUSION
With the inherent rarity of IH, especially when it affects the long bones, it has barely been reported in orthopedic literature. Subsequently, management protocols for such lesions are ill-defined, which can be deleterious to the patient as well as the surgeon. Through this case report, we show how to approach a patient presenting with associated complaints, and show a detailed outline of an efficacious management regime that gave excellent outcomes in our patient.
PubMed: 36660152
DOI: 10.13107/jocr.2022.v12.i05.2834 -
Journal of Orthopaedic Case Reports Jul 2022Lytic lesions of the proximal tibia include a plethora of differential diagnoses. The most common ones are the Giant cell tumor, fibrous dysplasia, adamantinoma,...
INTRODUCTION
Lytic lesions of the proximal tibia include a plethora of differential diagnoses. The most common ones are the Giant cell tumor, fibrous dysplasia, adamantinoma, chondromyxoid fibroma, and osteoblastoma. The rarer ones include vascular tumors such as hemangioma and hemangioendothelioma. A systematic line of investigations is essential to pick up the right diagnosis especially in case of rarer conditions. In this background, we present a case of lytic lesion of the proximal tibia which turned out to be epitheloid hemangioendothelioma (EHE).
CASE REPORT
A 37-year-old female presented with pain and swelling in the left knee for 2 years. On examination, the patient had a 3 × 4 cm firm, non-tender, and well-defined swelling on the anterolateral aspect of the proximal tibia. X-ray showed a lytic lesion of the proximal tibia. Magnetic resonance imaging was suggestive of a giant cell tumor. However, the biopsy revealed a rare diagnosis of epithelioid hemangioendothelioma.
CONCLUSION
The patient was managed with wide excision. In a young adult, arthrodesis may not be the best option; hence, we reconstructed the joint with a custom mega prosthesis (CMP). At 3 years follow-up, our patient had no signs of recurrence. To our best knowledge, this is the first report on the use of CMP in a case of EHE.
PubMed: 36659885
DOI: 10.13107/jocr.2022.v12.i07.2892 -
Medicina (Kaunas, Lithuania) Dec 2022: Benign osseous tumors of the spinal column comprise about 10% of all spinal tumors and are rare cause for surgery. However, these tumors pose various management...
: Benign osseous tumors of the spinal column comprise about 10% of all spinal tumors and are rare cause for surgery. However, these tumors pose various management challenges and conventional surgery may be associated with significant morbidity. Previous reports on minimally invasive resection of these lesions are rare. We report a series of patients managed by total resection of benign osseous spine tumors using MIS techniques. Surgical decisions and technical considerations are discussed. : A retrospective evaluation of prospectively collected data of patients who underwent minimally invasive surgery for removal of benign osseous vertebral tumors. Demographic, clinical and radiographic features, operative details and final pathological reports were summarized. Primary outcomes were completeness of tumor resection and pain relief assessed by VAS for back and leg pain. Secondary outcome measures were recurrence of tumor on repeat post-operative MRI and postoperative unstable deformity on standing scoliosis X-rays. : This series included 32 cases of primary osseous spine tumors resected by minimally invasive techniques. There were 17 males and 15 females aged 5-68 years (mean 23.3). The follow-up period was 8-90 months (mean 32 months) and the preoperative symptoms duration was 9-96 months. Axial spinal pain was the presenting symptom in all the patients. Five patients also complained about radicular pain and four patients had antalgic scoliosis. The tumor involved the thoracic spine in 12 cases, the lumbar segment in 11, the cervical in 5 and the sacral area in 4 cases. Complete tumor removal was performed in all patients. No procedure-related complications were encountered. Histopathology showed osteoid osteoma in 24 patients, osteoblastoma in 5 patients, and fibrous dysplasia, fibroadenoma and eosinophilic granuloma in one case each. All patients experienced significant pain relief after surgery, and had stopped pain medications by 12 months postoperatively. No patient suffered from tumor recurrence or spinal deformity. : Minimally invasive surgery is feasible for total removal of selected benign vertebral tumors and may have some advantages over conventional surgical techniques.
Topics: Male; Female; Humans; Spinal Neoplasms; Scoliosis; Retrospective Studies; Treatment Outcome; Neoplasm Recurrence, Local; Pain
PubMed: 36557042
DOI: 10.3390/medicina58121840 -
Journal of Dentistry (Shiraz, Iran) Sep 2022Osteoblastoma is a solitary benign bone-forming neoplasm, which comprises 1% of all primary bone tumors. Multifocal benign osteoblastoma of the jaws is very rare....
Osteoblastoma is a solitary benign bone-forming neoplasm, which comprises 1% of all primary bone tumors. Multifocal benign osteoblastoma of the jaws is very rare. Osteoblastoma must be differentiated from other similar bone-forming lesions such as osteoid osteoma and osteosarcoma for correct diagnosis and proper treatment planning. Therefore, precise examination of the patient and correlation with radiographic and histological features are essential for the best treatment and prognosis. This study reports a rare case of multifocal osteoblastoma in a 30-year-old female, involving the mandible and the maxilla, which was treated by surgical excision, iliac bone graft reconstruction, and implantation. Complete surgical excision is necessary to treat osteoblastoma with a good prognosis. The patient was followed-up for four years postoperatively, and there were no signs of recurrence in the panoramic view or the clinical examination.
PubMed: 36506877
DOI: 10.30476/DENTJODS.2021.90454.1491 -
Balkan Medical Journal Jan 2023
Topics: Humans; Osteoblastoma; Tibia; Fibroma; Diagnosis, Differential
PubMed: 36482109
DOI: 10.4274/balkanmedj.galenos.2022.2022-10-34 -
Multimodal Imaging Evaluation and Clinical Progress of Spinal Osteoblastoma: A Comprehensive Review.World Neurosurgery Feb 2023Spinal osteoblastoma is rare clinically, with insidious onset, atypical symptoms, and various imaging manifestations, which can easily lead to misdiagnosis and delayed... (Review)
Review
Spinal osteoblastoma is rare clinically, with insidious onset, atypical symptoms, and various imaging manifestations, which can easily lead to misdiagnosis and delayed diagnosis. It can cause severe neurological dysfunction in patients with intermediate to advanced stages and may easily recur after surgery. Imaging examinations such as radiography, computed tomography, magnetic resonance imaging, and positron emission tomography have different value for the diagnosis of spinal osteoblastoma, but they lack specificity. The preferred treatment is surgical resection, which is technically difficult, and in some cases, osteoblastoma cannot be completely removed. New clinical approaches such as radiofrequency ablation, radiotherapy, targeted chemotherapy, and other comprehensive treatments have emerged and are progressing rapidly, but no unified norms have yet been developed. This manuscript provides a systematic review of the literature and provides an extensive and comprehensive review of this rare tumor in terms of multimodality imaging manifestations and clinical progress.
Topics: Humans; Osteoblastoma; Neoplasm Recurrence, Local; Spine; Magnetic Resonance Imaging; Multimodal Imaging; Bone Neoplasms; Spinal Neoplasms
PubMed: 36455846
DOI: 10.1016/j.wneu.2022.11.118 -
Brain & Spine 2022•Metaplastic meningiomas are rare entities, and intracranial osseous subtype are even more rare.•Gross total resection is considered the best treatment... (Review)
Review
•Metaplastic meningiomas are rare entities, and intracranial osseous subtype are even more rare.•Gross total resection is considered the best treatment choice.•Differential diagnosis is mandatory, including osteoma, osteoblastoma, and calcified giant aneurysms.•This rare entity must be considered in a global approach and tailored surgical technique.
PubMed: 36248170
DOI: 10.1016/j.bas.2022.101189 -
International Journal of Surgery Case... Oct 2022Intraosseous schwannoma is a rare benign tumor, which mostly occurred in head and neck region. In this report we aimed to describe a unique case of intraosseous...
INTRODUCTION AND IMPORTANCE
Intraosseous schwannoma is a rare benign tumor, which mostly occurred in head and neck region. In this report we aimed to describe a unique case of intraosseous schwannoma in the distal femur without any other clinical finding aside from pain and tenderness.
CASE PRESENTATION
19-year-old female presented with persistent pain on her left thigh for 4 years. Aside from tenderness on her left thigh, her physical examination was unremarkable. Plain radiographic of left femur showed a small geographic osteolytic cortical lesion with sclerotic rim in the distal region. Further evaluation with MRI showed eccentric lytic lesion with an isointense signal on T1-weighted images and a hyperintense signals on T2-weighted images. Patient then temporarily diagnosed with osteoblastoma. Because there were no signs of malignancy, the patient underwent a curettage of the mass followed by synthetic bone graft application. Histopathological findings were consistent for schwannoma. Further immunohistochemical examination showed positive S100 staining, confirming the final diagnosis of intraosseous schwannoma. There were no signs of early complication on 3 months post-operation. The patient was further scheduled for follow up on 6 months and then routinely every year post-operation to evaluate any signs of complication or recurrence.
CLINICAL DISCUSSION
It is difficult to make an accurate initial diagnosis of intraosseous schwannomas. Because the clinical presentation was most likely not specific as such in this case and there many other tumors of the bone with similar radiographic finding which are more common. Curettage of the mass followed by synthetic bone graft application was performed as there were no sign of malignancy making more invasive option deemed to cause more harm than good to the patient.
CONCLUSION
The possibility of intraosseous schwannoma should have been taken under consideration in the differential diagnosis of osteolytic lesion with pain in long bone.
PubMed: 36174461
DOI: 10.1016/j.ijscr.2022.107643