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Journal of Orthopaedic Case Reports Jun 2024Osteoblastoma is an uncommon benign bone tumor characterized by the formation of osteoid tissue, occurring more frequently in men than in women. It is often associated...
INTRODUCTION
Osteoblastoma is an uncommon benign bone tumor characterized by the formation of osteoid tissue, occurring more frequently in men than in women. It is often associated with osteoid osteoma and can be found at various locations in the skeleton, although it is rare in the sacrum. Typically, these lesions involve the posterior elements of the spine, including the pedicle and the lamina. We would like to present a case of sacral osteoblastoma, clinically presenting as lumbar radiculopathy, which was treated at our institute.
CASE REPORT
A 23-year-old male presented to us with left gluteal pain radiating to the left lower limb pain for 2 years. He had multiple consultations elsewhere and was being treated as a probable case of a lumbar disc lesion with left lower limb radiculopathy. X-rays appeared normal. Magnetic resonance imaging of the lumbar spine and pelvis revealed a T2 hyperintense lesion affecting the posterior elements of S3, compressing the nerve roots. Computed tomography (CT) was a better investigation modality for osteoblastoma. En bloc excision and curettage were performed, and the histopathological analysis confirmed the diagnosis of osteoblastoma. The patient had immediate relief of symptoms postoperatively with no complications. At 2-year follow-up, the patient had no evidence of recurrence on a follow-up CT scan.
CONCLUSION
Osteoblastomas predominantly occur in the spine, with rare instances in the sacrum. Treatment typically involves en bloc excision. Confusing clinical presentation may delay diagnosis, resulting in persistent morbidity.
PubMed: 38910997
DOI: 10.13107/jocr.2024.v14.i06.4520 -
Genes, Chromosomes & Cancer May 2024Osteoblastomas (OBs) are benign neoplasms constituting approximately 1% of primary bone tumors with a predilection for the spine and sacrum. We describe an OB of the... (Review)
Review
Osteoblastomas (OBs) are benign neoplasms constituting approximately 1% of primary bone tumors with a predilection for the spine and sacrum. We describe an OB of the proximal phalanx of the left thumb in a 38-year-old female. MRI of left hand demonstrated a 29-mm mildly expansile enhancing lesion involving the entire proximal phalanx of the first digit. Histology displayed a bone-forming tumor consisting of trabeculae of remodeled woven bone framed by plump osteoblasts in a vascularized background. Next-generation sequencing analysis identified a PRSS44::ALK fusion gene.
Topics: Humans; Female; Adult; Thumb; Osteoblastoma; Bone Neoplasms; Oncogene Proteins, Fusion
PubMed: 38738966
DOI: 10.1002/gcc.23241 -
Radiology Case Reports Jul 2024An osteoblastoma is a benign bone tumor characterized by osteoblast proliferation that is more commonly diagnosed in young men during adolescence and youth. The...
An osteoblastoma is a benign bone tumor characterized by osteoblast proliferation that is more commonly diagnosed in young men during adolescence and youth. The condition mainly occurs in the posterior regions of the spine and sacrum, but in rare cases, the patella as well. We present a case of patellar osteoblastoma successfully managed through intralesional curettage and grafting, highlighting the need for comprehensive imaging and pathological studies to ensure an accurate diagnosis. A 26-year-old male with a history of knee plica excision presented with persistent knee pain over 1 year. Radiographic and CT evaluations revealed an osteolytic lesion in the patella, further characterized by MRI. An incisional biopsy confirmed the diagnosis of osteoblastoma. Intralesional curettage and grafting were performed. Later, subsequent follow-up demonstrated complete pain relief, restoration of knee function, and optimal graft incorporation. As shown in this case, precise diagnosis and effective management are key to improving the quality of life of patients. Furthermore, it illustrates that intralesional curettage and grafting are effective treatments for patellar osteoblastomas. Given the rarity of this condition, further research and comprehensive case studies are imperative to establish standardized guidelines for improved healthcare and patient outcomes. In summary, while the clinical characteristics of patellar osteoblastoma resemble those of osteoblastomas in general, its unique presentation warrants specific attention. Individualized consideration of adjuvant measures, graft selection, and preventive fixation is vital to ensure optimal outcomes in patellar osteoblastoma management.
PubMed: 38666146
DOI: 10.1016/j.radcr.2024.03.035 -
Journal of Craniovertebral Junction &... 2024This technical report illustrates the technique to perform computed tomography (CT)-guided bone biopsies in the body and dens of the axis (C2 vertebra) through a...
This technical report illustrates the technique to perform computed tomography (CT)-guided bone biopsies in the body and dens of the axis (C2 vertebra) through a posterior transpedicular approach with the use of preoperative contrast-enhanced scans to highlight the course of the vertebral artery. The technique is presented through two exemplification cases: a pediatric patient with osteoblastoma and secondary aneurysmal bone cyst and one adult patient with melanoma metastasis. This case highlights the potential of the CT-guided posterolateral/transpedicular approach for performing safe and effective biopsies in the body and dens of C2, even in pediatric patients.
PubMed: 38644913
DOI: 10.4103/jcvjs.jcvjs_183_23 -
Ear, Nose, & Throat Journal Apr 2024Osteoblastoma is a typically noncancerous bone tumor commonly found in the spine and long bones of the arms and legs. It is exceedingly rare for this tumor to occur in...
Osteoblastoma is a typically noncancerous bone tumor commonly found in the spine and long bones of the arms and legs. It is exceedingly rare for this tumor to occur in the paranasal sinuses. We present a case of osteoblastoma in a 13-year-old boy affecting the ethmoid sinus, which manifested as exophthalmos. A computed tomography scan revealed an expansive lesion in the right ethmoid sinus, causing compression and displacement of the orbital contents to the right. The lesion exhibited a mix of ground glass opacity and dense bone. On magnetic resonance imaging, the less dense areas of the tumor showed strong enhancement, while the densely sclerotic regions appeared as signal voids on all imaging sequences. A combined transorbital and transnasal approach was performed to remove the tumor. Histologically, the tumor consisted expansile growth surrounded by a sclerotic rim of inter-anastomosing trabeculae of woven bone set within loose edematous fibrovascular stroma. This case highlights the unusual occurrence of osteoblastoma in the ethmoid sinus, a location seldom associated with this type of tumor, and adds to the existing literature on this topic and offers a new surgical approach to managing this entity.
PubMed: 38624092
DOI: 10.1177/01455613241244659 -
Clinical Case Reports Apr 2024Osteoblastoma of the frontal sinus, although rare, can manifest with seizures and pneumocephalus, underscoring the importance of thorough evaluation and complete...
KEY CLINICAL MESSAGE
Osteoblastoma of the frontal sinus, although rare, can manifest with seizures and pneumocephalus, underscoring the importance of thorough evaluation and complete surgical excision to prevent serious complications and ensure optimal patient outcomes.
ABSTRACT
Osteoblastoma is an infrequent bone tumor, with origins typically in the vertebrae and long bones. While craniofacial involvement is rare, it may occur in regions such as the paranasal sinuses. We present a case of osteoblastoma located in the frontal sinus, an exceptionally uncommon site, resulting in seizures secondary to pneumocephalus. A 21-year-old male presented with a generalized tonic-clonic seizure and postictal confusion. Imaging studies revealed a well-defined lesion in the left frontal sinus causing cortical breach, destruction of the posterior wall, and pneumocephalus. A total surgical excision was performed through bifrontal craniotomy. Histopathological analysis confirmed the diagnosis of osteoblastoma. Postoperative recovery was uneventful, with a follow-up CT scan showing complete lesion excision. Osteoblastomas, especially in the cranial sinuses, are rare entities that may present asymptomatically but can lead to severe complications. The risk of recurrence underscores the importance of complete surgical resection for optimal patient outcomes.
PubMed: 38623357
DOI: 10.1002/ccr3.8776 -
ChemMedChem Apr 2024Aspartate transcarbamoylase (ATC) is the first committed step in de novo pyrimidine biosynthesis in eukaryotes and plants. A potent transition state analog of human...
Aspartate transcarbamoylase (ATC) is the first committed step in de novo pyrimidine biosynthesis in eukaryotes and plants. A potent transition state analog of human ATCase (PALA) has previously been assessed in clinical trials for the treatment of cancer, but was ultimately unsuccessful. Additionally, inhibition of this pathway has been proposed to be a target to suppress cell proliferation in E. coli, the malarial parasite and tuberculosis. In this manuscript we screened a 70-member library of ATC inhibitors developed against the malarial and tubercular ATCases for inhibitors of the human ATC. Four compounds showed low nanomolar inhibition (IC 30-120 nM) in an in vitro activity assay. These compounds significantly outperform PALA, which has a triphasic inhibition response under identical conditions, in which significant activity remains at PALA concentrations above 10 μM. Evidence for a druggable allosteric pocket in human ATC is provided by both in vitro enzyme kinetic, homology modeling and in silico docking. These compounds also suppress the proliferation of U2OS osteoblastoma cells by promoting cell cycle arrest in G0/G1 phase. This report provides the first evidence for an allosteric pocket in human ATC, which greatly enhances its druggability and demonstrates the potential of this series in cancer therapy.
PubMed: 38602859
DOI: 10.1002/cmdc.202300688 -
Diagnostic Pathology Apr 2024Cementoblastoma is a rare odontogenic tumor characterized by the formation of osteocementum-like tissue on a tooth root directly by neoplastic cementoblasts. Although it...
BACKGROUND
Cementoblastoma is a rare odontogenic tumor characterized by the formation of osteocementum-like tissue on a tooth root directly by neoplastic cementoblasts. Although it is categorized as benign, it has a high potential for growth with a certain degree of recurrence risk. However, there are only a few studies describing the features of recurrent cementoblastoma. The diagnosis of recurrent cementoblastoma is challenging not only due to its cytological atypia but also because of its large size and multicentric growth pattern. These characteristics suggest a potential for malignancy.
CASE PRESENTATION
A 29-year-old woman was transferred to our university dental hospital complaining of swelling of the right mandible. She had a history of enucleation of cementoblastoma associated with the third molar of the right mandible. Five years after the initial treatment, imaging demonstrated well-circumscribed multicentric radiopaque lesions in the same area. Histologically, the lesion consisted of osteocementum-like tissue rimmed with polygonal or plump tumor cells. Several cells were large epithelioid cells with bizarre nucleoli, which may be reminiscent of malignant tumors. Otherwise, there were no apparent malignant findings, including proliferative activity or atypical mitotic figure. Besides, tumor cells were positive for c-FOS, a marker of osteoblastoma and cementoblastoma. Eventually, the patient was diagnosed with recurrent cementoblastoma.
CONCLUSIONS
Pathological analyses of this case suggested that the recurrent event in the cementoblastoma altered its growth pattern and tumor cell shape. Moreover, in the case of enucleation surgery, long-term follow-up is important because there is some recurrent risk of cementoblastoma, although it is not high.
Topics: Female; Humans; Adult; Mandibular Neoplasms; Cementoma; Odontogenic Tumors; Tooth Root; Mandible
PubMed: 38589906
DOI: 10.1186/s13000-024-01479-0 -
Indian Journal of Surgical Oncology Mar 2024In this narrative review, we aim to describe the clinical features, diagnosis, and management of common primary osseous tumors affecting the posterior elements of the... (Review)
Review
In this narrative review, we aim to describe the clinical features, diagnosis, and management of common primary osseous tumors affecting the posterior elements of the spine in children. We searched PubMed, Mendeley, and Google Scholar using the terms primary osseous tumors of the spine in children, tumors of the posterior elements of the spine, and names of individual tumors. The clinical features, investigations, and treatment modalities were analyzed, and a narrative review of the topic was prepared. We have included 54 studies published in the last 20 years. The majority are isolated reports or case series. Tumors of the posterior elements of the spine are rare. They are common in children and the majority of them are benign. Pain and deformity are common presentations. It is better to perform thorough investigations of children complaining of back pain to rule out primary tumors of the posterior elements of the spine.
PubMed: 38545585
DOI: 10.1007/s13193-023-01729-5 -
Journal of Prosthodontics : Official... Mar 2024This technique presents a new fabrication workflow for a three-dimensional (3D) printed custom tray, which duplicates the morphology of the treatment denture for...
This technique presents a new fabrication workflow for a three-dimensional (3D) printed custom tray, which duplicates the morphology of the treatment denture for maxillofacial prostheses using an intraoral scanner, computer-aided design (CAD) software, and a 3D printer. A 70-year-old man underwent reconstruction of segmental mandibulectomy for mandibular osteoblastoma, followed by implant placement and secondary surgery. During the surgical treatment, a treatment denture was fabricated to restore oral function and determine the morphology of the definitive denture. To create the definitive denture with the same morphology as the treatment denture a custom tray was fabricated with the denture morphology after chairside adjustments. The oral cavity was scanned using an intraoral scanner, and the data acquired were imported into general-purpose CAD software, adjusted, and imported into a 3D printer to produce the custom tray. This was fitted into the patient's mouth without any issues, and closed tray impressions were made with impression caps for the locator attachments on the implant body. The morphology of the treatment denture was replicated in the definitive denture by making a silicon impression of the cameo surface at the fabrication of the cast after impression making. In this technique, the morphology of the treatment denture was transferred accurately to the definitive implant partial denture by leveraging existing digital technology. This method represents a practical approach for partial denture fabrication, including maxillofacial defects with complex denture configurations.
PubMed: 38513226
DOI: 10.1111/jopr.13850