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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 -
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 -
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 -
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 -
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 -
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