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Archives of Pathology & Laboratory... Oct 2010Osteoblastoma is a rare benign bone tumor. Although the histologic features in most cases are distinctive, there are various permutations that make the diagnosis...
Osteoblastoma is a rare benign bone tumor. Although the histologic features in most cases are distinctive, there are various permutations that make the diagnosis challenging. It can mimic a variety of other benign bone tumors, but more importantly, distinguishing it from osteoblastoma-like osteosarcoma can be difficult. In this case report, I describe the clinicopathologic findings for a 13-year-old adolescent boy with T7 spinal osteoblastoma and review salient clinical, radiographic, and pathologic features of osteoblastoma, as well as the differential diagnoses.
Topics: Adolescent; Bone Neoplasms; Cartilage, Articular; Diagnosis, Differential; Humans; Male; Osteoblastoma; Osteoblasts; Osteoclasts; Spinal Neoplasms; Tomography, X-Ray Computed
PubMed: 20923301
DOI: 10.5858/2010-0201-CR.1 -
Medical Science Monitor : International... Feb 2019BACKGROUND Osteoblastoma is a rare, benign, osteolytic neoplasm commonly found in the spine in early adulthood. Here, we review the clinical characteristics,... (Review)
Review
BACKGROUND Osteoblastoma is a rare, benign, osteolytic neoplasm commonly found in the spine in early adulthood. Here, we review the clinical characteristics, radiographic findings, and surgical management of patients with spinal osteoblastoma. MATERIAL AND METHODS Thirteen patients with osteoblastoma who underwent surgery at our institute from June 2008 to November 2017 were enrolled in this study. The American Spinal Injury Association (ASIA) impairment scale was used to assess neurological function. All patients were treated with either total excision or intralesional piecemeal excision without postoperative radiotherapy. Clinical efficacy was evaluated by visual analog scale (VAS) scores, the Oswestry Disability Index (ODI) of nerve function, physical and radiographic examinations, bone fusion, and neurologic status. RESULTS The follow-up lasted 23-82 months (average, 43.8 months). The average surgical time was 178.1 minutes (range, 100-230 minutes), with an average intraoperative blood loss of 574 mL (range, 230-1100 mL). Postoperatively, VAS scores decreased from 6.2±1.7 to 0.5±0.7 (P<0.001). The preoperative and final ODI scores were 51.1±7.7 and 22.6±4.9, respectively, reflecting a significant decrease (P<0.001). According to the ASIA classification, 3 patients had grade C, 3 patients had grade D, and 7 patients had grade E disease. Three months postoperatively, 1 patient had grade D and 10 patients had grade E disease; ultimately, all cases were grade E disease. Only 1 patient experienced local recurrence and underwent en bloc marginal resection with postoperative radiotherapy. All patients remained neurologically stable without any major complications. CONCLUSIONS Accurate intraoperative localization with complete resection is the key to preventing recurrence. Aggressive surgical resection can achieve satisfactory clinical and radiographic outcomes.
Topics: Adolescent; Adult; Aged; Bone Neoplasms; Child; China; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Osteoblastoma; Plastic Surgery Procedures; Retrospective Studies; Spine; Treatment Outcome
PubMed: 30785872
DOI: 10.12659/MSM.913666 -
Revista Da Associacao Medica Brasileira... May 2017Spinal tumors are rare in the pediatric population, presenting many specific peculiarities when compared to adults. We have performed a broad narrative review to... (Review)
Review
INTRODUCTION:
Spinal tumors are rare in the pediatric population, presenting many specific peculiarities when compared to adults. We have performed a broad narrative review to describe the most common spinal tumors in children, discussing their main characteristics and management options.
METHOD:
The authors have performed an extensive review of the peer-reviewed literature addressing the aforementioned objectives.
RESULTS:
Multimodality radiological studies (plain films, 3D computed tomography scan and magnetic resonance imaging) are necessary for proper evaluation and differential diagnosis of spinal tumors in children. In selected cases nuclear medicine imaging is used to improve the chances of a more accurate diagnosis. As a general rule, a fine needle biopsy is recommended after radiological evaluation to confirm the tumor's histology. Primary bone tumors can be divided into benign bone tumors, mostly represented by vertebral hemangiomas, osteoid osteomas, osteoblastomas, aneurismal bone cysts, and eosinophilic granulomas, and malign or aggressive tumors, such as Ewing's or osteogenic sarcomas. Secondary bone tumors (spinal metastases) comprise different tumor histologies, and treatment is mainly based on tumor's radiosensitivity. The characteristics and treatment options of the main spinal tumors are discussed in details.
CONCLUSION:
Spinal tumors in children are rare lesions that demand a thorough understanding of their main characteristics for their proper management. Understanding the nuances of spinal tumors in children is of paramount importance for improving outcomes and chances of cure.
Topics: Child; Humans; Magnetic Resonance Imaging; Neoplasm Metastasis; Spinal Cord Compression; Spinal Neoplasms; Tomography, X-Ray Computed
PubMed: 28724045
DOI: 10.1590/1806-9282.63.05.459 -
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 -
Anales Del Sistema Sanitario de Navarra Dec 2016Osteoblastoma is an infrequent primary osseous tumour. Its presentation in the upper extremities and more specifically in the carpal bones is unusual. We present a case...
Osteoblastoma is an infrequent primary osseous tumour. Its presentation in the upper extremities and more specifically in the carpal bones is unusual. We present a case of osteoblastoma localized in the hamate bone and review the treatment realized in this infrequent localization. A young male patient with pain and swelling in the back of his hand of one year’s evolution, resistant to medical treatment. Complementary tests showed lytic tumefaction in the hamate bone with non-aggressive characteristics. It was treated by curettage and filling the iliac crest with autologous graft. The pathological anatomical study diagnosed that it was a case of osteoblastoma. The result was satisfactory, with total disappearance of the pain and a radiological image of complete restitution of the osseous defect, with no signs of recurrence after 4 years. The treatment should be curettage plus autologous graft. Conversely, resection of the affected bone can be considered in cases with aggressive data.
Topics: Adult; Bone Neoplasms; Hamate Bone; Humans; Male; Osteoblastoma
PubMed: 28032879
DOI: 10.23938/ASSN.0246 -
Turkish Neurosurgery 2016To describe the demographics, clinical and radiologic presentation, surgical considerations, and clinical outcomes associated with spinal osteoblastoma. (Review)
Review
AIM
To describe the demographics, clinical and radiologic presentation, surgical considerations, and clinical outcomes associated with spinal osteoblastoma.
MATERIAL AND METHODS
A spinal tumor database of 522 patients treated surgically at a single institution between January 2002 and June 2012 was analyzed and five patients with spinal osteoblastoma were identified and included in this study. Basic demographic and epidemiological data were recorded. Tumor characteristics, surgical parameters, and clinical follow-up data were noted.
RESULTS
The mean follow-up was 21.9 months. There were four males and one female, and the mean age at diagnosis was 28.4 years. There was a mean reported symptom length of 26.4 months prior to diagnosis. There were three cervical lesions, one lumbar lesion, and one sacrococcygeal lesion. One patient was Enneking stage III and four patients were Enneking stage II. Based on spinal instability neoplastic score criteria, two patients were stable and three patients were potentially unstable. Four patients had intralesional gross total resections and one patient had an en bloc marginal resection. All patients remained neurologically stable or improved postoperatively. A single patient had recurrence of a previously resected osteoid osteoma with progression to osteoblastoma.
CONCLUSION
Aggressive surgical resection of spinal osteoblastoma is suggested to minimize the risk of tumor recurrence, although this may still occur even with en bloc resection. Patients rarely present with preoperative spinal instability, but surgical fusion is often required due to removal of structural elements of the spine during resection. Of note, osteoid osteoma may progress to osteoblastoma in the spine despite prior resection.
Topics: Adolescent; Adult; Disease Management; Female; Humans; Joint Instability; Lumbosacral Region; Male; Middle Aged; Neoplasm Recurrence, Local; Osteoblastoma; Retrospective Studies; Spinal Neoplasms
PubMed: 27400109
DOI: 10.5137/1019-5149.JTN.14348-15.1