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European Journal of Orthopaedic Surgery... Dec 2021Osteoid osteoma is the third most common benign bone tumor, with well-known clinical presentation and radiological features. Although surgical excision has been the only... (Review)
Review
Osteoid osteoma is the third most common benign bone tumor, with well-known clinical presentation and radiological features. Although surgical excision has been the only therapeutic option for a long time, to date it has been replaced by minimally invasive techniques, which proved satisfactory success rates and low complication occurrence. Therefore, the purpose of this literature review was to describe the main updates of these recent procedures in the field of interventional radiology, with particular attention paid to the results of the leading studies relating to the efficacy, complications, and recurrence rate. Nevertheless, this study aimed to analyze the peculiarities of each reported technique, with specific focus on the possible improvements and pitfalls. Results proved that all mininvasive procedures boast a high success rate with slight number of complications and a low recurrence rate. Radiofrequency ablation is still considered the gold standard procedure for percutaneous treatment of osteoid osteoma, and it has the possibility to combine treatment with a biopsy. Interstitial laser ablation's advantages are the simplicity of use and a lower cost of the electrodes, while cryoablation allows real-time visualization of the ablated zone, increasing the treatment safety. Magnetic resonance-guided focused ultrasound surgery is the most innovative non-invasive procedure, with the unquestionable advantage to be radiation free.
Topics: Bone Neoplasms; Catheter Ablation; High-Intensity Focused Ultrasound Ablation; Humans; Neoplasm Recurrence, Local; Osteoma, Osteoid; Radiology, Interventional; Treatment Outcome
PubMed: 33839926
DOI: 10.1007/s00590-021-02946-w -
Radiology Feb 2022Background Cryoablation is playing an increasing role in the percutaneous treatment of bone tumors. However, despite its potential advantages over heat-based ablation...
Background Cryoablation is playing an increasing role in the percutaneous treatment of bone tumors. However, despite its potential advantages over heat-based ablation techniques, the clinical safety and efficacy of cryoablation have not been established for osteoid osteoma treatment. Purpose To evaluate percutaneous CT-guided cryoablation for the treatment of osteoid osteoma in young patients and adults. Materials and Methods This retrospective study reviewed data from 50 consecutive patients who underwent percutaneous CT-guided cryoablation for the treatment of osteoid osteoma between January 2013 and June 2019 in a single institution. In 30 of 50 patients (60%), the procedure was carried out with the patient under local anesthesia and conscious sedation, with the cryoprobe covering the lesion from an extraosseous position, avoiding direct penetration of the nidus. Clinical and radiologic features, procedure-related data, visual analog scale (VAS) pain scores, complications, and overall success rate were evaluated. Statistical analyses were performed by using the nonparametric Friedman test and Wilcoxon signed rank test for repeated measures. Results Fifty patients (median age, 24 years; interquartile range [IQR], 19-38 years; 31 men) underwent CT-guided cryoablation for the treatment of osteoid osteoma, with a 96% (48 of 50 patients) overall clinical success rate. Of the two patients without clinical success, one patient had incomplete pain relief and the other experienced a recurrence of osteoid osteoma at 11 months, which was successfully treated with a second cryoablation procedure. The median VAS pain score was 8 (IQR, 7-8) before the procedure and 0 (IQR, 0-1; < .001) after the procedure at both primary (6 weeks) and secondary (18-90 months) follow-up. Three of the 50 patients had minor complications (6%); no major complications were reported. Conclusion Osteoid osteoma was safely, effectively, and durably treated with CT-guided percutaneous cryoablation. In the majority of patients, treatment could be performed without general anesthesia, with the cryosphere covering the nidus from an extraosseous position. © RSNA, 2021.
Topics: Adult; Cryosurgery; Female; Humans; Male; Osteoma, Osteoid; Pain Measurement; Postoperative Complications; Radiography, Interventional; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 34812672
DOI: 10.1148/radiol.2021211100 -
Journal of Clinical Orthopaedics and... May 2022Targeted cannulation of the nidus and subsequent thermal ablation is the basis of CT-guided radiofrequency ablation (RFA) of osteoid osteoma, which is considered... (Review)
Review
Targeted cannulation of the nidus and subsequent thermal ablation is the basis of CT-guided radiofrequency ablation (RFA) of osteoid osteoma, which is considered nowadays as the treatment of choice. The majority of complications during this procedure are due to thermal injury of adjacent structures. Specific measures as per the anatomical location of osteoid osteoma can avoid the majority of complications. This article enlists the possible complications and their necessary precautions and remedies to avoid these complications during CT-guided radiofrequency ablation of osteoid osteoma.
PubMed: 35494487
DOI: 10.1016/j.jcot.2022.101869 -
Journal of Clinical Medicine Apr 2023Osteoid osteoma (OO) is a common benign bone tumour, usually affecting young people. Typically, it is localised to the diaphyses or metaphyses of long bones. The... (Review)
Review
Osteoid osteoma (OO) is a common benign bone tumour, usually affecting young people. Typically, it is localised to the diaphyses or metaphyses of long bones. The classical manifestation includes distinctive night pain, almost always present, responding well to non-steroidal anti-inflammatory drugs, sometimes accompanied by complaints due to physical activity, and a typical picture on additional tests. A characteristic of osteoid osteoma is the presence of a nidus, usually visible on imaging tests. The nidus generally presents as a single, round lytic lesion up to 1 cm in diameter, surrounded by an area of reactive ossification. However, OO is a multifaceted neoplasm, and its diagnosis can cause numerous difficulties. OO can mimic multiple diseases and vice versa, which often leads to a prolonged diagnostic and therapeutic path and associated complications. There are few literature reviews about the differentiation and diagnostic difficulties of osteoid osteoma. Very effective therapies for this tumour are known, such as ablation and resection. Enhanced detection of osteoid osteoma could result in faster diagnosis and less suffering for the patient, avoidance of complications, and reduced costs of incorrect and prolonged treatment.
PubMed: 37048803
DOI: 10.3390/jcm12072721 -
In Vivo (Athens, Greece) 2021Osteoid osteoma, the third most common benign bone tumor, usually occurs in the cortex of long bones. It consists of a radiolucent nidus surrounded by reactive... (Review)
Review
Osteoid osteoma, the third most common benign bone tumor, usually occurs in the cortex of long bones. It consists of a radiolucent nidus surrounded by reactive osteosclerosis. Generally, osteoid osteoma affects young males. Nocturnal pain that eases with salicylates or nonsteroidal anti-inflammatory drugs (NSAID) is the typical clinical presentation. Sometimes, it remains undiagnosed for a long time. Plain radiography and computed tomography are usually sufficient for the diagnosis of osteoid osteoma. Initial treatment includes salicylates and NSAID because the tumor often regresses spontaneously over 2-6 years. Surgical treatment is indicated in case of unresponsive pain to medical therapy, no tolerance of prolonged NSAID therapy due to side effects, and no willingness to activity limitations. Nowadays, minimally invasive techniques have replaced open surgery and are considered the gold standard of surgical treatment. Although cryoablation seems superior in terms of the nerve damage and immunotherapy effect, radiofrequency ablation is the preferred technique.
Topics: Bone Neoplasms; Bone and Bones; Humans; Male; Osteoma, Osteoid; Radiography; Tomography, X-Ray Computed
PubMed: 34182465
DOI: 10.21873/invivo.12459 -
International Journal of Surgery Case... May 2022Osteoid osteoma (OO) is a type of benign bone tumor that usually affects long bones of the lower extremities. In this case report, we describe a successful surgical...
INTRODUCTION
Osteoid osteoma (OO) is a type of benign bone tumor that usually affects long bones of the lower extremities. In this case report, we describe a successful surgical resection of an OO located in the rib which is an extremely rare location.
CASE PRESENTATION
This is a 23-year-old man, referred to our thoracic surgery department for a very intense nocturnal right chest pain for over two months, the physical examination was normal without clinically palpable chest mass. The CT scan showed an osteocondensing lesion at the junction of the middle and posterior arches of the right 6th rib suggesting Ewing's sarcoma, a PET CT was then requested showed an appearance of a regular non-hypermetabolic inhomogeneous condensation at the junction of the middle and posterior arcs of the 6th right rib. After multidisciplinary concertation, a CT-guided biopsy of the lesion was performed, the histological examination of which revealed an osteoid osteoma, then a complete resection of the lesion was performed under posterolateral thoracotomy which histology confirmed a costal osteoid osteoma. The patient is currently in good health condition with complete disappearance of chest pain after one month of the operation and does not present any complications for the long-term follow-up.
DISCUSSION
Osteoid osteoma (OO) is a benign primary bone tumor with unknown pathogenesis. That occurs in patients during the first two decades of life in about 60 to 75% of cases with a strong predilection for long bones, in 60 to 70% of cases. Flat bones, such as the skull, jawbones, innominate bones, and ribs are rarely described (McDermott et al., 1996 [1]). The standard treatment for OO is complete surgical excision, which is offered to the patient when the pain is chronic and not relieved by medical treatment (Osteoid osteoma: the results of surgical treatment [Internet] [2]).
CONCLUSION
The osteoid osteoma of the rib is a very rare entity of bone neoplasms, this is the first case in our department that demonstrates that the OO of the rib must be suspected affront any painful rib and that complete surgical excision when it's possible, is a safe and effective treatment.
PubMed: 35658306
DOI: 10.1016/j.ijscr.2022.107139 -
Acta Medica Portuguesa 2009Osteoid osteoma is the third most common benign bone tumor. It usually affects the diaphysis of long bones, especially the femur or the tibia. This paper presents the...
Osteoid osteoma is the third most common benign bone tumor. It usually affects the diaphysis of long bones, especially the femur or the tibia. This paper presents the case of a 22-year-old male patient, with pain in the left knee. The x-ray and ultrasound of the knee were normal. The three phase bone scintigraphy revealed a focal uptake in the mid shaft of the left femur, strongly suggestive of osteoid osteoma. This case shows the significant role of bone scintigraphy in the diagnosis of an osteoma osteoid with atipical presentation.
Topics: Femoral Neoplasms; Humans; Male; Osteoma, Osteoid; Young Adult
PubMed: 19944046
DOI: No ID Found -
Virchows Archiv : An International... Jan 2020Bone tumours are difficult to diagnose and treat, as they are rare and over 60 different subtypes are recognised. The emergence of next-generation sequencing has partly... (Review)
Review
Bone tumours are difficult to diagnose and treat, as they are rare and over 60 different subtypes are recognised. The emergence of next-generation sequencing has partly elucidated the molecular mechanisms behind these tumours, including the group of bone forming tumours (osteoma, osteoid osteoma, osteoblastoma and osteosarcoma). Increased knowledge on the molecular mechanism could help to identify novel diagnostic markers and/or treatment options. Osteoid osteoma and osteoblastoma are bone forming tumours without malignant potential that have overlapping morphology. They were recently shown to carry FOS and-to a lesser extent-FOSB rearrangements suggesting that these tumours are closely related. The presence of these rearrangements could help discriminate these entities from other lesions with woven bone deposition. Osteosarcoma is a malignant bone forming tumour for which different histological subtypes are recognised. High-grade osteosarcoma is the prototype of a complex karyotype tumour, and extensive research exploring its molecular background has identified phenomena like chromothripsis and kataegis and some recurrent alterations. Due to lack of specificity, this has not led to a valuable novel diagnostic marker so far. Nevertheless, these studies have also pointed towards potential targetable drivers of which the therapeutic merit remains to be further explored.
Topics: Bone Neoplasms; Gene Rearrangement; Genes, p53; Genetic Predisposition to Disease; Humans; Osteoblastoma; Osteoma; Osteoma, Osteoid; Osteosarcoma; Retinoblastoma Protein
PubMed: 31741049
DOI: 10.1007/s00428-019-02683-w -
Journal of Orthopaedic Surgery and... Dec 2022Scoliosis behavior after curettage of spinal osteoid osteoma has been not clarified as most studies regarding scoliosis secondary to osteoid osteoma (OO) were case...
BACKGROUND
Scoliosis behavior after curettage of spinal osteoid osteoma has been not clarified as most studies regarding scoliosis secondary to osteoid osteoma (OO) were case reports. The aims of this study were to investigate (1) clinical and radiographic features of scoliosis secondary to OO; (2) scoliosis behavior after Curettage of OO.
METHODS
A retrospective study was performed at patients who were diagnosed as OO clinically or pathologically from July 1998 to December 2019 in a single institution. Age, gender, location of pain, location of lesion and curve pattern of scoliosis were collected preoperatively. Intraoperative blood loss, operation time and surgical complications were documented. VAS scores and curve magnitude were collected pre- and postoperatively and at last follow-up.
RESULTS
The mean operation time was 124 ± 32 min and the average intraoperative blood loss was 274 ± 134 ml. The mean preoperative VAS score was 6.2 ± 2.7, and the mean postoperative VAS score was 2.1 ± 1.8. Thoracic scoliosis was improved from 22.7 ± 10.6° to 6.2 ± 4.3° after operation, and to 4.1 ± 4.3° at last follow-up. Lumbar scoliosis was improved from 18.1 ± 7.4° to 6.7 ± 5.2° after operation, and to 5.3 ± 3.9° at last follow-up. Trunk shift was improved from 34.7 ± 12.4 to 10.5 ± 7.2 mm after operation, and to 8.4 ± 5.6 mm at last follow-up. There was no significant differences as to sagittal radiographic parameters (P > 0.05).
CONCLUSION
Patients with spinal OO had a significantly high incidence of scoliosis. Patients could get rapid relief of pain and scoliosis with low occurrence. Night pain, pain at the concave side of curve, normal sagittal alignment could help differentiate it from scoliosis associated with lumbar disc herniation.
Topics: Humans; Retrospective Studies; Blood Loss, Surgical; Scoliosis; Osteoma, Osteoid; Pain; Bone Neoplasms
PubMed: 36503626
DOI: 10.1186/s13018-022-03423-8 -
Frontiers in Oncology 2022Osteoid osteoma (OO) comprises approximately 11%-14% of benign bone tumors. The main symptom of OO is localized pain accompanied by nighttime aggravation. Surgical...
BACKGROUND
Osteoid osteoma (OO) comprises approximately 11%-14% of benign bone tumors. The main symptom of OO is localized pain accompanied by nighttime aggravation. Surgical treatment is frequently used in clinic, including open surgery and percutaneous ablation, the latter including radiofrequency ablation, cryoablation, and microwave ablation, but there is no consensus on when and how to choose the best treatment for OO.
PURPOSE
We did a systematic review of the literature on existing surgical treatments of OO to assess the safety and efficacy of surgical treatments of OO and to evaluate the surgical options for different locations of OO.
METHODS
The inclusion criteria in the literature are 1. Patients diagnosed with osteoid osteoma and treated surgically; 2. Include at least five patients; 3. Perioperative visual analogue scale (VAS), postoperative complications, and recurrence were recorded; 4. Literature available in PubMed from January 2014 to December 2021.
RESULTS
In the cohort, 1565 patients (mainly adolescents) with OO received 1615 treatments. And there are 70 patients with postoperative recurrence and 93 patients with postoperative complications (minor: major=84:9). The results of Kruskal-Wallis examination of each experimental index in this experiment were clinical success rate H=14.818, p=0.002, postoperative short-term VAS score H=212.858, p<0.001, postoperative long-term VAS score H=122.290, p<0.001, complication rate H=102.799, p<0.001, recurrence rate H=17.655, p<0.001, the technical success rate was H=45.708, p<0.001, according to the test criteria of α=0.05, H was rejected. The overall means of the outcome index in each group were not completely equal.
CONCLUSION
Percutaneous ablation and open surgery are safe and reliable for OOs, and the technical success rate of percutaneous ablation is higher than that of open surgery. Open surgery and cryoablation can be selected for OOs close to the nerve and atypical sites, while radiofrequency ablation and microwave ablation can be selected for OOs in most other sites.
PubMed: 35936708
DOI: 10.3389/fonc.2022.935640