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Cureus Mar 2019Osteoid osteoma is a benign primary bone tumor of unknown etiology that occurs most commonly in males during adolescence and early adulthood. Osteoid osteoma affects the...
Osteoid osteoma is a benign primary bone tumor of unknown etiology that occurs most commonly in males during adolescence and early adulthood. Osteoid osteoma affects the spine in 20% of cases, and may cause spinal deformity, stiffness, and pain that may sometimes be worst at night. We present a novel description of a partial laminectomy with cement augmentation after resection of an osteoid osteoma. A 22-year-old male with a past medical history of Hodgkin's lymphoma status post chemotherapy and radiation to the mediastinum, and right hip osteoblastoma treated with surgery and radiofrequency ablation presented with low back pain for five years with a recent onset of severe radicular symptoms. The pain was described as shooting and radiating laterally down the right leg to the mid-calf without bowel or bladder incontinence. He has a known right L5 laminar sclerotic lesion measuring 11 x 10 mm causing neuroforaminal narrowing and it kept increasing in size despite previous treatment with stereotactic radiosurgery and radiofrequency ablation. This lesion was metabolically active on positron emission tomography-computed tomography (PET-CT) imaging. His pain was worsening and was refractory to physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, and radiation therapy. A right L5 partial laminectomy was performed to resect the abnormality in an en-bloc fashion. The lesion did not involve the inner cortex of the bone. Lamina reconstruction was achieved with bone cement augmentation for the preservation of vertebral column strength. Pathology was consistent with osteoid osteoma with marrow edema. Microscopic findings include bony trabeculae associated with prominent rimming and hypercellular fibroblastic stroma. No nuclear atypia, necrosis or appreciable mitotic activity was observed. The patient remains neurologically intact with significantly improved radicular symptoms and low back pain. Osteoid osteoma of the lamina may be resected using a partial laminectomy and cement augmentation done to preserve the integrity of the posterior ligamentous complex, prevent potential fracture of the pars interarticularis, and avoid the need for lumbar fusion in younger patients in whom this pathology is commonly found.
PubMed: 31131163
DOI: 10.7759/cureus.4239 -
Acta Bio-medica : Atenei Parmensis Jan 2018Osteoid osteoma is a benign bone neoplasm with a reported incidence of 2-3% among all bone primary tumors. Although it is a small and benign lesion, it is often cause of... (Review)
Review
Osteoid osteoma is a benign bone neoplasm with a reported incidence of 2-3% among all bone primary tumors. Although it is a small and benign lesion, it is often cause of patient complaint and discomfort. It is generally characterized by a long lasting, unremitting pain that typically exacerbates at night, often leading to sleep deprivation and functional limitation of the skeletal segment involved, with a significant reduction of patient daily life activities and consequent worsening of the overall quality of life. Over decades, complete surgical resection has represented the only curative treatment for symptomatic patients. In the last years, new percutaneous ablation techniques, especially radiofrequency ablation, have been reported to be a safe and effective alternative to classical surgery, with a low complication and recurrence rate, and a significant reduction in hospitalization cost and duration. The aim of this article is to provide an overview about the radiofrequency thermal ablation procedure in the treatment of osteoid osteoma.
Topics: Bone Neoplasms; Humans; Imaging, Three-Dimensional; Magnetic Resonance Imaging, Interventional; Osteoma, Osteoid; Radiofrequency Ablation; Radiography, Interventional
PubMed: 29350646
DOI: 10.23750/abm.v89i1-S.7021 -
Journal of Clinical Medicine Jun 2021Pediatric benign osteocytic tumors include osteoma, enostosis, osteoid osteoma, and osteoblastoma. In pediatric populations, benign bone tumors are more common than... (Review)
Review
Pediatric benign osteocytic tumors include osteoma, enostosis, osteoid osteoma, and osteoblastoma. In pediatric populations, benign bone tumors are more common than malignancies. Benign osteocytic tumors may have a unique clinical presentation that helps narrow the differential diagnosis. A systemic imaging approach should be utilized to reach the diagnosis and guide clinicians in management. Radiographs are the most prevalent and cost-effective imaging modality. Cross-sectional imaging can be utilized for tissue characterization and for evaluation of lesions involving complex anatomical areas such as the pelvis and spine. Computed Tomography (CT) is the modality of choice for diagnosis of osteoid osteoma. CT scan can also be utilized to guide radiofrequency ablation, which has been found to be highly effective in treating osteoid osteoma and osteoblastoma. Enostosis is a no-touch lesion. Osteoma is commonly located in the paranasal sinuses. Osteoma needs an excision if it causes complications due to a mass effect.
PubMed: 34206870
DOI: 10.3390/jcm10132823 -
PloS One 2021To assess efficacy and safety of imaging-guided radiofrequency ablation (RFA) of Osteoid Osteoma (OO) in both typical and atypical sites.
PURPOSE
To assess efficacy and safety of imaging-guided radiofrequency ablation (RFA) of Osteoid Osteoma (OO) in both typical and atypical sites.
METHODS AND MATERIALS
Between January 2014 and March 2019, 102 consecutive percutaneous RFA were performed and retrospectively reviewed. The procedures were performed using a RFA bipolar ablation system (Covidien, exposed tip of 0.7-1cm), under Computed Tomography (CT) guidance or using a navigation system (Masmec) under CT and Cone Beam CT (CBCT) guidance. Patients were followed up over 24 months. Clinical success and recurrences were considered on the base of established criteria. In patients with clinical failure and/or imaging evidence of relapse, retreatment was considered.
RESULTS
Administered power per-procedure was ≤8 W (mean temperature, 90°C). The pre-procedure average value of visual analog scale (VAS) was 8.33+/-0.91. Primary and secondary success rate 96.08% (98/102) and100% (102/102), respectively. No major complication was described. Technical success was proved in every patient by CT scan acquisition after needle positioning. Relapse and tumour location were significantly correlated (p-value = 0.0165). The mean dose-length product was 751.55 mGycm2. Advanced bone healing was noted in 68 lesions after 1y-follow up and in 86 lesions after 2y-follow up.
CONCLUSION
Imaging-guided percutaneous RFA is a highly effective technique for OO, both in typical and atypical sites. CT or CBCT guidance, navigation systems and operator experience grant the technical success, which is the most crucial parameter affecting outcome.
Topics: Adolescent; Adult; Bone Neoplasms; Cancer Pain; Cone-Beam Computed Tomography; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Osteoma, Osteoid; Pain Measurement; Radiofrequency Ablation; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 33735214
DOI: 10.1371/journal.pone.0248589 -
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 -
RoFo : Fortschritte Auf Dem Gebiete Der... Apr 2020While ostoeid osteomas (OO) are typically located in long tubular bones, OO occurring elsewhere are referred to as "atypical". Aim of our study was to review the... (Observational Study)
Observational Study
PURPOSE
While ostoeid osteomas (OO) are typically located in long tubular bones, OO occurring elsewhere are referred to as "atypical". Aim of our study was to review the characteristics of atypically located OO, course of symptoms and therapy, as well as clinical outcome, safety, and patient satisfaction of radiofrequency ablation (RFA).
MATERIALS AND METHODS
In the period from 04/01 to 07/13, 33 patients were treated using thermal ablation (RFA or laser), partly with low temperature and short duration technique. Clinical records were analyzed. Additionally, 23 patients were interviewed via telephone. Primary endpoints were technical success, clinical success (recurrence rates), and adverse events. Secondary endpoints were course of symptoms and therapy as well as patient satisfaction.
RESULTS
Mean follow-up was 22.1 ± 21.5 months. Average patient age was 31.7 ± 16.3 years. Localization: Most atypical OO (61 %) were located in the lower extremity, followed by axial skeleton (26 %) and upper extremity (13 %). Pain anamnesis: 74 % of patients stated that their pain occured predominantly at night and responded to NSAID, as typical for OO. Diagnostics: Patients consulted on average 4 different doctors and in 52 % patients, ≥ 3 different radiologic imaging techniques where used before the diagnosis "OO" was made.
OUTCOME
Technical success of thermal ablation was 100 %. Primary clinical success was 91 %. Patient satisfaction was 100 %. No major complications occurred.
CONCLUSION
In ¼ of cases, atypical OO did not show the typical pain characteristics of OO. Image-guided thermal ablation is a promising and safe therapy also for patients with atypical OO.
KEY POINTS
· Atypical OO are challenging regarding diagnostics and therapy. · Image-guided thermal ablation is a safe and effective procedure also for patients with atypical OO. · Image-guided thermal ablation shows high patient satisfaction.
CITATION FORMAT
· Seemann RJ, Märdian S, Schwabe P et al. Atypically Located Osteoid Osteoma: Characteristics and Therapeutic Success After Image-Guided Thermal Ablation. Fortschr Röntgenstr 2020; 192: 335 - 342.
Topics: Adolescent; Adult; Bone Neoplasms; Child; Female; Follow-Up Studies; Humans; Laser Therapy; Male; Middle Aged; Neoplasm Recurrence, Local; Osteoma, Osteoid; Patient Satisfaction; Prospective Studies; Radiofrequency Ablation; Surgery, Computer-Assisted; Tomography, X-Ray Computed; Young Adult
PubMed: 31747706
DOI: 10.1055/a-1012-2143 -
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 -
Journal of Orthopaedic Case Reports 2019Osteoid osteoma of cervical spine is a rare clinical entity and accounts for 4% of cases of overall spinal osteoid osteoma. It has predilection for neural arch and...
INTRODUCTION
Osteoid osteoma of cervical spine is a rare clinical entity and accounts for 4% of cases of overall spinal osteoid osteoma. It has predilection for neural arch and complete resection is difficult task due to proximity to important neurovascular structures. Incomplete resection leads to recurrence in about 4.5% of patients. Computed tomography (CT)-based navigation may aid in resection of tumor without compromising stability, but whenever it inevitable fusion is mandatory.
CASE REPORT
We report two cases of osteoid osteoma of cervical spine managed with surgical excision. Case1 had recurrence of tumor at the left C6 pedicle after minimally invasive intervention that was later managed by surgical excision with the help of CT-guided navigation. Case 2 had osteoid osteoma of the right C4 lateral mass that was treated with surgical excision and fusion.
CONCLUSION
Osteoid osteoma is a rare pathology in cervical spine. Surgical excision of cervical osteoid osteoma is a daunting task due to the proximity to neurovascular structures. Recurrence though less often is the result of inadequate excision.
PubMed: 31245326
DOI: 10.13107/jocr.2250-0685.1318 -
Radiology Case Reports Nov 2021Atypical intra-articular osteoid osteoma can be difficult to diagnose and challenging to treat. We report a case of a right acetabular subchondral intra-articular...
Atypical intra-articular osteoid osteoma can be difficult to diagnose and challenging to treat. We report a case of a right acetabular subchondral intra-articular osteoid osteoma in a young male patient which was initially diagnosed as femoroacetabular impingement due to its atypical clinical and radiological presentations. After fully working up the patient the lesion was successfully treated with percutaneous CT-guided low-power bipolar radiofrequency ablation using several per procedural articular cartilage thermal protective measures including intra-articular thermocouple, and continuous per procedural joint space cooling with Dextrose 5% solution. A precise RFA electrode placement, using the No-touch technique, and applying different passive and active thermal protective measures were helpful in avoiding collateral damage of the hip joint articular cartilages. atypical intra-articular osteoid osteomas necessitate pertinent correlation between the clinical and radiological presentations. As far as intra-articular or subchondral nidus ablation is concerned, thermal protective measures should be considered.
PubMed: 34484539
DOI: 10.1016/j.radcr.2021.07.072 -
BMC Musculoskeletal Disorders Apr 2019Osteoid osteoma is a benign bone-forming tumour, which very unfrequently has multifocal or multicentric presentation. We report the first known case of a multicentric,...
BACKGROUND
Osteoid osteoma is a benign bone-forming tumour, which very unfrequently has multifocal or multicentric presentation. We report the first known case of a multicentric, multifocal and recurrent osteoid osteoma treated using radiofrequency ablation.
CASE PRESENTATION
A 39-year-old man with two-year history of left hip pain was admitted at our Institution. The pain was more intense during the night and partially relieved by salicylates. Pelvis CT demonstrated two lytic lesions (8 and 7 mm, respectively) with surrounding sclerotic reactive bone, both with a central focal area of high attenuation, located in the femoral neck and along the anterior portion of the acetabulum, respectively. Both lesions had clinical and imaging findings consistent with multicentric osteoid osteoma. Thus, the two lesions were biopsied - with pathologic confirmation of osteoid osteoma - and treated using radiofrequency ablation. Hip pain decreased but did not disappear, actually increasing a few months after treatment. CT and MRI were performed showing a smaller lesion (5 mm) with the same imaging features, surrounded by marrow oedema, along the posterior column of the acetabulum. The lesion was considered suspicious for osteoid osteoma, overlooked on previous examinations. Therefore, a diagnosis of multicentric and multifocal osteoid osteoma was established. The new lesion was again treated with radiofrequency ablation with symptom disappearance. However, hip pain relapsed after 18 months, and CT and MRI showed an osteoid osteoma recurrence on the posterior column of the acetabulum, which was biopsied and successfully treated using radiofrequency ablation.
CONCLUSIONS
To our knowledge, this is the first reported case of multicentric, multifocal, recurrent osteoid osteoma. Our case report highlights the importance of considering a diagnosis of multifocal osteoid osteoma when dealing with multifocal lytic lesions of the bone and with pain persistence after treatment. It also emphasises the combined role of CT and MRI in this setting.
Topics: Acetabulum; Adult; Biopsy; Bone Neoplasms; Femur Neck; Humans; Magnetic Resonance Imaging; Male; Neoplasm Recurrence, Local; Osteoma, Osteoid; Radiofrequency Ablation; Retreatment; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 30991974
DOI: 10.1186/s12891-019-2552-x