Abstract
IntroductionOsteoid osteoma is a benign tumor of the growing skeleton. It presents with pain, which is usually worse at night. The radiographic features consist of a central oval or round nidus surrounded first by a radiolucent area followed by another area of sclerotic bone. In the hand, osteoid osteoma is more commonly located in the phalanges and carpal bones. The metacarpals are the least common sites for osteoid osteoma.Case presentationWe present a case of an osteoid osteoma of the left third metacarpal bone in a 36-year-old woman. The clinical and radiographic findings along with the surgical management of the lesion are presented. The pain disappeared immediately after the operation. At the 2-year follow-up, the patient was pain-free and there was no evidence of recurrence.ConclusionPhysicians should be aware of the unusual presence and the atypical clinical presentation of this benign lesion in the metacarpal bones of the hand.
Highlights
Osteoid osteoma is a benign tumor of the growing skeleton
When the lesions appear in the hand, diagnosis is challenging for three reasons: first, the typical pain pattern may be absent; second, lesions in the hand may have unusual clinical signs and radiographic presentations; and third, histologic features may differ from classic osteoid osteomas, which occur in the long bones [6]
We report a case of an osteoid osteoma in the third metacarpal, and describe the clinical presentation, radiological findings and successful outcome after surgical excision of the lesion
Summary
Osteoid osteoma is a benign bone tumor of the growing skeleton representing approximately 10% of all benign bone neoplasias [1]. When the lesions appear in the hand, diagnosis is challenging for three reasons: first, the typical pain pattern may be absent; second, lesions in the hand may have unusual clinical signs and radiographic presentations; and third, histologic features may differ from classic osteoid osteomas, which occur in the long bones [6]. We report a case of an osteoid osteoma in the third metacarpal, and describe the clinical presentation, radiological findings and successful outcome after surgical excision of the lesion. A 36-year-old woman was referred to our clinic in May 2005 with a 1-year history of pain in her left hand. Computed tomography (CT) of the left hand clearly showed an oval radiolucent zone at the head of the third metacarpal bone and marked sclerosis around the lesion (Fig. 2). The history and clinical and radiographic findings pointed to the diagnosis of an osteoid osteoma of the head of the third metacarpal bone in the left hand. At the 2-year follow-up, the patient was painfree and there was no evidence of recurrence (Fig. 1)
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