Unusual Presentation of Osteoid Osteoma with Exacerbating Pain during Menses

Abstract

Osteoid osteomas (OO) are benign neoplasms commonly present during the second and third decade of life, showing a male predominance with classical nocturnal bone pain dramatically responding to nonsteroidal anti-inflammatory drugs. We report a rare OO in a young female who presented with right leg bone pain that was exacerbated during menstruation, a presentation that had never been reported before. The pain intensity increased and interfered with her daily activity, which urged for a careful evaluation by a computerized tomography scan showing OO signs. Surgical excision and histopathology confirmed OO. The patient’s pain drops down to zero on the visual analog scale. Two years after the surgery, she is well with no recurrence signs. A novel OO presentation may increase physician awareness of atypical presentation. A careful evaluation of a challenging presentation added to an imaging study may reveal the underlying cause and rule out other diagnostic dilemmas.