Benign Bone Tumors Research Articles

Association of MiRNA and Bone Tumors: Future Therapeutic Inroads.

Small endogenous non-coding RNA molecules known as micro-ribonucleic acids (miRNAs) control post-transcriptional gene regulation. A change in miRNA expression is related to various diseases, including bone tumors. Benign bone tumors are categorized based on matrix production and predominant cell type. Osteochondromas and giant cell tumors are among the most common bone tumors. Interestingly, miRNAs can function as either tumor suppressor genes or oncogenes, thereby determining the fate of a tumor. In the present review, we discuss various bone tumors with regard to their prognosis, pathogenesis, and diagnosis. The association between miRNAs and bone tumors, such as osteosarcoma, Ewing's sarcoma, chondrosarcoma, and giant-cell tumors, is also discussed. Moreover, miRNA may play an important role in tumor proliferation, growth, and metastasis. Knowledge of the dysregulation, amplification, and deletion of miRNA can be beneficial for the treatment of various bone cancers. The miRNAs could be beneficial for prognosis, treatment, future drug design, and treatment of resistant cases of bone cancer.

Rare case of mastoid osteoma: a case report

Osteoma of the temporal bone is a very rare slow growing benign tumour of bone. They commonly arise from skull. Temporal bone osteomas are commonly present without symptoms, but may cause bony deformity, pain, and hearing loss depending upon the site. Osteomas may arise from external ear canals, but very rarely from mastoid bone. Aetiology is unknown and many theories are postulated like congenital, traumatic and infectious. Here, we are presenting a case of 30 years old lady, presenting with progressively enlarging hard lump behind right ear for 3 years. It was diagnosed as osteoma and confirmed by computed tomography (CT) scan. Complete excision is done until normal mastoid cortex/air cells are exposed.

Large-Scale assessment of ChatGPT's performance in benign and malignant bone tumors imaging report diagnosis and its potential for clinical applications

ObjectiveThis study was designed to delve into the complexities involved in diagnosing of benign and malignant bone tumors and to assess the potential of AI technologies like ChatGPT in improving diagnostic accuracy and efficiency. The study also explores the few-shot learning as a method to optimize ChatGPT's performance in specialized medical domains such as benign and malignant bone tumors diagnosis. MethodsA total of 1366 benign and malignant bone tumors-related imaging reports were collected and diagnosed by 25 experienced physicians. The gold standard of diagnosis was established by combining clinical, imaging and pathological principles.These reports were then input into the ChatGPT model which underwent a few-shot learning method to generate diagnostic results. The diagnostic results of the physicians and the AI model were compared to evaluate the performance of ChatGPT. An experiment was conducted to assess the influence of different radiologist's reporting styles on the model's diagnostic performance. Furthermore, in-depth analysis of misdiagnosed cases was carried out, categorizing diagnostic errors and exploring possible causes. ResultsThe diagnostic results generated by ChatGPT showed an accuracy of 0.73, sensitivity of 0.95, and specificity of 0.58. After few-shot learning, ChatGPT demonstrated significant improvement, achieving an accuracy of 0.87, sensitivity of 0.99, and specificity of 0.73, bringing it much closer to the level of physician diagnostics. In an experiment analyzing the influence of the radiologist's reporting style, the model demonstrated higher sensitivity when interpreting reports written by high-level radiologists. In 56 benign cases, ChatGPT misdiagnosed them as malignant. Among these, 35 benign lesions- fibrous dysplasia and osteofibrous dysplasia- were incorrectly identified as metastatic tumors or osteosarcomas; 8 cases of myositis ossificans were wrongly diagnosed as extraosseous osteosarcoma. 7 cases of giant cell tumor of bone at the end of long bone were misdiagnosed as osteosarcoma by intermediate doctors. Chondroblastoma was misdiagnosed as malignant tumor in 6 cases −2 osteosarcoma and 4 chondrosarcoma-In this study, 23 osteosarcoma cases were misdiagnosed by ChatGPT as osteomyelitis; Chondrosarcoma was misdiagnosed as fibrous dysplasia or aneurysmal bone cyst in 8 cases. Four cases of spinal chordoma were misdiagnosed as spinal tuberculosis. ConclusionOur findings highlight the potential of ChatGPT in the diagnosis of benign and malignant bone tumors, offering advantages like enhanced efficiency and a reduction in missed diagnoses. However, the necessity of collaborative interactions between physicians and ChatGPT in practical settings was underscored. With an examination into AI's capacity in benign and malignant bone tumors diagnosis, this study lays the groundwork for future AI advancements in medicine. Additionally, the benefits of few-shot learning in fine-tuning ChatGPT applications in specialized fields were also demonstrated.

A rare case of an intraosseous lipoma associated with the resorption of a mandibular third molar

AbstractIntroductionIntraosseous lipomas (IL) are rare benign neoplasms of bone which very rarely occur in the facial bones such as the mandible. Of the documented cases, many are often asymptomatic and consequently, are an incidental finding discovered by the practitioner.Case ReportThe following case report recounts a 22‐year‐old patient referred for extraction of a carious molar at an Oral and Maxillofacial unit with an incidental finding of pathology involving the contralateral lower left wisdom tooth (LL8) on radiographic examination. Further investigations showed associated external root resorption of the lower left wisdom tooth and a provisional diagnosis of a radicular cyst was made. The case was managed by extracting the associated tooth and enucleating the lesion. During the procedure, fatty tissue was curetted at the apex instead of the expected cystic content. Subsequent histopathology confirmed the diagnosis of an IL.ConclusionTo the authors' knowledge, this is only the second documented case of an IL associated with tooth resorption. Findings from this case further our knowledge of the relatively uncommon pathology of intraosseous lipomas in the mandible and highlight the need for histopathological documentation and reporting of apical lesions.

Insights into the Distribution Patterns of Foot and Ankle Tumours: Update on the Perspective of a University Tumour Institute.

The rarity of foot and ankle tumours, together with the numerous histological entities, presents a challenge in accumulating sufficient patients to draw reliable conclusions. Therefore, we decided to present an update of a retrospective analysis of their distribution patterns, comprising 536 cases of foot and ankle tumours presented to our tumour board between June 1997 and June 2023. Our aim was to provide a comprehensive overview of the prevalence and distribution patterns of benign and malignant bone and soft tissue tumours of the foot and ankle. A total of 277 tumours involved bone (51.7%). Of these, 242 (87.4%) were benign and 35 (12.6%) were malignant. In addition, 259 soft tissue tumours (48.3%) were found, of which 191 (73.7%) were benign and 68 (26.3%) were malignant. The most common benign bone tumours were simple bone cysts, enchondromas, osteochondromas, aneurysmal bone cysts, and lipomas of bone. Common benign soft tissue tumours included a tenosynovial giant cell tumour, haemangioma, plantar fibromatosis, schwannoma, and lipoma. The most common malignant soft tissue tumours were synovial sarcoma, malignant melanoma, and myxofibrosarcoma. In terms of anatomical location, the hindfoot was the most common site (28.7%), followed by the midfoot (25.9%), ankle (25.4%), and forefoot (20.0%). The distribution of benign entities often follows typical patterns, which may facilitate an early diagnosis even without biopsy (e.g., simple bone cyst, plantar fibromatosis). On the other hand, the distribution patterns of many rare or malignant entities are inconsistent. Individual soft tissue malignancies occur very sporadically, even over long periods of time and in specialized tumour centres. It is therefore important to recognise that any suspicious mass in the foot and ankle must be considered a possible malignancy until proven otherwise.

Genetic effect of basal metabolic rate on the benign neoplasm of bone and articular cartilage: a Mendelian randomization study.

Previous studies have found an association between basal metabolic rate (BMR) and various malignant neoplasms, including bone tumors. BMR is also associated with bone mineral density, but the causality between BMR and benign neoplasms of bone and articular cartilage remains uncertain. Single nucleotide polymorphisms (SNPs) associated with BMR (p < 5 × 10-8) were used as instrumental variables for Mendelian randomization analysis of neoplasm risk. The inverse variance weighted (IVW) method was the primary approach, with the weighted median and MR-Egger regression serving as supplements. In this MR analysis, the IVW method supported a causal relationship between BMR and benign neoplasms of bone and articular cartilage (OR = 1.417; 95% CI, 1.039 to 1.930; p = 0.027). No evidence of heterogeneity or pleiotropy in the selected SNPs was found in our study. Thus, based on these results, we discovered a possible causal relationship between BMR and benign neoplasms of bone and articular cartilage. In this MR study, evidence suggested a genetic correlation between genetically predicted BMR and the risk of neoplasms in bone and articular cartilage.

Distribution Patterns of Benign and Malignant Bone and Soft Tissue Tumors and Tumor-like lesions in the Hindfoot and Ankle: A 12.5-year Analysis.

Benign and tumor-like lesions of the hindfoot and ankle are common, whereas malignant entities are rare. Accurate evaluation and timely management of these lesions can be challenging, making it crucial to understand their incidence and anatomic localization. This study retrospectively analyzed the distribution of benign and malignant bone and soft tissue tumors in the hindfoot and ankle. This study included patient data from a single center, such as age, sex, histologic diagnosis, and anatomic location over a 12.5 year period. Of the 105 cases reviewed, 19 cases (18.1%) were osseous lesions and 86 cases (81.9%) were soft tissue lesions. The latter were divided into 77 benign and 9 malignant cases, resulting in an overall malignancy rate of 8.6%. The most common osseous lesion was the intraosseous ganglion (n=12). The majority of benign soft tissue lesions (75.3%) were located in the hindfoot, with TGCT, schwannoma, and ganglion cysts being the most common types. The nine malignant cases were distributed among seven entities and were evenly distributed among both regions and sexes. Malignant cases had a higher mean age (59.2 years) compared to benign cases (40.8 years; p=0.001). Tumors, tumor-like lesions, and pseudotumors represent an important aspect of ankle pathology. The majority of focal masses and swellings are benign soft tissue or osseous lesions, but malignant entities can occur and may be mistaken for benign conditions. Preoperative imaging and histopathologic examination are essential, and preoperative presentation to a multidisciplinary tumor board is recommended in unclear cases.

Bilateral osteochondroma in a child: A rare case report

Abstract Osteochondroma has an incidence of 1 in 50,000 and is the most common benign bone tumor, which accounts for 30% (range 20%–50%) of all benign bone tumors. The incidence of osteochondroma is higher in males than females in both its solitary and hereditary forms. Osteochondroma can arise from any bone that develops from enchondral ossification. It commonly involves the long bones, and it rarely involves the ribs. Lesion is common in childhood, with 75%–80% occurring before the age of 20. Here, we report a case of bilateral rib osteochondroma that was presented during infancy.

Diagnostic value of combined detection of AKP, TSGF, and LDH for pediatric osteosarcoma: a case-control study.

To evaluate the diagnostic value of serum alkaline phosphatase (AKP), tumor-supplied growth factor group (TSGF), and lactate dehydrogenase (LDH) for pediatric osteosarcoma. A retrospective analysis of clinical data from 81 pediatric osteosarcoma patients (osteosarcoma group) and 63 patients with benign bone tumors (benign bone tumor group) admitted to Yantaishan Hospital from February 2023 to November 2023 was conducted. Basic and clinical data differences between the two groups of children were compared. A multivariate regression model was established to determine predictive factors for pediatric osteosarcoma, and the diagnostic value of identified indicators for pediatric osteosarcoma was evaluated. Osteosarcoma group demonstrated significantly higher serum AKP (375.76±73.47 vs 286.12±76.50 U/L), TSGF (69.01±16.30 vs 53.57±16.37 U/mL), and LDH (269.55±66.96 vs 207.46±59.20 U/L) levels as compared to the benign bone tumor group. Correlation analysis suggested significant positive correlations between AKP (rho=0.505), TSGF (rho=406), LDH (rho=0.449) and pediatric osteosarcoma. Multivariate regression analysis showed serum AKP, TSGF, and LDH were independent predictive factor for pediatric osteosarcoma. The AUC value for AKP was 0.794, with a Youden index of 0.459; the AUC value for TSGF was 0.736, with a Youden index of 0.406; and the AUC value for LDH was 0.761, with a Youden index of 0.462. The combined use of these three biomarkers yielded an AUC of 0.886. The combined detection of serum AKP, TSGF, and LDH can enhance the diagnostic accuracy of pediatric osteosarcoma, providing important evidence for clinical treatment.

Chronic Pain and Bone-Related Pathologies: A Narrative Review.

Pain related to bone may occur as a result of trauma, bone fracture, genetic disease, arthritis, benign or malignant primary bone tumors and bone cancer metastases. We discuss the pathophysiology of chronic bone-related pain, treatment options and therapeutic perspectives. Using predefined terms, we searched PubMed, MEDLINE, and Google Scholar for meta-analyses, evidence-based reviews, and clinical practice guidelines. This narrative article reviews pathologies linked to chronic bone pain and discusses the preventive and therapeutic strategies for better bone pain management. Pathophysiology of bone-related pain is complex, especially in cancer conditions and missing gaps are underlined. Treatment of pain, after adequate evaluation, includes classical analgesics, adjuvants for neuropathic and refractory pain, specific bone drugs, surgery and non-pharmacological approaches. Prevention of chronic bone pain encompasses prevention of central sensitization and of causal diseases. Translational research, drug repurposing, an interdisciplinary approach and a person-centered assessment to evaluate, beyond pain, physical, social and functional abilities, are proposed future directions to improve chronic bone pain management and optimize independence and quality of life. Chronic bone-related pain is frequent and is associated with an impairment of quality of life. In this review, we summarize the pathophysiology of chronic bone pain, describe treatment approaches and envisage new avenues for pain alleviation. Our article will help doctors manage chronic bone pain and address unmet needs for future research to alleviate bone-related pain.

Tumours of the foot: A 10 years retrospective analysis.

The foot is a complex structure composed of several tissues, each of which can be the origin of the proliferation and development of the tumour. Most lesions about the foot are reactive or inflammatory, but some are true neoplasms. This is a retrospective analysis of 4997 patient records treated in the Orthopaedic Oncology Unit of University Malaya Medical Centre, Malaysia, between 1 January 2010 to 31 December 2020. Demographic data of 195 patients with foot tumours were analysed out of 4997 neoplasm patients. There were 195 cases of foot tumours: 148 were benign, and 47 were malignant. 47 were bone tumours, 4 were metastases, and 144 were soft tissue tumours. Six patients succumbed to the disease, two cases of giant cell tumour (GCT) and one patient with synovial sarcoma had a recurrence. Treatment of foot tumours was wide resection in general. However, in metastasis cases, amputation was done. The majority of tumours were in the toes and dorsum of the foot. Soft tissue tumours of the foot occur in the elderly population in contrast to bone tumours, mainly in the second decade of life. The gender distribution was almost equal for foot tumours. Ganglion and Giant Cell Tumour of the bone are the commonest benign soft tissue and bone tumours. The most common malignant soft tissue and bone tumours are malignant melanoma and chondrosarcoma. The amputation rate is 5.64% the recurrence rate is 1.54%. Mortality rate is 3.08%. The MSTS score is 79%, and the TESS score is 76.23%. Foot tumours are relatively rare, mostly originating from soft tissue and exhibiting a benign nature. Nonetheless, a noteworthy proportion-approximately a quarter of these tumours-demonstrate malignancy. The surgical interventions undertaken in managing these tumours and associated functional outcomes generally yield acceptable results.

A Case of Aneurysmal Bone Cyst of Fourth Metacarpal Bone: A Rare Entity at Unusual Location

An Aneurysmal Bone Cyst (ABC) is a locally aggressive, rapidly growing, rare benign bone tumour that typically occurs in children and early adulthood. It usually occurs in the first and second decades of life, with a female predominance. The long bones of the lower extremities and spine are common sites for ABC, with rare involvement of the small bones of the hand. An 18-year-old female presented to the hospital with progressive swelling over her left hand for 4 to 5 months, associated with pain. Local examination elicits pain and tenderness over the 4th metacarpal bone with restricted movement at the Metacarpophalangeal (MCP) joint. A histopathological diagnosis of ABC was made due to the presence of osteoclastic giant cells lining a cyst, along with areas showing a pool of haemorrhage and stromal cells. The postoperative period remained uneventful, with no complaints of pain and good healing of the operation site noted during follow-up. Metacarpal bones are rare sites for ABCs.

Osteoid Osteoma in the Hand

Abstract Many patients associated with non-traumatic wrist or hand pain receive symptomatic treatment. Although temporary improvements are seen with these treatments, the underlying cause is masked, and delayed, or missed. Two patients with osteoid osteoma (OO) localized in the capitate and proximal phalanx are presented in this article. OO is a benign bone tumor typically seen in children, affecting long bones. While cases located in the upper extremities are shared, it is rare in the hand. Surgical intervention remains the primary treatment option. Favorable outcomes are achieved with complete excision of the nidus in an early-detected OO cases.

Medullary and Foraminal Stenosis by Lumbar Vertebral Hemangioma: Case Report

Vertebral hemangiomas can be defined as benign vascular bone tumors, accounting for only about 3% of spinal tumors. In general, they may demonstrate an asymptomatic clinical presentation, being found accidentally on imaging tests. They have an incidence of about 2.0-27% in the general population and do not require intervention in incidental cases.

A rare location of the rare tumour-chondromyxoid fibroma of calcaneum

Chondromyxoid fibroma (CMF) primary location is the long tubular bones of the lower extremity followed by foot and knee. This benign cartilaginous tumor of bone is the rarest reported neoplasm of cartilaginous origin. This mass can mimic other benign and malignant bone tumors owing to its variable histologic features. We report a case of CMF of the calcaneum with varying presentations. Pathologic examination is difficult but can be used to differentiate this lesion from more serious conditions. A quick and accurate diagnosis of CMF can prevent unnecessary treatment that could be harmful to the patient.

Unusual sites of giant cell tumor of bone

Giant cell tumor (GCT), a benign but regionally aggressive and destructive tumor, is most frequently found at the epiphysis of long bones. The distal femur, proximal tibia, and distal radius are the three most typical locations. The pelvis, proximal femur, proximal humerus, distal tibia, and sacrum are uncommon locations. About 18– 23% of benign bone neoplasms are GCT. They often manifest in early adulthood because they happen after the growth plate has closed, with the majority of instances being documented between the ages of 20 and 50. GCT is a primarily benign bone tumor that exhibits local recurrence, has metastasis potential, and may show malignant change. Depending on the site, complications such as hemorrhage or pathological fracture, GCTs can have varied appearances. Rarely, ribs, vertebral bodies, and bones of the hand and foot may be affected. Other than the long bones, the radiographic characteristics of GCT are non-specific and resemble those of other osteolytic diseases. This review shows GCT imaging features from both typical and unusual locales.

Surgical Procedure for a Rare Case of Skull Bone Cysts

Introduction: Bone cysts are inclusive of but not limited to the unicameral bone cyst (UBC) and aneurysmal bone cyst (ABC). UBC have a predilection for males (3:1). UBC make up 3% of primary bone lesions. Most UBCs are found in long bones, most common sites are proximal humerus and femurs, rarely found in flat bones (Skull). Cases of UBC observed following trauma are thought to occur due to intraosseous bleeding when bone organization or repair mechanisms fail. Case Report: Twenty-one-year-old male complained of headache, a history of traumatic brain injury. Motoric examinations show diminished motor function on the left side. CT Scan shows an expansile sclerotic lytic lesion on the right parietal bone. We diagnosed this case with a suggested Bone Cyst on the right parietal, and craniotomy tumor removal with a direct approach was performed. Thickened dura mater was identified, cleansed using NaCL and povidone-iodine, and drilled using a high-speed drill until flattened. The yellowish-colored bony lesion was discovered to contain a semi-translucent substance, the lesion was found to be a unicameral bone cyst. Discussion: UBCs are generally asymptomatic, and usually appear as lesions with lucent characteristics and small zones of transition. As a benign bone tumor, treatments are not required unless the lesion is large and symptomatic, due to the patient's symptomatic condition, craniotomy tumor removal was performed. Conclusion:UBC is a rare condition, that’s scarcely located in the skull. Post-operatively, the patient shows normal motor function and no complaint of pain. Craniectomy tumor removal and flattening of the dura mater using a high-speed drill is sufficient in treating this rare disease.

Giant Cell Tumor of Mandible : A Case Report.

Giant cell tumor is locally aggressive primary benign neoplasm of bone with tendency of frequent recurrence, metastasis and malignant transformation. Because of the rarity of the disease involving mandible, no definite treatment guideline is established. Surgical treatment is the treatment of choice for giant cell tumor. Due to its proximity to vital structures including skull base, the recurrent disease associated with less invasive procedure could be difficult to manage while more invasive procedure will result in higher morbidity and complex reconstruction. Medical management with denosumab or zoledronic acid has been advocated in surgically unresectable disease. We present a rare case of giant cell tumor of mandible. Patient was a 33 years old lady who presented with gradually progressive painful swelling in chin. After exclusion of distant metastasis by F-18 FDG PET scan, she underwent en-bloc resection of the tumor with free fibula flap reconstruction. During 6 months of follow up visit patient had no recurrence.

Rare coexistence of multiple osteochondromas and solitary osteoid osteoma: A case report

Rare coexistence of multiple osteochondromas and solitary osteoid osteoma: A case report

A rare case of chondromyxoid fibroma of distal phalanx of great toe

Chondromyxoid fibroma (CMF) is rare benign tumour of bone which are due to incomplete cartilage differentiation and first described by Jaffe and Lichtensein in 1948. CMF’s constitutes for less than 1% of all bone tumors. Histopathology is diagnostic and CMF show lobulated areas of spindle shaped or stellate cells with hypocellular center of chondroid or myxoid material and periphery is hypercellular with abundant fibromyxoid tissue and few multinucleated osteoclasts like giant cell. CMFs are commonly seen in metaphysis of long bones including proximal tibia or distal femur. Short tubular bones of hand and feet are uncommon sites and toes constitutes less than 5% of the tumors. We present a case of chondromyxoid fibroma of distal phalanx of left great toe in 35 years old male patient.