Benign Osteoblastoma Research Articles

Benign osteoblastoma of the temporal bone: case report and review of the literature

Background Benign osteoblastoma arising from the temporal bone is extremely rare in elderly patients. We reviewed the literature on benign osteoblastoma of the temporal bone and now propose a new classification of this pathologic entity based on its anatomical location in the temporal bone. Case Description A 68-year-old woman presented with tinnitus and hearing disturbance with a duration of 1 year. Her neurologic examination revealed mixed hearing disturbance and hypogeusia. Preoperative computed tomography showed a bony destructive isodensity mass with calcified component involving the temporal bone. The FDG-PET scan showed high uptake on the lesion. After preoperative embolization on the day before surgery, the patient underwent tumor removal via a left infratemporal approach under neuronavigated guidance. The pathologic examination revealed a benign osteoblastoma. Conclusion We present the first case of FDG-PET showing high uptake on the lesion. Preoperative embolization is useful to reduce the amount of bleeding during the surgery.

Benign Intraspinal Osteoblastoma Stemming From C7 Lamina in Cervicothoracic Junction

A case report of a rare benign osteoblastoma successfully treated with total en bloc excision. To describe the clinical and radiographic features of an adolescent female patient with intraspinal osteoblastoma in cervicothoracic junction and the effect of surgical treatment. A rare case of massive benign osteoblastoma stemming from left side lamina of C7 and extension to spinal canal from C6 to T1 resulting in spinal cord compressed severely is reported. And the excellent results achieved from surgical intervention are presented. A 13-year-old girl complained of gradually increasing pain of her lower part of the neck and left shoulder radiating to the left upper extremity, and the neurologic deficits were found in physical examination. A massive neoplasm located in intraspinal cervicothoracic junction and the spinal cord compressed severely was shown in radiographs, MRI, and CT. The neoplasm was removed totally with instrumentation performed in surgical intervention. She was followed up for 2.5 years; clinical symptoms and plain radiograph and CT films were investigated. The specimen of the removed mass was proven osteoblastoma pathologically. Her symptoms were relieved and the neurologic deficits recovered completely. Recurrence of the tumor was not seen at the final follow-up. A case of massive intraspinal osteoblastoma stemming from C7 lamina was successfully treated by excised grossly with instrumentation for reconstruction of stability.

Benign osteoblastoma of the occipital bone: Case report and literature review

We present a case of benign osteoblastoma of the occipital bone. Benign osteoblastoma is an uncommon primary bone tumor, which usually involves the vertebrae and the long bones. This tumor rarely develops in the calvaria, showing a preference for the temporal and frontal bones when it does. To the best of our knowledge, this case is only the eighth reported case of benign osteoblastoma confined to the occipital bone. A 20-year-old male presented with a mild tender mass lesion of the occipital area, just below the lambda. Plain X-ray films and CT scans demonstrated an osteolytic mass surrounded by the sclerotic rim within the diploic space. MRI proved to be effective for the evaluation of the intracranial and intraosseous extensions of the tumor. However, it was very difficult to formulate a differential diagnosis against other osteoblastic tumors, or osteoid osteoma, in view of its radiological appearance. The final diagnosis was obtained by careful consideration of the histopathological characteristics of the tumor combined with its clinical and radiological features. Although generally regarded as benign, a complete resection is preferred over conventional curettage as this can guard against possible recurrence and malignant transformation.

Occipitoparietal benign osteoblastoma: should entire lesion be resected when magnetic resonance images reveal wide abnormal signal intensity in surrounding bone marrow?

Background Benign osteoblastoma is an uncommon primary bone tumor that usually affects long bones and the vertebral column. Its occurrence in the calvarium is rare. Despite the characteristically benign nomenclature of osteoblastoma, it sometimes recurs with the possibility of transforming into a malignant form after an incomplete resection. Therefore, radical resection is recommended whenever possible. However, it has not been clarified whether the adjacent bones should also be completely resected when magnetic resonance (MR) images reveal abnormal signal intensity in the bone marrow. Case Description Presented in this case report is a 12-year-old boy with occipital tenderness associated with occipitoparietal bone tumor. Neuroradiological studies demonstrated a solid tumor located in the occipital bone extending over the right parietal bone. Magnetic resonance images further revealed abnormal signal intensity in the bone marrow of the entire occipital and bilateral parietal bones. Macroscopically, the calvarial bone adjacent to the solid tumor appeared to be reddish, but it was not covering the entire area, contradicting the abnormal intensity found on the preoperative MR images. The resected area was determined according to macroscopic findings, and bones with normal color tone were preserved. Because histological examination did not clearly indicate tumor invasion at the margin of the resection site, no additional therapy was given. Although MR images revealed abnormal intensity in the bone marrow of the surgical margin immediately after the operation, the intensity had been normalized by degrees and there was no evidence of recurrence during a follow-up period of 34 months. This may suggest that bone marrow lesion showing abnormal intensity was edema rather than tumor invasion. Conclusions The authors conclude that total resection, including a bone marrow lesion, is not always necessary for benign osteoblastoma. Macroscopic findings that show an abnormal color tone of the cortex could be a good indicator in revealing tumor activity invading bone marrow.

Petrous bone osteoblastoma invading the cavernous sinus

A 45-year old female was admitted complaining of double vision. A CT scan revealed a mass originating from the petrous part of the temporal bone with infiltration of the cavernous sinus. The patient was operated and a subtotal excision of the tumor was achieved. Pathological examination revealed benign osteoblastoma. During an 18 year follow up period, no progression of tumor has been detected.

Osteoblastoma of the mandible: Clinicopathologic study of four cases and literature review

Osteoblastoma is a benign bone tumor accounting for 1% of all bone tumors; it commonly involves the spine and the sacrum of young individuals, with less than 5% being localized to the posterior mandible. In view of its rarity in the maxilla and mandible, osteoblastoma is rarely diagnosed as such in the absence of interdisciplinary cooperation. A retrospective study of four benign osteoblastomas was performed based on a review of the clinical, radiographic, and histopathologic features of all cases. The tumors involved the posterior mandible of young patients (age range, 10-21 years; two male and two female patients) and appeared as painful bone expansions. Radiologically, they were poorly defined, radiolucent/radiopaque lesions containing calcifications and not showing sclerotic borders or periosteal reactions. Histologically, they were composed of osteoid and woven bone surrounded by plump osteoblast-like cells with interposed fibroblasts, inflammatory cells, and red blood cells. All patients were disease free after prolonged follow-up. Osteoblastomas may be distinguished from other bone tumors, fibro-osseous lesions, and odontogenic neoplasms on the basis of integrated clinical, radiologic, and histologic features and usually manifest an indolent clinical course.

Osteoblastoma of the mandible: systematic review of the literature and report of a case

Benign osteoblastoma is a bone tumour that seldom occurs in the facial bones. The objective of this article is to add one more case of this rare lesion to the academic literature and to provide a systematic review of previously published cases. A new case of benign osteoblastoma is presented and clinical, radiographic and microscopic aspects, as well as differential diagnosis, treatment and follow-up are discussed. The importance of the correct diagnosis of this type of lesion is stressed, since it presents a clinical, radiographic and microscopic similarity to other bone lesions, including malignant tumours, which may lead the professional into conducting the case in an improper manner.

Current concepts and differential diagnosis of benign osteoblastoma of the mandible

Current concepts and differential diagnosis of benign osteoblastoma of the mandible

Pediatric Osteoblastoma of the Sternum: A New Surgical Technique for Reconstruction After Removal

Benign osteoblastoma is a rare tumor of bone that has been reported in a variety of skeletal locations. A case of an isolated benign osteoblastoma in the sternum of an 11-year-old boy is described. In the chest wall, osteoblastoma has been reported in the ribs, and rarely in the sternum. To the authors' knowledge, this is the first report of an isolated sternal osteoblastoma in a child presented in the literature. The clinical and radiologic presentation of osteoblastoma is discussed, as well as an approach for reconstruction of the sternal defect following removal of the tumor. Experience with sternal reconstruction in the pediatric population is limited. This case demonstrates that osteoblastoma of the sternum can be successfully treated with wide resection and that sternal defect reconstruction can be accomplished successfully in a child.

Benign fronto-orbital osteoblastoma arising from the orbital roof: case report and literature review

Background Osteoblastoma is an uncommon benign osteogenic neoplasm that rarely involves the orbit. Intracranial and intraorbital extension causing neurologic and ophthalmologic symptoms and signs is very unusual. We report the case of an osteoblastoma of the orbital cavity with ethmoidal and anterior cranial fossa extension presenting as unilateral proptosis. Manifestations and management of this rare fronto-orbital lesion are discussed, and the relevant literature is reviewed. Case description This 22-year-old man experienced a 3-month history of progressive left proptosis without neurologic symptoms. Computed tomography and magnetic resonance imaging scans demonstrated a bony mass involving the roof of the left orbit and extending laterally to the adjacent ethmoid cells and upward to the lower part of the homolateral frontal convexity without parenchymal abnormality. A presumptive diagnosis of osteoma was considered. A left fronto-orbital craniotomy was performed. At surgery, the tumor was well circumscribed by a sclerotic margin. It was granular with bony spicules, destroying the orbital roof and involving the orbital cavity, ethmoidal cells, and anterior cranial fossa. The lesion was totally removed, and the anterior cranial base reconstructed. The histologic features were typical of benign osteoblastoma. After a follow-up period of 12 months, the patient has remained well without evidence of recurrence. Conclusion Osteoblastoma should be considered in the differential diagnosis with other fronto-orbital bone-forming lesions. Although generally regarded as benign, a complete resection is recommended to prevent the possibility of postoperative recurrence and malignant transformation. Twelve previously reported cases were also reviewed.

Benign osteoblastoma of the temporal bone: Case report and literature review

We report a case of benign osteoblastoma of the temporal bone and a review of the literature. Osteoblastoma is a rare bony tumor that usually develops in the long bones or in the vertebral column. To our knowledge, this is the fourth reported case of benign osteoblastoma confined to the temporal bone, and it is the second such reported case to include facial paralysis as the initial symptom. Result of computed tomography scan, magnetic resonance imaging scan, and angiography are reported. The diagnosis and management of this type of lesion are also discussed. (Am J Otolaryngol 2001;22:211-214. Copyright © 2001 by W.B. Saunders Company)

Benign osteoblastoma of the mandibular ramus: Review of the literature and report of a case

Benign osteoblastoma is a rare primary bone tumor that was first recognized as a distinct neoplasm by Lichtenstein1 and Jaffe2 in the same year, 1956. It is a vascular osteoid and bone-forming benign tumor characterized cytologically by the abundant presence of osteoblasts. It constitutes approximately 1% of all primary bone tumors.3-6 The sites of predilection for the tumor are the long bones, vertebral column, and small bones of hands and feet. Its occurrence in the skull and jaw bones is relatively rare and represents only 15% of all osteoblastomas.6 The tumor shows a sex predilection for males and constitutes less than 1% of all tumors of the maxillofacial region.7 The mandible is affected more frequently than the maxilla,8 with 90% of cases arising in persons younger than 30 years of age, with an average of 17 years.6 At sites other than the skull and jaw bones, the sex and age distribution of benign osteoblastoma is equal.9 The first case of benign osteoblastoma of the jaws was reported by Borello and Sedano10 in 1967. Clinically, it is characterized by swelling, pain, and erosion and expansion of the bony cortex, depending on the site and size of the lesion.1,11-17 The tumor consists of a proliferation of abundant plump osteoblasts forming trabeculae of osteoid and immature bone in a wellvascularized stroma with numerous multinucleated cells adjacent to the osteoid trabeculae.12,14 The radiographic appearance is extremely variable and, depending on the degree of calcification in the lesion, it may appear radiolucent or semiradiolucent with radiopaque mottling and a well-demarcated margin. This report describes a case of benign osteoblastoma in a rare site, namely, the subcondylar region of the ramus of the mandible. It is presented with special reference to its differential diagnosis from the clinical, radiologic, and histologic aspects. A 1991 review of the literature listed only 45 cases of osteoblastoma of the maxillofacial region since 1967.17 Eight cases, including this one, are added to the previously documented cases in this review and report.

下顎骨良性骨芽細胞腫の１例

Fibro-osseous lesions of the craniofacial bones are a challenging group of pathologicconditions that are difficult to classify. Unfortunately, there are no universally accepted clinical, radiographic, or histopathologic criteria that categorically distinguish these lesions from one another. A case ofbenign oseoblastoma of the right side of the mandible with diverse histopathologic findings is reported. Thepatient was a 9-year-old Spanish-Peruvian girl who presented with enlargement of the right side of themandible of 4 months' duration. Mandibular radiographs showed a well circumscribed mass containing both radiopaque and radiolucent lesions without periosteal spiculated new bone formation. Extirpation and curretage of the lesion were done. Histologically, the tumor was composed of lesions cosistent withbenign osteoblastoma. The peripheral region of the tumor mimicked fibrous dysplasia, cemento-ossifying fibroma, and sclerosing osteomyelitis. The final diagnosis was mandibular benign osteoblastoma. One year 8 months postoperatively, the patient was well, with no sign of recurrence.

Intra-articular Benign Osteoblastoma of the Acetabulum

The acetabulum is an unusual location for benign osteoblastoma, usually seen in adolescents and young adults. This article reports a case of an intra-articularly expanding benign osteoblastoma of the acetabulum in a 6-year-old boy. The diagnostic and surgical features of the disease in this unusual location at this young age are discussed. Excisional biopsy and curettage of the lesion followed by bone grafting resulted in healing of the acetabular lesion without acetabular dysplasia, but with a resultant coxa magna.

Benign Osteoblastoma of the Odontoid Process of the Axis: A Case Report

Background The majority of benign spinal osteoblastomas arise from the posterior elements of the spine; there have been no published reports of the tumor in the odontoid process of the axis. Accurate preoperative localization of the tumor is important for planning minimally invasive surgery on such benign tumors. However, the magnetic resonance imaging (MRI) findings may be misleading, because peritumoral changes may be confusing. Case Description We report the case of a 20-year-old man, who presented with a 4-year history of protracted left posterior neck pain. Preoperative computed tomography (CT) revealed a discrete mixed-density mass within the odontoid process. MRI showed diffusely abnormal signal intensity and enhancement both in the odontoid process and the body of the axis, including regions from which biopsy specimens were normal or had minimal inflammatory changes. Precise preoperative localization of the tumor margins using CT and biopsy allowed for successful resection of the tumor via a transoral approach with preservation of a part of the axis and the odontoid process. Consequently, stabilization of the spine was unnecessary, and the patient remained symptom-free for 3.5 years. Conclusion We reported a rare case of benign osteoblastoma of the odontoid process of the axis. The tumor was successfully resected via a transoral approach, preserving a part of the axis and the odontoid process. We have emphasized an advantage of CT over MRI for accurate localization of the tumor.

Osteoblastoma of the ethmoid sinus in a nine-year-old child—an unusual occurrence

Osteoblastoma is a benign bone tumor which is common in the vertebral column and long bone of the extremities. The paranasal sinus involvement is rare. We reported a case of benign osteoblastoma of the ethmoid sinus in a nine-year-old boy who presented with exophthalmos. The tumor had aggressive growth with cranial base involvement. Radiologic finding was a mottled soft tissue mass with sclerotic margin. Histologic features were the presence of osteoblast, small trabeculae of woven bone and rich vascular fibrous stroma. Differential diagnoses consist of various kinds of fibro osseous lesions; the closest one is osteoid osteoma. Surgery is the treatment of choice, external ethmoidectomy with lateral rhinotomy was performed in this case. Recurrence is common according to previous reports. Previous literature were reviewed and discussed.

Osteoblastoma in the anterior maxilla mimicking periapical pathosis of odontogenic origin

A patient with a 6-yr history of chronic orofacial pain and periapical pathosis in the anterior maxilla presented for evaluation and treatment. Previous root canal therapy had failed to resolve the persistent pain. Further evaluation suggested a non-odontogenic etiology of the patient's symptoms. Exploratory surgery revealed an osseous cavity across the maxillary anterior palatal midline filled with osteoid and early mineralized bone. The tumor was surgically removed in toto. A diagnosis of benign osteoblastoma was made.

Benign osteoblastoma of the mandible: Report of a case

Benign osteoblastoma of the mandible: Report of a case

Benign osteoblastoma of the mastoid part of the temporal bone: case report

Osteoblastoma is a benign bone lesion that mainly affects the long bones and rarely the temporal bones. Very few cases have been reported in the literature. This paper reviews the literature, discusses the differential diagnosis, clinical presentation, and CT scan findings of such a condition and details our experience with a young patient who had a temporal bone (mastoid process) osteoblastoma.

Benign osteoblastoma of the temporal bone: MRI

We investigated a 27-year-old woman with a retroauricular tumour. MRI revealed a signal void on T1 and T2-weighted images, and irregular enhancement with gadolinium-DTPA. The underlying dura mater also enhanced. The tumour was resected completely, and histological examination showed a benign osteoblastoma.