Case Of Osteoblastoma Research Articles

Gnathic osteoblastoma: Clinicopathologic review of seven cases with long-term follow-up

The clinical, radiographic and histopathologic features of seven cases of osteoblastoma of the jaw bones were analyzed. The mandible was involved in six cases and a periosteal presentation of the tumor was noted in three cases. Six tumors were symptomatic with pain being the common presentation. The radiographic appearance of the intraosseous tumors varied from well-defined radiolucencies to poorly-defined mixed lesions. A small periosteal tumor was undetectable radiographically. Histopathologically, the tumors exhibited variation in woven bone formation, osteoblastic rimming, lesional maturation as well as interaction of the tumor with surrounding host tissue. Intraosseous tumors were managed with aggressive surgical curettage and periosteal tumors were resected and the underlying bone was curetted down to normal host bone. Follow-up of cases ranged from 2 years to 18 years with no recorded recurrences. Gnathic osteoblastomas offer a unique diagnostic challenge as they resemble other tumors of the jaws including the cementoblastoma, cemento-ossifying fibroma, cemento-osseous dysplasia and most importantly the gnathic osteosarcoma. We stress on the need to correlate the histopathologic findings with clinical and radiographic features to reach an accurate diagnosis.

A Case of Osteoblastoma of the Mandible with Immunohistochemical Findings of Bone Related Proteins

Clinical Summary A 19 years old female patient came to consult at the Okayama University Dental Hospital with a complaint of dull aching pain and swelling at the left side of the mandible. Radiaographic examination revealed a well-defined mixed radiolucent radiopaque lesion at the left retromolar area with no sclerotic border. The lesion was well-separated from the teeth and the mandibular canal. Complete resection of the lesion was done under general anesthesia.

Application of computer-assistant neuronavigation in spinal operation

To discuss the efficacy, accuracy, and safety of computer-assistant neuronavigation in operation of vertebrae and spinal cord. The data of computer-assistant neuronavigation used in the operation for 41 cases, including 9 cases of neurinoma, 10 cases of ependymoma, 5 cases of angioreticuloma, 7 cases of spinal meningioma, 4 cases of astrocytoma, and 1 case of cysticercosis, and 1 case of osteoblastoma. from March 2001 to December 2003 were reviewed. Twenty-six screws were fixed in 4 patients. Total removal was succeeded in 33 of the 37 cases of 37 spinal tumors and all patients survived after operation. Image-guided navigation for spinal surgery is able to save time and reduce operational lesion. More importantly, it improves neurosurgeon's comprehension of spinal anatomy.

下顎骨に発生した骨芽細胞腫の１例

Osteoblastoma is a rare bone tumor associated with osteoid and atypical bone formation. We describe a case of osteoblastoma of the mandible in a 19-year-old woman. Radiographic examination of the tumor showed a well-defined radiopaque region, measuring approximately 13 mm in diameter and surrounded by a radiolucent area. The treatment was complete surgical excision. The postoperative course was uneventful. The osteoblastoma was mainly composed of abundant connective tissue showing active angiogenesis and osteoid bone covered with osteoblast-like cells and osteoclast-like multinuclear giant cells. We studied the tumor histologically and ultrastructually and examined tumor cell proliferation with MIB antibody immunohistologically.

A review of osteoblastoma and case report of metachronous osteoblastoma and unicystic ameloblastoma

A case is reported of a young woman who, within a 2-year period, was diagnosed with an osteoblastoma at the apex of a maxillary molar and with a plexiform unicystic ameloblastoma in the posterior mandible. Previous cases of osteoblastoma occurring in the jaws are reviewed. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:570-5)

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.

Intraarticular Osteoid Osteoma Associated with Synovitis: A Possible Role of Cyclooxygenase-2 Expression by Osteoblasts in the Nidus

To clarify the condition of development of synovitis associated with intraarticular osteoid osteoma (OO), expressions of cyclooxygenase-2 (COX-2) protein and its messenger ribonucleic acid were investigated both in the nidus and the synovial tissue using immunohistochemical and reverse transcription-polymerase chain reaction analyses. Diffuse and strong COX-2 immunoreactivity was found in osteoblast-like tumor cells in the nidus of all six cases of OO (three of six cases were intraarticular OO associated with synovitis) and one case of osteoblastoma associated with synovitis. Expression of COX-2 messenger ribonucleic acid was demonstrated in one case of OO associated with synovitis, and was higher in the nidus than that in the inflamed synovial tissue. However, there were no significant difference between the nidus and synovium in the expression of cytosolic phospholipase A2, one of the enzymes involved in arachidonic acid metabolism, and inflammatory cytokines such as interleukin-1β and tumor necrosis factor alpha. Finally, as there was only one case in which the examinations of gene expression were performed, no definitive overall conclusions could be reached; rather it is suggested that COX-2 expressed primarily by osteoblasts in the nidus of intraarticular OO may play a role in activating the pathway of arachidonic acid metabolism, resulting in synovitis of the involved joint.

Childhood temporal bone osteoblastoma: A case report

Osteoblastoma is a rare primary tumor of the bone. Its sites of predilection are the vertebrae and the long bones. Occurrence in the skull is rare. The authors describe an unusual case of osteoblastoma occurring in the temporal bone of a child. Interestingly, although the clinical and radiological features were suggestive of an aggressive lesion, the histological features were consistent with that of a benign tumor. Although generally regarded as benign, osteoblastoma has potential for recurrence, local invasion, and, rarely, malignant transformation. As such, complete resection, whenever possible, is preferred over conventional curettage. J Pediatr Surg 35:1127-1129. Copyright © 2000 by W.B. Saunders Company.

Vertebral osteoblastoma: are radiologic structural changes necessary for diagnosis?

BACKGROUND A case of osteoblastoma localized at the pedicle of the 10th thoracic vertebra is presented. CASE DESCRIPTION The patient complained of nocturnal back pain not relieved by salycilates, a typical symptom of osteoblastoma. Bone scintigraphy showed a lower thoracic focus of increased osteoblastic activity; however, X-rays, computed tomography, and magnetic resonance images (MRI) were within normal limits, showing only obscure changes that were also noted in the rest of the spine. Repeat MRI with contrast revealed a focal enhancement. After pediculectomy, histopathologic examination confirmed the diagnosis of osteoblastoma. Fifteen months postoperatively, the patient is symptom-free. CONCLUSION Our case demonstrates that some cases of osteoblastoma may not have the classical radiological appearance. Although non-contrast computed tomography and T1-weighted MRI are mildly positive in some instances, osteoblastoma is best visualized on MRI with gadolinium. Like any other neoplasm, osteoblastoma should be detected and removed early, before it can cause structural bony changes.

Escoliose de evolução súbita por osteoblastoma lombar.

The clinical presentation and treatment of a case of osteoblastoma of the lumbar spine (L4) is described, with a notable delay between the onset of symptoms and the definitive diagnosis (2 years). Besides scoliosis, the usual roentgenograms, bone scans, CAT and MRI, did not show any relevant abnormality, which is a possibility that does not allow us to exclude the diagnosis of this tumor in a young patient with lower back pain and a rigid scoliosis.

Tumores primitivos de pared torácica (1991-1994)

Between 1991 and 1994, 582 operations were performed in our service; 19 (3.26%) were on primitive tumors of the chest wall. We analyze the data for these patients, including age, sex, clinical findings, chest images, diagnoses, therapy and course. Ten tumors were benign and 9 were malignant. The most frequent clinical findings were pain and/or tumor. Diagnosis was achieved before surgery in only 2 cases. Except when there are clear macroscopic and X-ray signs that the tumor is benign, we performed broad exeresis of the chest wall, sometimes also resecting adjacent structures. The defect was repaired directly in 12 cases. The defects were covered by prostheses and/or muscle plasty in the remaining patients. The most frequent tumor was chondrosarcoma (3 cases), followed by 2 cases of osteoblastoma and osteochondroma. Only 1 each of the following tumors were found: plasmocytoma, chondroma, fibrous dysplasia, eosinophilic granuloma, osteosarcoma, Ewing's tumor, epithelioid sarcoma, fibrosarcoma, hemangioma, benign neurilemmoma, desmoid tumor and liposarcoma. Two patients with chondrosarcoma were operated on for recurrences and there was also recurrence in the patient with Ewing's tumor. We conclude that: 1) chest wall tumors are infrequent, 2) radical exeresis is the treatment of choice and prosthesis is often necessary, and 3) chondrosarcoma, with poor outcome in our patients, is the most frequent tumor.

Functional reconstruction in a case of osteoblastoma of the mandibular condyle

Resection of the mandibular condyle inevitably leads to functional impairment even in cases of reconstruction with prosthesis or autogenous bone graft. Loss of function is caused by the loss of action of the lateral pterygoid muscle. Therefore, preservation and fixation of this muscle to a transplant should be performed whenever possible. A case of osteoblastoma of the condylar head and neck with functional reconstruction after ablative surgery is presented.

Osteoblastoma of the nasal cavity

The clinicopathological features of a rare case of osteoblastoma of the nasal cavity arising from the nasal turbinate are reported and compared with four reported cases of osteoblastoma with nasal cavity involvement. Two of the five tumours involved the nasal cavity and paranasal sinuses. The remaining three tumours were confined in the nasal cavity; one arose from nasal bone and two from nasal turbinate periosteum. Four tumours were successfully treated with local excision. One tumour recurred locally after excision; the recurrence was apparently controlled by further local excision.

Osteoblastoma with Cartilaginous Matrix

By definition, the occurrence of cartilaginous matrix in a bone-forming tumor eliminates the diagnosis of osteoblastoma and suggests a possible diagnosis of osteosarcoma. However, this rule is not absolute, as demonstrated by 18 cases of osteoblastoma that produced cartilaginous matrix. Hyaline cartilage was detected in four cases, and chondro-osteoid material was detected in 14 cases. In all patients, the tumor was in the appropriate patient age range and location for an osteoblastoma. The radiographic features as well as the histology, with the exception of the cartilaginous components, were in keeping with diagnosis of osteoblastoma. Intralesional excision (curettage or debulking) was performed in 13 patients and wide resection in five patients. Persistent tumor in one patient required a further intralesional excision. There were four recurrences, and no metastases were reported after follow-up of 1 to 23 years. The presence of cartilaginous matrix in a bone-forming lesion does not exclude the diagnosis of osteoblastoma and, more importantly, it is not always an indication that the tumor is an osteosarcoma.

The successful use of radiotherapy for osteoblastoma

We report a case of osteoblastoma arising in the petrous temporal bone of a 16-year-old boy. Attempts at surgical resection were unsuccessful. The patient was treated with radiotherapy and is now well 10 years later. A review of the literature indicates that radiotherapy has been used rarely for this tumour and some have felt it to be detrimental. Our report illustrates a case where planned radiotherapy has been successful when full surgical resection had not been possible.

骨肉腫と鑑別を要した良性骨腫ようの一例

A case of osteoblastoma of the distal femur is reported here. The patient was a 25-year-old man with pain in the left knee. Roentgenograms revealed an osteolytic lesion of the distal end of the left femur extending from the metaphysis to the epiphysis. Clinically, a giant cell tumor of bone was suspected most. The tumor was treated by an incisional resection and replaced by methylmethacrylate. Histologically, the tumor cells consisted of the spindle and ovoid shaped cells which proliferated with a high cellularity in a stroma of tumorous osteoid. The tumor cell had a large nucleus with a prominent nucleolus. Neither atypia nor mitosis were seen. Osteoclast-like giant cells were also present around the osteoid. Ultrastructurally, the tumor cells revealed the characteristics of osteoblasts. The lack of atypia and mitosis led us to a diagnosis of osteoblastoma, distinguishing from osteoblastoma-like osteosarcoma.

Osteoblastoma of the Spine

Clinical and radiologic features of 75 cases of osteoblastoma of the spine were reviewed. In addition to pain, which was the most frequent complaint, 18 patients demonstrated objective neurologic deficit, while scoliosis was observed in 17 patients. Aspirin yielded pain relief in 13 patients. Pathologic fracture was not encountered. The radiologic and histologic characteristics of osteoblastoma of the spine are indistinguishable from those arising in other sites. The typical lesion exhibited a well-defined, geographic margin with a sclerotic, frequently lobulated border. Approximately one half of the cases were predominantly lucent, the remainder displaying varying degrees of matrix mineralization. Distribution of the osteoblastomas through the spinal axis was as follows: cervical-29, thoracic-16, lumbar-17, sacral-13. Other significant findings included posterior element involvement in 73 of 75 cases, and a striking male to female ratio of 2.5 to 1.

Magnetic resonance imaging of vertebral osteoblastoma: A report of two cases

Two patients with vertebral osteoblastoma evaluated with computed tomography and magnetic resonance imaging are presented. A literature review revealed that cases of osteoblastoma originating within the vertebral body are exceedingly rare.

“Aggressive” osteoblastoma of the maxilla

A case of osteoblastoma in the maxilla of a 6-year-old boy is reported. The tumor was clinically characterized by locally aggressive behavior but histologically consisted of a relatively well-circumscribed mass of bone-producing epithelioid osteoblasts and occasional multinucleated osteoclasts characteristic of osteoblastoma. Radiographically the tumor appeared to penetrate the cortical plate. Because of the size of the lesion, its histologic features, and the clinical and radiographic impression of its being poorly confined, the diagnosis of “aggressive” osteoblastoma was rendered. The problem of differentiating between benign and aggressive forms of osteoblastoma is discussed.

Benign osteoblastoma of the maxilla

A rare case of osteoblastoma of the maxilla was seen in a 15 year old male. It was surgically excised. At 2 years follow up he was disease free. It is being reported for clinical interest.