Osteoid Osteoma Research Articles

Spinal Osteoid Osteoma in L5 Vertebral Body-A Case Report and Literature Review

An osteoid osteoma (OO) is a benign bone tumour with a higher predisposition to affect long bones such as the femur and tibia, presenting in the vertebral spine in approximately 10%-25% of the cases. Clinically, pain is the most frequent symptom. Radiography should be the first imaging choice. Computed tomography (CT) is the elective exam for anatomical location of the nidus and surgical excision is the treatment of choice

Treatment of Osteoid Osteoma.

First described by Bergstrand in 1930, osteoid osteomas are benign lesions of bone.[1] The cause of osteoid osteoma is unknown, but suggested etiologies include benign neoplastic cells, trauma, and inflammation. Histologically, osteoid osteomas are composed of mature lamellar bone and have a simple karyotype with FOS and FOSB rearrangements on cytogenetic studies.[2] [3] This can be utilized as diagnostic markers for osteoblastoma and osteoid osteoma. There is no known potential for malignant transformation.[3] Osteoid osteomas account for approximately 5% of all primary bone lesions and 10% of benign bone tumors. These lesions measure less than 2 cm in diameter and commonly occur between the first and third decades of life, with a male predilection of 3:1.[4] Lesions with a diameter larger than 2 cm are referred to as osteoblastoma, which has an increased incidence in patients with Gardner's syndrome, as they harbor a germline mutation in the APC gene.[2] Lesions have a predilection for long bones, particularly the diaphysis and metaphysis of the femur and tibia.[5] In the upper limb, the phalanges of the hand are the most commonly affected sites.[6]

Differential diagnosis of an osseous cranial tumor from Hellenistic Muğla, Turkey

ObjectiveThis project evaluates a cranial lesion from a Hellenistic-era individual excavated by the Muğla Archaeological Museum in Gülağzı, Turkey. MaterialsAn osseous tumor measuring 3.02 × 3.54 × 2.98 cm originating from the occipital bone of a probable young adult male. MethodsThe tumor was examined using gross morphological inspection, plain radiography (x-ray), and computed tomography (CT) imaging to identify potential differential diagnoses for the osseous cranial tumor. ResultsThe lesion in question displays features highly consistent with both osteoid osteoma and osteoblastoma. The tumor had a non-sclerotic, sharply demarcated border, a radiolucent nidus measuring less than 2 centimeters in diameter, and homogeneous sclerotic bone surrounding the nidus. ConclusionsDifferential diagnosis determined the osseous tumor to be a benign neoplasm, and in this case the features of the tumor are highly consistent with a diagnosis of either osteoblastoma or osteoid osteoma. SignificanceThe identification of novel neoplastic cases in paleopathology represents an important contribution to ongoing discussions regarding the temporality and regional variability of neoplastic conditions in the past. Additionally, a rigorous diagnostic study augmented by x-ray, CT scans, and 3D modeling provides data that can be utilized in future paleopathological studies. LimitationsDiagnostic interpretation would be aided by histological examination of the tumor, which was impossible in this case. Histological examination would provide a definitive diagnosis. Suggestions for further researchGiven the high incidence of benign tumors in the clinical literature but a paucity of reports in the paleopathological record, further research is indicated to better understand the implications of benign neoplasms in antiquity.

Outcomes of Surgical Treatment for Extradural Benign Primary Spinal Tumors in Patients Younger than 25 Years: An Ambispective International Multicenter Study.

Extradural primary spinal tumors were retrospectively analyzed from a prospective database of 1495 cases. All subjects with benign primary tumors under the age of 25 years, who were enrolled between 1990 and 2012 (Median FU was 2.4 years), were identified. Patient- and case-related characteristics were collected and statistically analyzed. Results: 161 patients (66f;95m; age 17.0 ± 4.7 years at time of diagnosis) were identified. The most common tumors were osteoblastomas n = 53 (32.9%), osteoid osteomas n = 45 (28.0%), and aneurysmal bone cysts n = 32 (19.9%). The tumor grade, according to the Enneking Classification S1/S2/S3, was 14/73/74 (8.7/45.3/46.0%), respectively. Tumor-related pain was present in 156 (96.9%) patients. Diagnosis was achieved by biopsies in 2/3 of the cases. Spinal fixation was used in >50% of the cases. Resection was Enneking appropriate in n = 100 (62.1%) of cases. Local recurrence occurred in 21 (13.1%) patients. Two patients died within a 10-year follow-up period. Conclusion: This is one of the largest international multicenter cohorts of young patients surgically treated for benign spinal tumors. The heterogenic young patient cohort presented at a mid-term follow-up without a correlation between the grade of aggressiveness in resection and local recurrence rates. Further prospective data are required to identify prognostic factors that determine oncological and functional outcomes for young patients suffering from these rare tumors.

Pediatric and Young Adult Image-Guided Percutaneous Bone Biopsy-A New Standard of Care?

There are no consensus guidelines regarding the use of percutaneous needle biopsy for the diagnosis of soft tissue and bone tumors. The aim of this study was to understand the efficacy of image-guided percutaneous biopsy for pediatric patients with soft tissue and bony masses, the role of intraoperative image guidance, and diagnostic accuracy. A retrospective institutional chart review was performed on patients who underwent percutaneous biopsy of soft tissue or bone tumors between 2007 and 2017. Data collected included preoperative imaging, type of biopsy, demographics, insurance status, number of samples taken, and pathologic results. One hundred forty-one children and young adults underwent 169 biopsies. Female patients received 48.2% of biopsies. The mean age was 14.3 ± 7.0 years. Core needle biopsies made up 89.4% of procedures, while 10.6% were fine needle aspirate. The mean number of samples per patient was 3.6 ± 2.5. All patients had imaging guidance, with computed tomography used in 44.7% of patients, 9.9% using fluoroscopy, 7.1% using ultrasound for guidance, and 53 (37.6%) patients had more than one modality. Diagnostic specimens were obtained in 97.9% of biopsies. The most common overall pathology was osteoid osteoma. The most common malignant tumors were osteosarcoma and Ewing's sarcoma. Image-guided percutaneous biopsy is a safe and effective method of obtaining accurate tissue samples in children and young adults with soft tissue or bone masses. Level 4-Study of diagnostic test.

Does the histological presence of a nidus correlate with improved outcomes in osteoid osteoma treated with percutaneous radiofrequency ablation (RFA)?

Osteoid osteoma (OO) is a benign bone tumour generally found in childhood and adolescence, typically causing bone pain, usually during night-time.1–3 It consists of a small, non-progressive osteoblastic lesion, first reported by Jaffe, representing up to 12% of all skeletal neoplasms.4,5 OO can be symptomatically managed conservatively with anti-inflammatories, minimally invasive therapies and surgical resection. CT-guided radiofrequency ablation (RFA) was introduced in the early 90s, becoming the most common OO management, with a high success rate.

An Osteoid Osteoma of the 4th metatarsal mimicking a stress fracture – A case report

Osteoid osteoma is a common benign bone tumor that infrequently affects the metatarsal bones. We present the case of a 29-year-old female that has mistakenly been treated for a stress fracture of the 4th metatarsal bone for almost 3 years. During this period, 4 conventional radiographs, 4 MRIs and 1 CT have been performed. After referral to our institution repeated thorough anamnesis and reevaluation of the diagnostic imaging raised suspicion for an osteoid osteoma. The patient was successfully treated with magnetic resonance-guided focused ultrasound (MRg-FUS). Osteoid osteoma is a rare but important differential diagnosis of stress fractures. Typical clinical presentation and diagnostic pathways should be known by professionals treating patients with nontraumatic foot and ankle pain.

Intra-articular osteoid osteoma: report of two cases

骨样骨瘤是一种良性骨肿瘤，常见于长骨骨干，具有特征性的临床和放射学表现。关节内骨样骨瘤少见，通常累及髋部，很少累及肘部。由于肿瘤位于关节内，会产生关节僵硬、疼痛和活动能力下降等类似于关节炎的临床表现。骨样骨瘤的典型放射学表现是沿着长骨骨干以小的溶骨灶为中心的丰富的骨硬化，而关节内骨样骨瘤的影像学特征通常不典型，因此常导致诊断延误。本文报道2例临床诊断为关节炎的肘关节内骨样骨瘤，探讨其临床影像学、组织学、免疫表型及分子特征，为诊断提供帮助。.

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Introduction: Osteoid osteomas are painful benign bone tumors, accounting for 10% of overall primary bone tumors. Typical osteoid osteomas are located intracortical or intramedullary in the metadiaphyseal region of the long bones. The Atypical ones are the Juxta and Intraarticular type, posing greater challenges in its diagnosis and management. CT and MRI scans have better chances of defining the nidus lesions in Atypical osteoid osteoma of the hip joints. Surgical treatment options include, image guided percutaneous interventions such as Radio frequency ablation, Laser or Cryo ablation. These modalities achieve surgical cure, but lacks the opportunity for a histo-pathological confirmation. Our cases will highlight the ‘wandering nidus’ in hip osteoid osteoma and the possibility of dual pathology (Osteoid osteoma and Osteomyelitis) in the same hip. Case study: We present two cases of hip joint osteoid osteomas (aged 18 yrs and 10 yrs) to highlight the diagnostic challenges and to discuss the different methodology of treatment. CT scan with additional MRI studies confirmed the radiological diagnosis after a delay of 6-8 months. The first case will highlight the wandering nature of the nidus (explained by the position of the calcific spicule within the nidus with reference to the needle tip), the challenges for needle trajectory with close proximity to femoral vessels and the “coaxial technique using chopstick maneuver” for CT guided needle excision. The second case will highlight the feasibility of percutaneous excision and surgical curettage in the presence of dual pathology. Conclusion: Both the cases were successfully treated by CT guided n excision biopsy and had the histopathological confirmation. Needle technique allows confirmation of diagnosis and exclusion of other differential pathology. Keywords: Wandering nidus, Atypical osteoid osteoma hip, Chopstick maneuver, Coaxial technique, Double hip lesion.

Osteoid Osteomas of Spine: From Open to Minimally Invasive Excision of the Nidus – A Case series

Osteoid osteomas of spine are not uncommon and majority of which occurs in posterior elements of lumbar spine. Management of such lesions in spine ranges from open en bloc excision to percutaneous radiofrequency ablation. In this series, we have managed three cases of osteoid osteomas of spine, each managed differently from conventional open technique to minimally invasive method. All three cases underwent appropriate radiological investigations and followed by surgical excision of the lesion and histopathological analysis post-operatively. First case was managed with open excision of the lesion with conventional unilateral pedicle screw stabilisation. Second case, who underwent open excision of the lesion developed recurrence which was managed by re-excision without any further complications. Last case underwent microendoscopic quadrant tubular excision of the tumour with unilateral MISS with pedicle screws. The technique of Microendoscopic quadrant tubular excision of posterior element benign tumour had advantages of small skin incision, less bleeding, clear macroscopic visualisation of the small tumour (enables complete excision of the nidus thus decreasing the recurrence), early mobilisation and shorter hospitalization with effective and complete excision of the tumour better than open method. Further, histological evidence of tumour will be available. The complete excision of nidus using microendoscopic tubular retractors with unilateral fixation in young age gives encouraging results. This case series is followed by review of literature highlighting the role of COX-2 inhibitors in osteoid osteoma, cause for scoliosis and neurological deficit in osteoid osteoma and management of osteoid osteomas of spine. Keywords: Tumor, Osteoid osteoma, Minimally invasive, Dorsolumbar spine, Excision biopsy

Osteoid Osteoma of the Second Metatarsal: An Exceptional Localization and Unusual Clinical Features

Osteoid osteoma of the foot can be difficult to diagnose, the clinical presentation may be mimicking other local pathologies leading to a considerable delay in diagnosis. We report an exceptional localization of osteoid osteoma in the second metatarsal in a 30-year-old patient, expressed for 3 years by metatarsalgia, with no clinical and radiological architecture defect of the foot. After discovering the nidus, the patient underwent surgical excision with an excellent outcome.

Osteoid Osteoma Mimicking Arthritis

Intra-articular osteoid osteoma may simulate arthritis, due to the intra-articular presence of prostaglandin, which leads to synovitis, joint effusion, pain, and high local temperature. Also, intra-articular osteoid osteoma may present with minimum or no cortical thickening. Therefore, a high suspicion is needed for a correct and early diagnosis. Perfusion weighted imaging, such as dynamic contrast-enhanced imaging, can aid in the localization of the tumor nidus, seen as an early arterial-phase focal enhancement after the gadolinium injection, with fast washout, as a result of its hypervascularity.

A New Technique to Remove Accurately Osteoid Osteomas Using Gamma Probe

A New Technique to Remove Accurately Osteoid Osteomas Using Gamma Probe

Mid-Term Results of Computed Tomography-Guided Percutaneous Radiofrequency Ablation Therapy in the Treatment of Osteoid Osteoma

Özet
 Amaç: Çalışmamızda klinik ve radyolojik olarak osteoid osteoma tanısı alan bilgisayarlı tomografi kılavuzluğunda radyofrekans ablasyon (RFA) tedavisi uyguladığımız hastalardaki tedavi başarısını araştırmayı amaçladık.
 Gereç Yöntem: Ocak 2018-Şubat 2021 tarihleri arasında RF ablasyon tedavisi uygulanmış olan 13 hasta çalışmaya dahil edildi. Arşiv görüntüler ve klinik notlar retrospektif olarak incelendi. Takiplerde vizuel analog skala (VAS) kullanılarak yapılmış olan ağrı skorlarına göre klinik tedavi başarıları değerlendirildi. 
 Bulgular: İşlem sonrası VAS skorunda 11 hastada tam, 2 hastada da tama yakın azalma sağlandı. Klinik başarı %100 olarak hesaplandı. Hiçbir hastada komplikasyon izlenmedi.
 Sonuç: Osteoid osteomalı hastalarda bilgisayarlı tomografi eşliğinde RF ablasyon minimal invaziv, güvenilir ve etkili bir tedavi yöntemidir.

Minimally Invasive Resection of Benign Osseous Tumors of the Spinal Column: 10 Years' Experience and Long-Term Outcomes of a Specialized Center.

Background and Objectives: Benign osseous tumors of the spinal column comprise about 10% of all spinal tumors and are rare cause for surgery. However, these tumors pose various management challenges and conventional surgery may be associated with significant morbidity. Previous reports on minimally invasive resection of these lesions are rare. We report a series of patients managed by total resection of benign osseous spine tumors using MIS techniques. Surgical decisions and technical considerations are discussed. Materials and Methods: A retrospective evaluation of prospectively collected data of patients who underwent minimally invasive surgery for removal of benign osseous vertebral tumors. Demographic, clinical and radiographic features, operative details and final pathological reports were summarized. Primary outcomes were completeness of tumor resection and pain relief assessed by VAS for back and leg pain. Secondary outcome measures were recurrence of tumor on repeat post-operative MRI and postoperative unstable deformity on standing scoliosis X-rays. Results: This series included 32 cases of primary osseous spine tumors resected by minimally invasive techniques. There were 17 males and 15 females aged 5-68 years (mean 23.3). The follow-up period was 8-90 months (mean 32 months) and the preoperative symptoms duration was 9-96 months. Axial spinal pain was the presenting symptom in all the patients. Five patients also complained about radicular pain and four patients had antalgic scoliosis. The tumor involved the thoracic spine in 12 cases, the lumbar segment in 11, the cervical in 5 and the sacral area in 4 cases. Complete tumor removal was performed in all patients. No procedure-related complications were encountered. Histopathology showed osteoid osteoma in 24 patients, osteoblastoma in 5 patients, and fibrous dysplasia, fibroadenoma and eosinophilic granuloma in one case each. All patients experienced significant pain relief after surgery, and had stopped pain medications by 12 months postoperatively. No patient suffered from tumor recurrence or spinal deformity. Conclusions: Minimally invasive surgery is feasible for total removal of selected benign vertebral tumors and may have some advantages over conventional surgical techniques.

Spontaneous correction of scoliosis after curettage of spinal osteoid osteoma: How and when?

BackgroundScoliosis behavior after curettage of spinal osteoid osteoma has been not clarified as most studies regarding scoliosis secondary to osteoid osteoma (OO) were case reports. The aims of this study were to investigate (1) clinical and radiographic features of scoliosis secondary to OO; (2) scoliosis behavior after Curettage of OO.MethodsA retrospective study was performed at patients who were diagnosed as OO clinically or pathologically from July 1998 to December 2019 in a single institution. Age, gender, location of pain, location of lesion and curve pattern of scoliosis were collected preoperatively. Intraoperative blood loss, operation time and surgical complications were documented. VAS scores and curve magnitude were collected pre- and postoperatively and at last follow-up.ResultsThe mean operation time was 124 ± 32 min and the average intraoperative blood loss was 274 ± 134 ml. The mean preoperative VAS score was 6.2 ± 2.7, and the mean postoperative VAS score was 2.1 ± 1.8. Thoracic scoliosis was improved from 22.7 ± 10.6° to 6.2 ± 4.3° after operation, and to 4.1 ± 4.3° at last follow-up. Lumbar scoliosis was improved from 18.1 ± 7.4° to 6.7 ± 5.2° after operation, and to 5.3 ± 3.9° at last follow-up. Trunk shift was improved from 34.7 ± 12.4 to 10.5 ± 7.2 mm after operation, and to 8.4 ± 5.6 mm at last follow-up. There was no significant differences as to sagittal radiographic parameters (P > 0.05).ConclusionPatients with spinal OO had a significantly high incidence of scoliosis. Patients could get rapid relief of pain and scoliosis with low occurrence. Night pain, pain at the concave side of curve, normal sagittal alignment could help differentiate it from scoliosis associated with lumbar disc herniation.

Treatment of an osteoid osteoma of the mandible with endodontic microsurgery and grafting with a biphasic calcium sulfate material: A case report

Treatment of an osteoid osteoma of the mandible with endodontic microsurgery and grafting with a biphasic calcium sulfate material: A case report

A Novel High-Throughput Screening Method for a Human Multicentric Osteosarcoma-Specific Antibody and Biomarker Using a Phage Display-Derived Monoclonal Antibody

Osteosarcoma is a malignant tumor that produces neoplastic bone or osteoid osteoma. In human multicentric osteosarcoma (HMOS), a unique variant of human osteosarcoma (HOS), multiple bone lesions occur simultaneously or asynchronously before lung metastasis. HMOS is associated with an extremely poor prognosis, and effective treatment options are lacking. Using the proteins in our previously generated HMOS cell lines as antigens, we generated antibodies using a human antibody phage library. We obtained antibody clones recognizing 95 independent antigens and developed a fluorescence probe-based enzyme-linked immunosorbent assay (ELISA) technique capable of evaluating the reactivity of these antibodies by fluorescence intensity, allowing simple, rapid, and high-throughput selection of antibody clones. These results were highly correlated with those using flow cytometry. Subsequently, the HMOS cell lysate was incubated with the antibody, the antigen-antibody complex was recovered with magnetic beads, and the protein bands from electrophoresis were analyzed using liquid chromatography-mass spectrometry (LC/MS). CAVIN1/polymerase I transcript release factor was specifically detected in the HMOS cells. In conclusion, we found via a novel high-throughput screening method that CAVIN1/PTRF is an HMOS-specific cell membrane biomarker and an antigen capable of producing human antibodies. In the future, antibody-drug conjugate targeting of these specific proteins may be promising for clinical applications.

Midterm Clinical, Radiological, and Functional Results of Arthroscopic Excision of Osteoid Osteoma of the Hip Joint: a Case Series.

We aimed to evaluate the midterm functional and clinical outcomes of the patients who underwent arthroscopic excision of hip osteoid osteoma (OO). We reviewed records of patients diagnosed with intra-articular hip OO, treated with hip arthroscopic excision procedure, and a minimum of 1-year postoperative between 2011 and 2020. Clinical outcomes were assessed range of motion (ROM) pre and postoperatively, and functional outcomes were evaluated with a modified Harris hip score (modified HHS) and Visual analog scale test. All patients were assessed by hip radiography, and three radiological measurements, including lateral center-edge angle (LCEA), alpha angle, and Tönnis angle, were measured. These parameters were compared with unaffected hips. Fifteen (5 female and 10 male) patients were included in the study, with a mean age of 32.6 ± 12.7 (range 12-53). The average postoperative follow-up period was 59.1 ± 28 (range 13-106) months. The functional and clinical scores were significantly improved at the final visit compared to the preoperative values. No differences were found between the operated and unaffected sides with respect to the radiological parameters. The preoperative alpha was significantly higher on the operated side than on the unaffected side (p = 0.007). In this study, within an average of 5years after surgery, hip arthroscopy provided successful clinical outcomes in the treatment of OO of the hip joint without recurrence. The modified HHS, VAS, and HOS values improved significantly at the final follow-up; 14 of 15 patients had satisfactory outcomes after hip arthroscopy for hip OO. Prognostic Level IV study.

CT-Guided Radiofrequency Thermal Ablation for the Treatment of Atypical, Early-Onset Osteoid Osteoma in Children Younger than 4 Years Old: Single-Institution Experience and Literature Review.

The aim of our study is to report our experience on CT-guided radiofrequency ablation (RFA) for osteoid osteoma (OO) in children under 4 years of age and to review the literature regarding this atypical, early onset of the disease. We retrospectively reviewed the clinical and radiological records of the patients treated with CT-guided RFA for OO at our institution (2006-2021), including those under 4 years of age. Data regarding technical success, clinical success, and biopsy diagnostic yield were collected. Moreover, we performed a literature review including previous articles on early-onset OO. We found only 12 patients that were under 4 years of age (12/842-1.4%) at the time of RFA treatment: 4 F and 8 M, mean age at the time of the treatment 35.3 months (range 22-46 months). The mean follow-up was 22.8 months (range 6-96 months). Technical success was achieved in all cases (12/12). In all patients (12/12), a complete remission of the pain symptoms was achieved at clinical follow-up controls. No recurrence of pain or complications were documented. The histopathological diagnosis was confirmed in 4 patients (4/12-33.3%). Moreover, we found another 9 articles in the literature with a main focus on early-onset OO (<4 years old), with a total of 12 patients included; 6 of those patients (6/12-50%) were treated with CT-guided RFA, with success reported 5 cases (5/6-83.3%). Our series of cases treated at a single institution, together with the existing data from the literature, confirms that CT-guided RFA is effective and safe for the treatment of osteoid osteoma, even in atypical, early onset in children under 4 years of age.