Presentation Of Osteoma Research Articles

Unusual Presentation of Osteoid Osteoma with Exacerbating Pain during Menses

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.

Novel Delivery of Cryoablation Through Transoral Surgical Approach for Atypical Presentation of Osteoid Osteoma of the C1 Lateral Mass: Technical Case Illustration

BACKGROUND AND IMPORTANCE: Neurosurgical literature rarely explores cases of osteoid osteomas of the atlas. Traditionally, neurosurgeons performed en bloc surgical resection for refractory osteoid osteomas in the subaxial and lumbar spine, but minimally invasive ablation therapies have gained favor. Complete lesioning of the nidus, either by surgical or minimally invasive therapies, produces curative results with recurrence only developing after partial lesioning. CLINICAL PRESENTATION: We discuss the case of a 16-year-old adolescent boy who presented with neck and occipital pain refractory to multimodal pain management. Prolonged workup demonstrated a subtle radiographic lesion of the left C1 lateral mass. Interventional radiologists attempted a posterior approach percutaneous computed tomography-guided radiofrequency ablation but aborted due to proximity of the vertebral artery. Surgeons then pursued an open transoral approach to provide a corridor for cyclical cryoablation therapy, which proceeded without complication. The patient was discharged on postoperative day one with remission of occipital pain at the 10-month follow-up. No clinical or radiographic evidence of instability appeared on postoperative cervical films. CONCLUSION: No reports exist in the literature of an osteoid osteoma of C1 treated by an open anterior approach and with cryoablation. The transoral approach is a safe, effective method to access ventral pathologies of C1. The transoral approach may minimize blood loss and reduce the risk of craniocervical instability, allowing for preserved cervical mobility and improved patient outcomes. Surgeons may especially consider cryoablation when the nidus is within proximity to critical neural structures.

Osteoma of the temporal bone squama: a case report and review of literature

BackgroundOsteomas are benign slow-growing tumors, which typically arise on the surface of the bone. They rarely arise from the temporal bone, accounting for 0.1–1% of all benign tumors of the skull. The external auditory canal (EAC) is the most common site for osteomas in the temporal bone. Other extra-canalicular osteomas of the temporal bone are uncommon and infrequently reported. In this case report, we discuss the clinical presentation and surgical management of osteoma of the squamous part of the temporal bone. A limited review of literature is also presented.Case presentationA 20-year-old male presented to the outpatient department (OPD) with a chief complaint of a hard swelling above his left ear, for 4 years. He had no other complaints other than cosmetic concern. On examination, there was a solitary, smooth, bony hard swelling just antero-superior to the left pinna, and the overlying skin was unremarkable. The left EAC and tympanic membrane were normal. A non-contrast computed tomography (CT) scan of the head and face with 3-D reconstruction showed a16 × 18 mm exophytic, pedunculated bony lesion arising from the squamous part of the temporal bone suggestive of an osteoma. The patient was taken up for surgical excision under general anesthesia. The bony lesion was removed from its attachment to the skull using a gouge and a mallet. The base of the tumor was drilled using a polishing burr to ensure complete removal and prevent recurrence. The histopathology was confirmatory of compact osteoma. Postoperative period was uneventful, and follow-up at 18-month post-surgery did not reveal any recurrence clinically.ConclusionOsteoma of the temporal squama is rarely reported, and surgical excision is the definitive treatment if symptomatic. This case report highlights the surgical management of this rare tumor. A limited review of literature suggests that squamous part of the temporal bone is an unusual site for extra-canalicular osteomas, and the prognosis is good after surgery.

Unusual Presentation of Osteoid Osteoma of the Cervical Spine with Dysphagia: A Case Report.

The online version contains supplementary material available at 10.1007/s12070-023-03835-w.

A Giant Fronto-Ethmoidal Osteoma Presenting With Proptosis and Diplopia.

Osteomas are benign bone tumors commonly involving paranasal sinus walls. They are divided into three groups as ivory, mature, and mixed form. We reported demonstrative radiological features of an unusual case of giant osteoma presenting with proptosis and diplopia.

Surgical management of gigantiform osteoma of angle causing facial deformity

Osteoma is a rare, benign lesion wherein deposition of newly formed bone results in a tumor mass. Variants of osteomas can develop either as a peripheral mass arising from the periosteum or a central mass arising from the endosteum. Peripheral ones are usually asymptomatic and larger lesions primarily cause facial asymmetry. Central osteoma, in most cases results in cortical expansion and root displacement in some. Central osteomas pose a diagnostic dilemma and need to be discriminated from other similar lesions such as condensing osteitis, odontoma, ossifying fibroma, osteoblastoma. Isolated single osteomas are usually non-syndromic whereas, multiple osteomas are hallmark features of Gardner syndrome. Craniofacial bones such as paranasal sinuses and jawbones are frequently affected, although rare cases in other bones and soft tissues have been reported. This is a presentation of osteoma in the rare angle of mandible region in a young patient which was managed by intraoral approach.

609 Metachronous Osteoid Osteoma of the Mid-Diaphysis of the Fibula and Distal Humerus: A Case Report

Abstract A 7-year-old boy presented with a 4-week history of pain and swelling of the right leg. He had a history of mucoepidermoid carcinoma of the parotid gland, treated by surgical resection without any complication. There was no other significant past medical history. A radiograph of the right leg showed a lytic lesion of the right diaphysis of the fibula with periosteal reaction. An MRI of the right leg showed osteoid osteoma of the fibula with marked cortical thickening with osseous and soft tissue oedema. The patient subsequently had a Jamshidi biopsy and curettage of the lesion, with the histopathological results of the biopsy showing fragments of a typical osteoid osteoma nidus with irregular calcified bony lamellae. His symptoms had significantly improved after the procedure, and he was ambulating without any discomfort or pain. The patient remained asymptomatic until he returned seven years later with right elbow swelling, pain and reduced range of movement over 2–3 months. A radiograph of the elbow joint had shown a large effusion with a sclerotic lesion on the coronoid fossa of the distal humerus in keeping with an osteoid osteoma. The patient had a confirmational biopsy and subsequently radiofrequency ablation of the lesion with complete resolution of pain. To our knowledge, our case is an atypical presentation of osteoid osteoma in two widely separate bones, between the lower and the upper limb separated by seven years disease-free interval.

A Case of Chronic Myeloid Leukemia Presenting with Osteoid Osteoma: A Diagnostic Dilemma

Chronic myeloid leukemia is a hematological malignancy resulting from a clonal proliferation of hematopoietic stem cells of the myeloid series. It is developed by chromosomal translocation. Chronic Myeloid Leukemia (CML) usually occurs in adults and is rare in children. Osteoid osteoma is a benign bone lesion with no malignant potential. The association of chronic myeloid leukemia with osteoid osteoma is not reported in the literature. An atypical presentation of osteoid osteoma may complicate the diagnosis when associated with a primary malignancy. In this report, we have discussed a case of atypical presentation of osteoid osteoma suspected to be a lytic bone lesion in CML.

Is radiofrequency ablation safe and effective in treating osteoid osteomas? A prospective single-center study with atypical cases.

Osteoid osteomas are benign and nonprogressive lesions. The clinical presentation of osteoid osteoma is typical with night pain responsive to nonsteroidal anti-inflammatory agents. The typical radiological appearance is lucent nidus and adjacent reactive sclerosis. The most traditional management of osteoid osteoma is surgical removal which is associated with significant morbidity. This article aims to demonstrate our single-center experience of 55 patients with osteoid osteoma treated with percutaneous radiofrequency ablation (RFA). Fifty-five symptomatic patients who were seen at our orthopedics outpatient clinics, diagnosed with osteoid osteoma, and referred to interventional radiology department between May 2015 and April 2019 were enrolled. The nidus size, pain numeric rating scale score, and intramedullary edema diameter before and after RFA were compared. Clinical and technical success, intervention-related complications, and need for subsequent ablation were recorded. Of the 55 patients, including 12 pediatric cases, 6 had atypical locations such as metatarsal, vertebra, and scapula, while 1 case had osteoid osteoma with multiple nidus. The mean age was 18.5 ± 9.6 years. Preintervention maximum nidus diameter, pain score, and edema diameter were significantly lower in postintervention measurements (p < 0.001). Technical success rate was 98.1%, and clinical success was 96.36%. Severe complication occurred in one patient with soft tissue burn and osteomyelitis. This is one of the largest series of osteoid osteoma treated with RFA done in a single center with atypical cases. In conclusion, RFA is safe and effective in both pediatric and adult patients with rare complications even in challenging cases with atypical locations.

Osteoid osteoma: multimodality imaging with focus on hybrid imaging

Osteoid osteoma is a painful, benign, osteoblastic lesion that occurs in younger patients and affects the extremities or the axial skeleton. While plain film findings may suggest the diagnosis, in complex anatomical regions such as the spine, pelvis, wrist and foot advanced imaging modalities are often required. A typical nidus surrounded by sclerosis or cortical thickening characterizes osteoid osteoma on plain radiography and CT. MR is the cross-sectional imaging modality of choice for most musculoskeletal disorders. Unfortunately, extensive accompanying bone marrow oedema, soft-tissue alterations, difficulty detecting the nidus, and lesion locations close to a joint (with reactive arthritis) may make a confident diagnosis of osteoid osteoma by MR imaging difficult. Hybrid imaging with bone-seeking tracers such as SPECT/CT with 99mTc-labelled bisphosphonates or PET/CT with 18F-labelled sodium fluoride (18F-NaF) combines high radionuclide uptake with morphological details and provides accurate diagnosis of osteoid osteoma and additional information for treatment planning. FDG is not the recommended PET tracer because osteoid osteoma is normally FDG-negative, although some osteoid osteomas may show increased FDG uptake. Osteoblastoma, Brodie's abscess and stress fractures may mimic osteoid osteoma on imaging and clinical presentation. Once identified as the pain generator, destruction of the osteoid osteoma nidus by ablation or resection techniques usually leads to complete healing. Image-guided drill excision and radiofrequency ablation are widely used interventions. We review the presentation of osteoid osteoma across all imaging modalities, with special focus on hybrid imaging techniques.

Osteoma of mastoid temporal bone

&lt;p&gt;Osteoma is a benign slow growing bone tumour with predominance in long bones, and is rare in the skull. They are a rare occurrence in the mastoid temporal bone, being usually asymptomatic and treated mainly for cosmetic reasons. We report a case of a young female who presented with a history of swelling in the left post aural region since 10 years. Swelling was gradually increasing in size and was painless. Patient underwent excision of the tumour without any significant complication. As per our knowledge this appears to be the largest tumour reported in literature. The clinical presentation and radiological features of osteoma are characteristic but differential diagnosis should include eosinophilic granuloma, giant cell tumour, monostotic fibrous dysplasia, solitary variant of multiple osteoma, and osteoblastic metastasis. Osteomas present on the mastoid or squamous portion of the temporal bone need to be dealt for cosmetic purposes or if they are causing symptoms, while surgery should include careful removal of periosteal cover and safe margin of the mastoid cortex around it. &lt;/p&gt;

The unusual demographic presentation of an osteoid osteoma

Demographics are an important tool for narrowing down the differential diagnosis for many medical presentations, and though usually steadfast, there are exceptions in using demographics as a guideline for diagnosis. Neoplastic bony lesions are particularly reliable in their presentation within a specific age range. However, if these cases are not fully evaluated and demarcated from one another, it may lead to overevaluation and treatment or underevaluation and treatment of benign neoplastic bony lesions. In this report, we present the case of a 30-year-old male with an osteoid osteoma presenting out of the typical age range. We also include the subsequent treatment of the benign tumor with radiofrequency ablation after the initial failure in medical management. The age range of the presentation of osteoid osteomas is commonly reported in the literature as 5–25 years, and the treatment can be medical or surgical. Here, we discuss the treatment options, demographic presentation, and course of osteoid osteomas. The following core competencies are addressed in this article: Patient care, Medical knowledge.

Clinical presentation of intra-articular osteoid osteoma of the hip and preliminary outcomes after arthroscopic resection: a case series.

ABSTRACTIntra-articular osteoid osteoma (IAOO) of the hip is a relatively rare diagnosis, but one that can closely mimic symptomatic presentation of femoroacetabular impingement (FAI). Although there are multiple case reports of osteoid osteoma (OO) in the hip, we present the largest case series of hip IAOO treated with hip arthroscopy and discuss limited patient-reported outcomes after treatment with hip arthroscopy. We retrospectively identified patients diagnosed with IAOO of the hip with confirmatory computed tomography, magnetic resonance imaging or biopsy diagnoses of OO. We analyzed lesion location, main presenting symptoms, symptom duration and treatment undertaken. For the patients who underwent hip arthroscopy for treatment of their IAOO, we reviewed patient-reported outcome scores when available.Forty patients with confirmed IAOO were identified. Thirteen underwent excision with hip arthroscopy. The most common presenting symptom was groin pain. In limited patients who had pre- and post-operative outcome scores, we found significant improvements in modified Harris Hip Score (mHHS), Hip Outcome Score-Activity of Daily Living (HOS-ADL) and international Hip Outcomes Tool (iHot33) scores. Compared with patients undergoing hip arthroscopy for FAI alone, baseline mHHS, HOS-ADL, Hip Outcome Score–Sport-Specific Subscale and iHot33 scores were almost identical. We found that the presenting symptoms of hip IAOO closely mimic symptomatic FAI, including groin pain and anterior hip pain, so it is important to keep IAOO of the hip in the differential diagnosis of hip pain. Based on our experience, arthroscopy can be an effective treatment option for excision of intra-articular OO and is especially effective in patients with concomitant FAI in treating both pathologies.

Osteoma presenting as a painless solitary mastoid swelling.

Introduction. Osteoma of the temporal bone is a very uncommon benign tumor of bone. Osteomas may occur in the external auditory canals but are reported to be very rare in the mastoid bone. Case Report. A 36-year-old male presented to our department with a hard swelling behind the right ear diagnosed as osteoma. Complete excision was done through a postauricular approach. Histopathology confirmed the diagnosis of osteoma. Conclusion. Osteomas, although rare, should be considered when dealing with any hard mastoid swelling. Complete removal can be ensured by drilling till the normal cortical bone is reached to avoid recurrence. A cortical mastoidectomy should be done if the mastoid air cell system is involved.

Osteoid osteoma of distal phalanx of toe: a rare cause of foot pain.

Osteoid osteoma is an uncommon benign tumor and causes severe pain, being worse at night, that responds dramatically to nonsteroidal anti-inflammatory medications. An osteoid osteoma of the toe is very rare and arising in a pedal phalanx may be difficult to diagnose. A 34-year-old male has local swelling and tenderness but there were no hyperemia, temperature increase, or clubbing. There was a 2-month history of antibiotic treatment with suspicion of soft tissue infection in another clinic. The osteoid osteoma was completely excised by curettage and nidus removal with open surgical technique. The patient was followed up for 63 months with annual clinical and radiographic evaluations. There was no relapse of the pain and no residual recurrent tumour. Osteoid osteoma may be difficult to distinguish from chronic infection or myxedema. The patients may be taken for unnecessary treatment. The aim of the treatment for osteoid osteoma is to remove entire nidus by open surgical excision or by percutaneous procedures such as percutaneous radiofrequency and laser ablation. Osteoid osteomas having radiologic and clinical features other than classical presentation of osteoid osteoma are called atypical osteoid osteomas. Atypical localized osteoid osteomas can be easily misdiagnosed and treatment is often complicated.

Radiological Imaging Findings of a Case with Vertebral Osteoid Osteoma Leading to Brachial Neuralgia

Osteoid osteoma is a small, benign osteoblastic tumor consisting of a highly vascularized nidus of connective tissue surrounded by sclerotic bone. Three-quarters of osteoid osteomas are located in the long bones, and only 7-12% in the vertebral column. The classical clinical presentation of spinal osteoid osteoma is that of painful scoliosis. Other clinical features include nerve root irritation and night pain. Osteoid osteoma has characteristic computed tomography (CT) findings. Because magnetic resonance imaging (MRI) findings of the osteoid osteomas causing intense perinidal edema can be confusing, these patients should be evaluated with clinical findings and other imaging techniques. In this study, we present X-ray, CT, and MRI findings of a case with osteoid osteoma located in thoracic 1 vertebra left lamina and transverse process junction leading to brachial neuralgia symptoms.

Osteoid Osteoma

Osteoid osteomas consist of a nidus with surrounding sclerotic bone. The differential diagnosis covers a wide range of conditions due to the variable presentation of osteoid osteoma. The natural history is for regression to occur within 6 to 15 years with no treatment; however, this can be reduced to 2 to 3 years with the use of aspirin and non-steroidal anti-inflammatory drugs. Computed tomography-guided percutaneous techniques, including trephine excision, cryoablation, radiofrequency ablation, and laser thermocoagulation, are described.

Atypical osteoid osteomas

Osteoid osteoma is a very painful benign bone tumor that affects young adults. It is exceptional before 5 and after 30 years of age. It can be seen in any part of the skeleton. Presentation of the tumor may be intracortical, juxta-cortical or cancellous. In long bones, the tumor is frequently intracortical, and in the spine, it is usually located at the posterior elements. Osteoid osteomas having radiologic and clinical features other than classical presentation of osteoid osteoma are called atypical osteoid osteomas. Atypical osteoid osteomas are important because the diagnosis and treatment are often complicated in these cases. Misdiagnosis with prolonged impairment and sometimes overtreatment appears as a major problem concerning atypical osteoid osteomas. This paper gives brief general information about the classical presentation of osteoid osteoma, discusses the pathogenesis of the lesion and focuses on the clinical presentation, radiologic features and characteristics of atypical osteoid osteomas as well as their treatment modalities.

Osteoid Osteoma of the Intercondylar Notch: An Uncommon Cause of Knee Stiffness

The presence of an osteoid osteoma in a periarticular or intra-articular location about the knee is rare. Osteoid osteoma of the knee may be present with nonspecific complaints including knee pain, stiffness, effusions, and atrophy. Depending on the clinical setting, these symptoms could represent a variety of different diagnoses, including meniscal pathology, chondral pathology, synovitis, or Plica syndrome. In this article, we present the unique case of an osteoid osteoma within the intercondylar notch of the knee that underwent a significant delay in diagnosis and several unnecessary procedures due to misdiagnosis. Although intra-articular osteoid osteomas have been described, there remains a paucity of case reports discussing these lesions within and around the knee, and currently there are no reports available describing such a lesion located within the intercondylar notch. Although osteoid osteomas are relatively common, the intra-articular location of such lesions presents a diagnostic challenge. Vague, nonspecific symptoms including joint pain, swelling, and mechanical symptoms coupled with nonspecific radiographic findings in an otherwise healthy, young patient are more likely to guide the clinician toward a more common diagnosis of a sports-related injury as opposed to a benign bone tumor. This case represents an extremely rare presentation of osteoid osteoma within the intercondylar notch of the knee. The case presentation provides an excellent reminder of the need to consider rare diagnoses such as osteoid osteoma, especially in cases of chronic, unrelenting, localized pain in the absence of any other explicable pathology.

Synovitis of the wrist joint caused by an intraarticular perforation of an osteoid osteoma of the scaphoid

Uncommon location and atypical presentation of the osteoid osteomas of the scaphoid can pose a diagnostic challenge. Because of its intraarticular location, scaphoid osteoid osteoma can present with synovitis which is the more commonly reported presentation for other intraarticular locations like in hip and elbow and only rarely reported at the wrist. We report a case of perforation of the osteoid osteoma into the wrist joint, resulting in exuberant synovitis. The clinical significance of this report is to reinforce that synovitis can be a presentation of osteoid osteoma and it should be considered in the differential diagnosis of monoarticular arthritis. Prolonged synovitis may cause damage to the other joint surfaces of the wrist and hence carpal osteoid osteoma should be considered for early surgical excision.