Polyostotic osteoid osteoma: A case report

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

Multiple osteochondromas (MOs) are inherited in an autosomal-dominant manner, with a penetrance of ~96 and 100% in female and male patients, respectively. Osteochondromas primarily involve the metaphyses and diaphyses of long bones, including the ribs. Osteoid osteomas account for ~3 and 11% of all bone tumors and benign bone tumors, respectively. Furthermore,1 the male-to-female ratio is 2-3:1, and they generally occur in the long bones of the lower extremities, with the femoral neck being the most frequent site. The present study describes the case of a 16-year-old male patient with a bony mass around the left knee joint and pain in the left calf. Radiography revealed MOs in the upper and lower extremities, while computed tomography showed a nidus in the cortex of the tibial shaft. The patient's family history included the presence of MOs, and the patient was diagnosed with MOs and a solitary osteoid osteoma. Surgical excision of the osteochondroma and curettage of the osteoid osteoma in the proximal tibia and tibial shaft, respectively, were performed simultaneously. Postoperative pathological examination revealed osteochondroma and osteoid osteoma. Furthermore, the pain resolved, and no recurrence was observed 7 months post-operation. To the best of our knowledge, no reports exist on coexisting MOs and osteoid osteoma; therefore, the present study describes the first case of such a condition. Marginal excision for osteochondroma and curettage for osteoid osteoma effectively improved the symptoms.

Atypical Presentation of Non-Ossifying Fibroma in a Professional Muay Thai Boxer: A Case Report and a Narrative Review of the Literature

Introduction

Sports injuries occur during sport athletic activities, or exercising. However, there are some lesions which are typically associated to sports, in such a demanding and physical sport like Muay Thai that no typical lesion has been detected yet. We performed a narrative review of the literature to highlight the typical lesions of this sport to analyze the differential diagnosis of those conditions.

Case Report

A 28-year-old female, Muay Thai athlete since 16 years, presented with a 6 months history of a persistent pain in the metaphyseal lateral part of the right tibia. Differentiation between stress injuries, malignant bone tumors, and tumor-like lesions after repetitive microtrauma following sport activities can be difficult. The diagnostic approach involved conventional X-ray, echotomography, computed tomography scan, and magnetic resonance imaging scan with controversial findings. The biopsy confirmed the final diagnosis of non-ossifying fibroma.

Conclusion

The purpose of this case report is to exhibit the challenges in the diagnosis of a professional Muay Thai athlete with tibial pain and to discuss the clinical presentation of this type of patients with a limited population in the literature. Our case illustrates that even modern imaging techniques cannot always distinguish between tumor and tumor-like lesions caused by sports; meanwhile remembered us that we should never be too focused on a particular characteristic forgetting even rare pathologies as adamantinoma.

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

Osteoid osteomas are mostly solitary. We report a case of metachronous osteoid osteoma of mid-diaphysis of fibula followed by distal humeral osteoid osteoma after a 7-year interval.

Osteoid Osteoma of the Scapular Neck: A Cause of Long-lasting Unexplained Pain

Introduction:

Osteoid osteoma (OO) is a common tumor of the diaphysis of long bone, where the reported incidence is up 10% of all benign bone tumors. Its presence in flat bone is seldom mentioned in literature and can be misleading when the bone involved is in proximity to a zone of wide variety of possible pathology. We report a case of a young patient with OO in a very rare location of the body –the scapular neck – that was misdiagnosed for a long period of time before receiving adequate therapy.

Case Report:

A 20-year-old female patient presented to the clinic with chronic left shoulder pain. During the past 2 years, she received medical and physical therapy, to deal with different diagnosis such as cervical spine pathology, muscular spasm, and rotator cuff disease. However, she did not improve. At time of presentation to our clinic, radiographs of the shoulder were done and turned to be inconclusively normal. After negative magnetic resonance imaging of the cervical spine, a computed tomography scan of the shoulder was done and showed a round well-defined lesion localized in the scapular neck with a focal lucent nidus within surrounding sclerotic reactive bone measuring 8.5 mm in largest diameter, compatible with OO. Bone scan showed increased uptake. The patient was given aspirin in an intention to test and treat. The patient had dramatic pain relieve at first, which confirmed the diagnosis of OO. But then, pain became unremitting, so a decision was made for radiofrequency ablation of the lesion which gave excellent results.

Conclusion:

OO is a common benign neoplasm with high variable clinical picture and anatomic localization. Despite being more common in long bone, flat bone OO localization should be always kept in mind. Careful history and physical examination should be done for each patient presenting with unexplained pain; night pain should always raise suspicion of this condition. Radiographs are not always conclusive, and the patient with high suspicion of this condition should undergo more investigation to make the diagnosis.