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de Almeida Gonçalves Secco T, Meohas W, Costa FM, Corrêa DG. Test yourself answer: pain in the right hemithorax. Skeletal Radiol 2023; 52:1259-1262. [PMID: 36773083 DOI: 10.1007/s00256-023-04300-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 02/12/2023]
Affiliation(s)
- Tatiana de Almeida Gonçalves Secco
- Department of Radiology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil.
| | - Walter Meohas
- Department of Orthopedic Oncology, National Institute of Traumatology and Orthopedics, Av. Brasil, 500, Caju, Rio de Janeiro, RJ, 20940-070, Brazil
| | - Flavia Martins Costa
- Department of Radiology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, 2640-102, Brazil
| | - Diogo Goulart Corrêa
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, 2640-102, Brazil
- Department of Radiology, Federal Fluminense University, Rua Marquês de Paraná, 303, Centro, Niterói, RJ, 24070-035, Brazil
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Si Z, Meng W. Multimodal Imaging Evaluation and Clinical Progress of Spinal Osteoblastoma: A Comprehensive Review. World Neurosurg 2023; 170:28-37. [PMID: 36455846 DOI: 10.1016/j.wneu.2022.11.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 11/29/2022]
Abstract
Spinal osteoblastoma is rare clinically, with insidious onset, atypical symptoms, and various imaging manifestations, which can easily lead to misdiagnosis and delayed diagnosis. It can cause severe neurological dysfunction in patients with intermediate to advanced stages and may easily recur after surgery. Imaging examinations such as radiography, computed tomography, magnetic resonance imaging, and positron emission tomography have different value for the diagnosis of spinal osteoblastoma, but they lack specificity. The preferred treatment is surgical resection, which is technically difficult, and in some cases, osteoblastoma cannot be completely removed. New clinical approaches such as radiofrequency ablation, radiotherapy, targeted chemotherapy, and other comprehensive treatments have emerged and are progressing rapidly, but no unified norms have yet been developed. This manuscript provides a systematic review of the literature and provides an extensive and comprehensive review of this rare tumor in terms of multimodality imaging manifestations and clinical progress.
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Affiliation(s)
- Zhiguang Si
- Department of Medical Imaging, People's Hospital of Dehong Prefecture, Yunan, P.R. China.
| | - Wangpin Meng
- Department of Surgery, People's Hospital of Dehong Prefecture, Yunan, P.R. China
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Liu J, Han S, Li J, Yuan Y, Guo W, Yuan H. Spinal osteoblastoma: a retrospective study of 35 patients' imaging findings with an emphasis on MRI. Insights Imaging 2020; 11:122. [PMID: 33226535 PMCID: PMC7683662 DOI: 10.1186/s13244-020-00934-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/27/2020] [Indexed: 01/25/2023] Open
Abstract
Objective To investigate the values of multimodal imaging approaches in the diagnosis of spinal osteoblastomas with an emphasis on MRI findings. Materials and methods We retrospectively evaluated the imaging findings of 35 patients with spinal osteoblastomas. The imaging methods included radiography, whole-body bone scintigraphy (WBBS), CT and MRI. Results Radiography detected 87.1% (27/31) of the lesions; WBBS demonstrated increased radionuclide activity in all the lesions. CT could precisely show and localize all niduses, and calcification was always detected. MRI usually could adequately delineate the niduses of osteoblastomas, especially on T2WI (88.2%; 30/34). 71.9% (23/32) of osteoblastomas were surrounded with moderate or extensive bone marrow edema (BME) with soft tissue edema (STE). STE always extended along the muscle bundle adjacent to the lesion; there was no subcutaneous fat involvement. BME was eccentrically distributed in the vertebral body and spread inward from the sides of the nidus. The extent of BME in the vertebral body tended to be inversely proportional to the distance from the nidus. In addition, rare magnifications of osteoblastoma including multifocal diseases (n = 2), vertebra plana (n = 1) or with aneurysmal bone cysts (n = 6) were also observed in our study. Conclusions In patients showing moderate or extensive BME together with STE on MRI, both CT and MRI should be used to confirm nidus presence. The above-mentioned characteristics of edema on MRI of patients with spinal osteoblastoma are helpful in not only localizing the nidus, but also enhancing the diagnostic confidence.
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Affiliation(s)
- Jianfang Liu
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Songbo Han
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Jie Li
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Yuan Yuan
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Wei Guo
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.
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Huang Z, Fang T, Si Z, Li Y, Zhang L, Zheng C, Li S, Su M, Liu X, Li X, Wu Y. Imaging algorithm and multimodality evaluation of spinal osteoblastoma. BMC Musculoskelet Disord 2020; 21:240. [PMID: 32290828 PMCID: PMC7158089 DOI: 10.1186/s12891-020-03252-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/31/2020] [Indexed: 11/25/2022] Open
Abstract
Background To analyze the features of CT, MRI and PET/CT and their diagnostic value for spinal osteoblastomas (OBs). Methods The radiological and clinical data of 21 patients with histopathologically-confirmed spinal OBs were analyzed retrospectively. Results Sixteen of the 21 cases were benign and 5 were aggressive OBs. Tumors were located in the lumbar (n = 11), cervical (n = 4), thoracic (n = 5), and sacral (n = 1) spinal regions. Nineteen cases were centered in the posterior elements of the spine, 13 of which extended into the vertebral body. Punctate or nodular calcifications were found in all cases on CT with a complete sclerotic rim (n = 12) or incomplete sclerotic rim (n = 8). The flare phenomenon (indicative of surrounding tissue inflammation) was found in 17/21 cases on CT, thin in 11 cases and thick in 6 cases, and in 19/19 cases on MRI, thin in 1 case and thick in 18 cases. On 18F-FDG PET/CT, all cases (8/8) were metabolically active with the SUVmax of 12.3–16.0; the flare sign was observed in 8 cases, including 7 cases of hypometabolism and 1 case of coexistence of hypermetabolism and hypometabolism. Based on CT, 3, 12, and 6 cases were classified as Enneking stage 1, 2 and 3, respectively. Of 19 cases with MRI, 1 and 18 cases were classified as Enneking stage 2 and 3, respectively. Conclusions Spinal OB has multiple unique characteristic radiological features. Although a larger sample size is needed, combining CT, MRI and PET may be beneficial to optimize preoperative diagnosis and care of patients with OBs.
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Affiliation(s)
- Zihuan Huang
- The First Clinical Medical College, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Tingsong Fang
- Department of Radiology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, 510515, P.R. China
| | - Zhiguang Si
- Department of Radiology, Dehongzhou People's Hospital, Dehongzhou, Yunan, 678400, P.R. China
| | - Youcai Li
- Department of PET/CT Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510000, P.R. China
| | - Lan Zhang
- The First Clinical Medical College, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Chunling Zheng
- The First Clinical Medical College, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Shenmei Li
- The First Clinical Medical College, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Manting Su
- The First Clinical Medical College, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Xiaomin Liu
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangzhou, Guangdong, 510515, P.R. China
| | - Xiaodan Li
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangzhou, Guangdong, 510515, P.R. China
| | - Yuankui Wu
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangzhou, Guangdong, 510515, P.R. China.
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Chen YL, Jiang WY, Ma WH. Osteoid osteoma: lower back pain combined with scoliosis. J Int Med Res 2020; 48:300060520903873. [PMID: 32046556 PMCID: PMC7254605 DOI: 10.1177/0300060520903873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 01/08/2020] [Indexed: 12/17/2022] Open
Abstract
Osteoid osteoma is a small benign bone tumor that is primarily localized in long bone; lumbar osteoid osteoma combined with scoliosis has rarely been reported. Here, we describe a 9-year-old boy who complained of back pain and scoliosis. He underwent nidus resection and did not experience complications or osteoid osteoma recurrence. His pain and scoliosis were relieved after the operation. The findings in this case indicate that resection of osteoid osteoma is an effective and safe method of treatment. The lumbar spine is the most common location of osteoid osteoma, which causes painful scoliosis. Nidus resection can provide relief of back pain and scoliosis.
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Affiliation(s)
- Yun-lin Chen
- Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo, China
| | - Wei-yu Jiang
- Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo, China
| | - Wei-hu Ma
- Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo, China
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Preoperative Embolization and Complete Tumoral Resection of a Cervical Aggressive Epithelioid Osteoblastoma. World Neurosurg 2017; 106:1051.e1-1051.e4. [PMID: 28710051 DOI: 10.1016/j.wneu.2017.06.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/28/2017] [Accepted: 06/30/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Epithelioid "aggressive" osteoblastoma (EOB) is a rare and more aggressive subtype of osteoblastoma (OB) with a higher recurrence rate, greater risk of malignant transformation, larger size, and greater intraoperative blood loss. The present case report illustrates that preoperative angioembolization of an EOB can be safely performed with low intraoperative blood loss. CASE DESCRIPTION A 21-year-old male patient presented to our institution with a 4-month history of neck discomfort, radicular pain in the proximal right arm, and mild weakness of the right biceps and triceps muscles. Imaging was suggestive of EOB, and computed tomography-guided biopsy confirmed the diagnosis. The patient underwent same-day preoperative angioembolization of the major feeding vessels and subsequent complete tumor resection. During the procedure, he experienced minimal blood loss and did not require blood transfusion. CONCLUSIONS EOB is a highly vascular primary bony lesion. To minimize intraoperative blood loss, preoperative angioembolization should be considered in the treatment of cervical spine EOB.
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Gumustas SA, Cagırmaz T, Guler O, Ofluoglu O, Kayahan S. A case report of osteoblastoma on the distal phalanx of the ring finger successfully treated with curettage and polymethylmethacrylate filling. Int J Surg Case Rep 2015; 12:128-31. [PMID: 26072004 PMCID: PMC4486407 DOI: 10.1016/j.ijscr.2015.05.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 05/30/2015] [Accepted: 05/31/2015] [Indexed: 12/03/2022] Open
Abstract
This is the first report of osteoblastoma on the distal phalanx. The finger was monitored closely for two years; sequential films showed a radiopaque interface and no evidence of local recurrence.
Background Osteoblastoma is an aggressive benign tumor whose presentation varies with location and size. This rare bone tumor is thus difficult to diagnose particularly when it occurs outside its most common location – the vertebral column and long bones. Case We report a case of osteoblastoma of the fourth distal phalanx of the left hand in an 18-year-old male, presented with pain and swelling and treated with curettage and polymethylmethacrylate filling followed by immobilization by a cast, which was opened 10 days later to start physical therapy. Patient was pain-free, recovered full function of his finger, and remained without pain at one month post-surgery. The finger was monitored closely for two years; sequential films showed a radiopaque interface and no evidence of local recurrence. Conclusion This is the first report of osteoblastoma on the distal phalanx. The possibility of osteoblastoma should be considered in cases of pain and swelling of phalanx, and if diagnosed, curettage and polymethylmethacrylate filling may be the treatment of choice.
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Affiliation(s)
- Seyit Ali Gumustas
- Orthopedics and Traumatology Department, Yavuz Selim Bone and Joınt Disease State Hospital, Trabzon, Turkey
| | - Talat Cagırmaz
- Orthopedics and Traumatology Department, Medipol University, Medical Faculty, Istanbul, Turkey.
| | - Olcay Guler
- Orthopedics and Traumatology Department, Medipol University, Medical Faculty, Istanbul, Turkey
| | - Onder Ofluoglu
- Orthopedics and Traumatology Department, Bahçeşehir University, Medical Faculty, Istanbul, Turkey
| | - Sibel Kayahan
- Pathology Department, Dr. Lutfı Kırdar Kartal Training Hospital, Istanbul, Turkey
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Feng G, Huang K, Li L, Gong Q, Liu H, Song Y. Treatment of osteoblastoma at C3-4 in a child: a case report. BMC Musculoskelet Disord 2014; 15:313. [PMID: 25257797 PMCID: PMC4195949 DOI: 10.1186/1471-2474-15-313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 09/24/2014] [Indexed: 02/05/2023] Open
Abstract
Background Osteoblastoma is a rare and benign osteoid-producing primary bone tumor that affects mainly the long bones. 36% of these tumors are observed around the spine and the vast majority arises around the posterior. Case presentation This report describes a case of C3-4 osteoblastoma occurring in a 5-year-and-8-month-old Han Chinese child. The pathophysiology of symptom development, evaluations, and management are presented. Because of the close proximity of the osteoblastoma to the vertebral artery canal, the artery suffered a minor laceration intraoperatively. Hemostatic gelatin sponges were used to compress the bleeding site instantly and a tricortical iliac crest fixed with a screw was also used to add pressure to the gelatin sponges. Fusion on the other side was also used to stabilize the spine. To the best of our knowledge, this is the first report of a case of osteoblastoma at C3-4 with artery injury intraoperatively. Conclusions This case delineates the difficulties in diagnosing this tumor, the challenges and problems encountered during its surgical management, and the favorable prognosis after adequate treatment. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-313) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | - Hao Liu
- Department of Orthopedics, West China Hospital, Sichuan University, 17 Renmin South Road, Chengdu, Sichuan (610041), P,R, China.
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Abstract
STUDY DESIGN Retrospective case series. OBJECTIVE (1) To analyze clinical and radiographical characteristics, treatment, and outcome in patients with sacral osteoblastoma, (2) to evaluate progression-free survival and local recurrence rate, and (3) to identify prognostic factors. SUMMARY OF BACKGROUND DATA Osteoblastoma is a rare tumor that has been reported to affect the sacrum from 7% to 17%. Symptoms are various and the diagnosis is often delayed. METHODS From 1980 to 2010, 18 patients with sacral osteoblastoma (16 males and 2 females) were treated at Rizzoli Institute. Lesion involved S1 (2 cases), S1-S2 (3 cases), S2 (1 case), S2-S3 (1 case), S2-S4 (1 case), S3 (2 cases), S3-S4 (5 cases), S4 (1 case), and almost the entire sacrum in 2 cases. According to Enneking classification for benign bone tumors, 13 (72%) were diagnosed at stage 2 and 5 (28%) at stage 3. Mean tumor volume was 64 cm (range, 2-441 cm). Nine patients had preoperative magnetic resonance imaging. Five patients had a previous inadequate intralesional surgery elsewhere. Treatment consisted in intralesional surgery (16 cases), intralesional surgery and radiotherapy (1 case), and wide resection (1 case). Local adjuvants used were phenol (7 patients), cryocoagulation with "iceball" technique (1 case). Embolizations were performed in 7 patients. RESULTS At a mean of 8.4 years (range, 1-28 yr), 15 patients (83%) remained continuously disease free, whereas 3 patients had local recurrence (17%). Progression-free survival was 87% at 5 years and 74% at 10 years. No statistical difference was found between patients who received or not local adjuvants (P = 1.254), older or younger than 20 years (P = 0.970), at stage 2 or 3 (P = 0.826), evaluated preoperatively with or without magnetic resonance imaging (P = 0.160), primarily treated versus patients with previous intralesional surgery elsewhere (P = 0.131). CONCLUSION In our series, curettage was successful in most of the patients. Local adjuvants did not seem to reduce the risk of local recurrence when combined with intralesional surgery. LEVEL OF EVIDENCE 4.
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Taghipour Zahir S, Sefidrokh Sharahjin N, Kargar S. A rare case of rib osteoblastoma: imaging features and review of literature. IRANIAN JOURNAL OF RADIOLOGY 2013; 10:152-5. [PMID: 24348601 PMCID: PMC3857978 DOI: 10.5812/iranjradiol.7108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 10/28/2012] [Accepted: 12/12/2012] [Indexed: 01/07/2023]
Abstract
Osteoblastoma is a rare benign, but locally aggressive bone tumor with rare malignant transformation. It mostly affects the vertebral column and long bones. Radiographically, it is seen as an expansile, oval, sclerotic or lytic mass-like lesion with well-defined borders, although sometimes it may mimic a malignant tumor such as osteogenic sarcoma by its irregular borders. Herein, we report a case of osteoblastoma in a 22 year-old man with a long history of back and neck pain accompanied with neck stiffness. On the routine chest X-ray, the salient lesion appeared as an expansile, oval, sclerotic mass with well-defined borders and speckled calcification without any internal lucency and periosteal reaction, involving the posterolateral aspect of the first left thoracic rib, a rare anatomical site. Despite the unusual location, osteoblastoma should be considered in the differential diagnosis of a solitary rib lesion.
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Affiliation(s)
- Shokouh Taghipour Zahir
- Department of Pathology,Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Corresponding author: Shokouh Taghipour Zahir, Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Tel.: +98-3518113615, Fax: +98-3518224100, E-mail:
| | | | - Saeed Kargar
- Department of Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Modaressi K, Fuchs B, Sutter R, Bode P, Meili S, Weber U. Clinical Images: Osteoblastoma of the Ilium Mimicking Sacroiliitis. ACTA ACUST UNITED AC 2013; 65:1674. [DOI: 10.1002/art.37915] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kourosh Modaressi
- University of Zurich and Orthopedic University Hospital Balgrist; Zurich; Switzerland
| | - Bruno Fuchs
- University of Zurich and Orthopedic University Hospital Balgrist; Zurich; Switzerland
| | - Reto Sutter
- University of Zurich and Orthopedic University Hospital Balgrist; Zurich; Switzerland
| | - Peter Bode
- University Hospital Zurich; Zurich; Switzerland
| | - Severin Meili
- Cantonal Hospital Winterthur; Winterthur; Switzerland
| | - Ulrich Weber
- University of Zurich and Orthopedic University Hospital Balgrist; Zurich; Switzerland
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Ye J, Liu L, Wu J, Wang S. Osteoblastoma of the rib with CT and MR imaging: a case report and literature review. World J Surg Oncol 2012; 10:49. [PMID: 22397553 PMCID: PMC3320550 DOI: 10.1186/1477-7819-10-49] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 03/07/2012] [Indexed: 11/17/2022] Open
Abstract
Osteoblastoma is a rare bone tumor which is mostly found in the vertebral column and long bone. We describe a 59-year-old woman with osteoblastoma in the right fifth posterior segment of the rib, whose presenting symptoms were right back pain for two years and awakened at night. Chest computer tomography (CT) and thoracic spine magnetic resonance (MR) imaging findings included an expansile lesion of the right fifth rib and an ossified matrix. Surgical resection of the lesion confirmed a benign osteoblastoma. 12 months follow-up revealed disappearance of right back pain. Rib osteoblastoma in plain film has been described previously; however, to our knowledge this is the only case report emphasized in CT and MR imaging.
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Affiliation(s)
- Jing Ye
- Department of Medical Imaging, Yang Zhou University Academy of Clinical Medicine, Yangzhou 225001, China.
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Abstract
Osteoid osteoma and osteoblastoma are commonly seen benign osteogenic bone neoplasms. Both tumors are typically seen in the second decade of life, with a notable predilection in males. Histologically, these tumors resemble each other, with characteristically increased osteoid tissue formation surrounded by vascular fibrous stroma and perilesional sclerosis. However, osteoblastomas are larger than osteoid osteomas, and they exhibit greater osteoid production and vascularity. Clinically, osteoid osteoma most commonly occurs in the long bones (eg, femur, tibia). The lesions cause night pain that is relieved with nonsteroidal anti-inflammatory drugs (NSAIDs). Osteoblastoma is most frequently located in the axial skeleton, and the pain is usually not worse at night and is less likely to be relieved with NSAIDs. Osteoblastoma can be locally aggressive; osteoid osteoma lacks growth potential. Osteoid osteoma may be managed nonsurgically with NSAIDs. When surgery is required, minimally invasive methods (eg, CT-guided excision, radiofrequency ablation) are preferred. Osteoblastoma has a higher rate of recurrence than does osteoid osteoma, and patients must be treated surgically with intralesional curettage or en bloc resection.
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Patel AJ, Fox BD, Fahim DK, Fulkerson DH, Whitehead WE, Curry DJ, Luerssen TG, Jea A. A clinicopathologic correlation in osteoblastoma of the spine in a child. J Clin Neurosci 2011; 18:1728-30. [PMID: 21992740 DOI: 10.1016/j.jocn.2011.03.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 03/14/2011] [Accepted: 03/21/2011] [Indexed: 11/30/2022]
Abstract
Spinal osteoblastomas are considered benign tumors but can be locally aggressive. Patients usually present with pain and undergo radiologic and histologic work-up to establish a diagnosis. Osteoblastomas have discordant appearances on CT scans and MRI because of the inflammatory response seen on MRI that characterizes these tumors - the "flare" phenomenon. Solely using MRI can lead to over-resection, as signal abnormality may include areas devoid of tumor. There are a few reports of this phenomenon in the radiology literature, but to our knowledge, there are none in neurosurgery journals. We report an 11-year-old boy who presented with back pain and radiculopathy with an osteoblastoma at the L4 level. We totally excised the lesion to definitively treat the patient but also, based on MRI findings, differentially biopsied portions of the lesion and correlated them to the imaging studies, to confirm that the intense reactive portion of the lesion was devoid of tumor cells.
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Affiliation(s)
- Akash J Patel
- Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery, Baylor College of Medicine, 6621 Fannin Street, CCC 1230.01, 12th Floor, Houston, Texas 77030, USA
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Bahouq H, Allali F, Hajjaj-Hassouni N. Osteoblastoma of scaphoid of the carpus: a case report. Pan Afr Med J 2011; 8:39. [PMID: 22121447 PMCID: PMC3201602 DOI: 10.4314/pamj.v8i1.71154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 04/03/2011] [Indexed: 11/25/2022] Open
Abstract
Osteoblastoma is a rather uncommon tumor, especially when located in the wrist (and hand). Its diagnosis therefore appears to be problematic. We describe a case of osteoblastoma of the scaphoid bone and its management. To our knowledge, this is the fourth case of osteoblatoma of the carpus reported in the literature. Proximal row carpectomy was chosen because of the aggressive nature of the tumor. A tendon transfer was performed in the same session for wrist stabilization. Other authors have opted for a more conservative approach (tumor curettage with bone grafting).
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Affiliation(s)
- Hanane Bahouq
- Department of rheumatology, CHU Ibn Sina, Hospital El Ayachi, Rabat-Sale, Morocco
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