Figure 6 - uploaded by Darshan Gandhi
Content may be subject to copyright.
Osteoid osteoma with RF ablation: Left leg CT bone window axial view (A) in a 13-yearold patient shows well defined sclerosis with surrounding lytic margin along the posterior tibial cortex (white arrow), suggesting an osteoid osteoma. Status post RF ablation of the same lesion (B) showed developing minimal scattered sclerosis in lytic component (white arrow) with an ablation track (black arrow). MRI left leg sagittal T1 (C) and axial proton density image (D) of the same patient shows diffuse ring sign which is identified as central hypointense area surrounded by peripheral hyperintense area, suggesting favorable response to ablation (white arrows).
Source publication
Pediatric benign osteocytic tumors include osteoma, enostosis, osteoid osteoma, and osteoblastoma. In pediatric populations, benign bone tumors are more common than malignancies. Benign osteocytic tumors may have a unique clinical presentation that helps narrow the differential diagnosis. A systemic imaging approach should be utilized to reach the...
Context in source publication
Context 1
... to the results published by Arrigoni et al., all 14 patients treated with MRgFUS showed significant improvement in pain of about 68% at 6 months and 90% at 12 months [34]. Imaging signs to prove success of CT-guided RFA and MRgFUS include disappearance of bone marrow edema around the lesion, reduction in perilesional synovial reaction, and remodeling of the bone and ring sign, which is identified as a central hypointense area surrounded by peripheral hyperintense area (which is the granulation tissue between the necrotic and viable bone) ( Figure 6) [35]. Other minimally invasive techniques include cryoablation, ethanol injection, interstitial laser photocoagulation, and arthroscopic excision. ...
Similar publications
Osteoblastoma (OB) is a rare, benign bone tumor, accounting for 1% of all primary bone tumors, which occurs usually in childhood and adolescence. OB is histologically and clinically similar to osteoid osteoma (OO), but it differs in size. It is biologically more aggressive and can infiltrate extraskeletal tissues. Therapy is required because of sev...
Citations
... The possibility of a bone tumour in a child with unexplained musculoskeletal pain should always be considered. Osteoid osteoma may co-occur with or clinically mimic musculoskeletal conditions such as chronic shoulder pain [4,51]. Also, fibrous dysplasia and fatigue fractures can cause cortical thickening and proliferation, which can lead to a misdiagnosis of OO [37]. ...
... Benign bone tumours in the paediatric population are much more common than malignant ones. They may have a unique presentation that helps narrow down the diagnosis; however, there are cases which pose differential diagnostic difficulty [51]. ...
Osteoid osteoma (OO) is a common benign bone tumour, usually affecting young people. Typically, it is localised to the diaphyses or metaphyses of long bones. The classical manifestation includes distinctive night pain, almost always present, responding well to non-steroidal anti-inflammatory drugs, sometimes accompanied by complaints due to physical activity, and a typical picture on additional tests. A characteristic of osteoid osteoma is the presence of a nidus, usually visible on imaging tests. The nidus generally presents as a single, round lytic lesion up to 1 cm in diameter, surrounded by an area of reactive ossification. However, OO is a multifaceted neoplasm, and its diagnosis can cause numerous difficulties. OO can mimic multiple diseases and vice versa, which often leads to a prolonged diagnostic and therapeutic path and associated complications. There are few literature reviews about the differentiation and diagnostic difficulties of osteoid osteoma. Very effective therapies for this tumour are known, such as ablation and resection. Enhanced detection of osteoid osteoma could result in faster diagnosis and less suffering for the patient, avoidance of complications, and reduced costs of incorrect and prolonged treatment.
... Recidíva osteómov po resekcii je zriedkavá a opätovný rast je zvyčajne výsledkom nedostatočného odstránenia [4,14]. U pacientov s malým a asymptomatickým tumorom alebo u chorých, ktorí nesúhlasia s operačným výkonom, je možné pacienta sledovať v 6-mesačných intervaloch základným fyzikálnym vyšetrením [2,5,13]. ...
... Osteóm sa v CT zobrazí ako homogénne, hyperdenzné a dobre ohraničené ložisko. Pri podozrení na intrakranické šírenie sa odporúča doplniť MR vyšetrenie, kde sa tumor zobrazí ako homogénny hypointenzívny signál v T1 obraze [13]. Osteómy prinosových dutín sa riešia chirurgicky alebo len sledujú. ...
Background:
Osteomas of the paranasal sinuses occur rarely in the pediatric population, we find only a few reference of symptomatic osteomas in the literature. Opinions on the indication for surgical treatment are controversial.
Case:
The authors present a case of symptomatic osteoma of the right ethoimoidal sinus in a 12-year-old boy, who was treated surgically, with endoscopic endonasal approach. The symptomatology, diagnosis and therapy of these tumors in the pediatric patient are discussed.
Conclusion:
Osteomas of the paranasal sinuses are slow-growing benign lesions. Symptomatic osteomas can grow expansively and cause serious complications. The treatment of osteoma is surgical and the endoscopic approach offers the possibility of removal with cosmetic benefits.
... Osteoid osteoma is the most common cause of painful scoliosis in pediatric patients, representing approximately 70% of cases. 23 ...
... Skeletal scintigraphy has 100% sensitivity for detecting osteoid osteomas and is very useful for guiding MRI or CT examination of the tumor area. 23 The imaging features of osteoid osteoma are shown in Table 2. ...
... 10,156 Minimally invasive options such as radiofrequency thermoablation or CTguided core biopsy are treatment choices. 23,157 A recent meta-analysis of nonrandomized studies including 354 individuals treated with CT-guided RFA found a significant pain reduction of 6.85/ 10 and 7.29/10 at 12 and 24 months, respectively, measured in a numerical rating scale. Additionally, high control rates were noticed. ...
Benign tumors that grow in the spinal canal are heterogeneous neoplasms with low incidence; from these, meningiomas and nerve sheath tumors (neurofibromas and schwannomas) account for 60% to 70% of all primary spinal tumors. Benign spinal canal tumors provoke nonspecific clinical manifestations, mostly related to the affected level of the spinal cord. These tumors present a challenge for the patient and healthcare professionals for they are often difficult to diagnose, and the high frequency of posttreatment complications.
In this review we describe the epidemiology, risk factors, clinical features, diagnosis, histopathology, molecular biology, and treatment of extramedullary benign meningiomas, osteoid osteomas, osteoblastomas, aneurysmal bone cysts, osteochondromas, neurofibromas, giant cell tumors of the bone, eosinophilic granulomas, hemangiomas, lipomas, and schwannomas located in the spine, as well as possible future targets that could lead to an improvement in their management.
The pediatric spine undergoes complex stages of development and growth, resulting in highly age-dependent physiology and variable susceptibility to certain pathologies. Optimal radiologic evaluation requires image acquisition tailored to the clinical history and an interpretive approach that accounts for demographic variations. In this article, the author discusses the diagnostic approach to pediatric spine masses, beginning with a discussion of normal anatomy and variants, clinical evaluation, and imaging techniques and protocols. The author then covers the major etiologies, imaging appearances, and mimics of pediatric spine masses in the following categories: congenital malformations, genetic syndromes, intramedullary, intradural, epidural, bone, and paraspinal lesions.
Spinal extradural tumors, although uncommon, have high morbidity and mortality rates. Radiographs and computed tomography scans are typically used to assess and determine the characteristics of these tumors. However, MR imaging is the preferred method for the evaluation of complications that can increase morbidity, such as spinal cord and nerve compression. Imaging features, such as type of matrix, cortical involvement, and margins, aid in determining the diagnosis. This article discusses common and infrequent extradural spinal tumors, their imaging characteristics, and how age, location, and clinical presentation help in diagnosing these neoplasms.
Osteoid osteoma (OO) is a benign osteoblastic bone tumor typically involving the diaphysis or metaphysis in long tubular bones. OO in phalanges of the great toe has been rarely reported, and it is often challenging to differentiate with subacute osteomyelitis, bone abscess, or osteoblastoma. This case report describes an uncommon case of a 13-year-old female patient with subperiosteal OO in the proximal phalanx of the great toe. The atypical location of OO should be familiarized to include appropriate differential diagnosis and to ensure accurate diagnosis by radiologic evaluations. Surgical excision remains the benchmark for the treatment of OO with its advantages on direct visualization and histologic confirmation for the diagnosis.
Benign bone lesions may occasionally be incidentally detected on radiographs and are also increasingly found on computed tomography or magnetic resonance imaging performed for other clinical indications. Although mostly asymptomatic or associated with minor symptoms, these lesions may simulate true pathological lesions, causing problems in diagnosis. For instance, asymptomatic benign bone lesions can be misinterpreted as metastasis when incidentally encountered in a patient with known cancer. Recognizing these entities as “do-not-touch” lesions helps avoid unnecessary further investigation or harmful intervention. In this review, we highlight three groups of bone incidentalomas found in adults, namely: osteolytic lesions, osteoblastic lesions, and bone protuberances. We aim to review the key imaging features of selected common and less common conditions in these three groups, so as to help radiologists confidently identify these benign do-not-touch lesions and to distinguish them from more sinister pathological lesions.
