Aggressive Osteoblastoma: A Case Report Involving a Unique Chromosomal Aberration

Abstract

Osteoblastomas are rare bone-producing neoplasms that generally occur in the young and can be misdiagnosed as an osteosarcoma if correlation with clinical history, radiology, and histology is not carefully considered or if the several variants of osteoblastoma are not recognized. These variants lie on a morphologic spectrum between conventional osteoblastoma and osteosarcoma. Aggressive osteoblastoma is one such subtype. As the name implies, the histologic features of aggressive osteoblastoma may appear malignant, and its biologic behavior may separate it from conventional osteoblastoma. We report a case of aggressive osteoblastoma occurring in the femoral diaphysis of a 12-year-old girl; this osetoblastoma was dyssynchronous from the radiologic appearance and a diagnostic challenge. Cytogenetic evaluation of the neoplasm revealed a pseudodiploid clone with a balanced translocation involving chromosomes 4, 7, and 14. Using the premise that cytogenetics might be useful as a diagnostic tool for a more specific classification, we reviewed the literature in order to compare our findings with known chromosomal aberrations.

Aggressive Osteoblastoma of the Maxilla: A Case Report and Review of the Literature

“…Although the balanced translocation found was unique, the authors could not unequivocally state whether the abnormality provided any insight into differentiating CO, AO, or OB-like OS. They concluded that cytogenetic studies are not yet useful for either diagnostic or prognostic purposes with these challenging lesions and concurred with others that careful correlation of clinical, radiographic and histologic findings is paramount to proper patient management [19].…”

“…Baker et al reported a case of a unique chromosomal aberration in aggressive osteoblastoma of the femoral diaphysis of a 12-year-old girl. The cytogenetic analysis performed in that case showed that of the 22 metaphases analyzed, 20 revealed a pseudodiploid clone with a balanced translocation between chromosomes 4, 7, and 14 [19]. Although the balanced translocation found was unique, the authors could not unequivocally state whether the abnormality provided any insight into differentiating CO, AO, or OB-like OS.…”

Osteoblastoma of scaphoid of the carpus: a case report

“…Histologically, osteoblastomas are similar to osteoid osteomas, both producing osteoid and primitive woven bone amidst fibrovascular connective tissue. Although the tumor is usually considered benign, a controversial aggressive variant has been described in the literature, with histologic features similar to those of malignant tumors such as osteosarcomas [1,5,20]. Differential diagnosis of scaphoïd bone tumors should also include intraosseous ganglion cysts, aneurismal bone cyst, enchondroma, giant cell tumor and osteosarcoma.…”

“…Rossner and al [21,22] reported mutation of the p53 gene at exon 5 in a patient with malignant osteoblastoma. Radig and al [21,22] described another mutation at exon 7 in a patient with osteoblastoma-like osteosarcoma.…”

“…Rossner and al [21,22] reported mutation of the p53 gene at exon 5 in a patient with malignant osteoblastoma. Radig and al [21,22] described another mutation at exon 7 in a patient with osteoblastoma-like osteosarcoma. Luca and al [21,22] have previously reported abnormalities in exon 10 of the p53 gene of osteosarcomas, suggesting that exon 10, which is probably involved in the protein oligomerization, is essential for protein function.…”