Osteoid osteoma: Contemporary management

Abstract

Osteoid osteoma is a benign bone-forming tumor with hallmark of tumor cells directly forming mature bone. Osteoid osteoma accounts for around 5% of all bone tumors and 11% of benign bone tumors with a male predilection. It occurs predominantly in long bones of the appendicular skeleton. According to Musculoskeletal Tumor Society staging system for benign tumors, osteoid osteoma is a stage-2 lesion. It is classified based on location as cortical, cancellous, or subperiosteal. Nocturnal pain is the most common symptom that usually responds to salicyclates and non-steroidal anti-inflammatory medications. CT is the modality of choice not only for diagnosis but also for specifying location of the lesion, i.e. cortical vs sub periosteal or medullary. Non-operative treatment can be considered as an option since the natural history of osteoid osteoma is that of spontaneous healing. Surgical treatment is an option for patients with severe pain and those not responding to NSAIDs. Available surgical procedures include radiofrequency (RF) ablation, CT-guided percutaneous excision and en bloc resection.

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

“…The median preinterventional maximum edema diameter was 18.5 mm (9-25), and the median postintervention maximum diameter was 6.5 mm. [2][3][4][5][6][7][8][9][10] The difference was statistically significant (p < 0.001) ( Table 2). Technical success rate was 98.1%.…”

“…The clinical and technical success rates in our cohort were 96.3% and 98%, respectively, which are compatible with the literature reporting success rate approaching 100%. 16 Only two patients needed an extra session of RF Journal of Orthopaedic Surgery 28 (3) and ablated completely at the second sequence. In the literature, the recurrence rate varies between 7% and 16%, but during the median follow-up of 18 months none of our patients experienced recurrence.…”

“…13 There is no cost-effectiveness analysis comparing surgery and RF in our country, but the expense is estimated to be higher in case of surgery due to operation charge, prolonged hospital stays or possible intensive care unit need, and higher recurrence rates and associated subsequent treatments. 3 One advantage of our cohort was having atypical cases such as scapula, metatarsal, and vertebral facet involvement. The metatarsal involvement on toe is rare with few published cases.…”

Post-traumatic Bone Granuloma Caused by Retained Foreign Bodies

“…In our case, enchondroma was excluded due to the age of patient and location of the lesion [9]. Osteoid osteoma was not considered because it presents a typical appearance of intralesional nidus and surrounding sclerosis, and it is commonly found in patients between the ages of 10 and 35 [10]. Solitary cysts are often discovered right after trauma as pathological fractures and are most common in proximal humerus and femur [11].…”

Musculoeskeletal Tumours

“…Lo normal en el osteoma osteoide es la resolución espontánea del tumor, por lo que el tratamiento sintomático no quirúrgico siempre debe ser la primera opción (7,8). Suele tardar entre 6 y 15 años en resolverse espontáneamente, y si se trata con AINEs o aspirina, se reduce a 2 o 3 años (9).…”