Prostaglandins in osteoid osteoma

Abstract

Osteoid osteoma is a tumour of bone characterised by pain which is relieved by aspirin and nonsteroidal anti-inflammatory drugs. Very high levels of prostaglandins have been found in the lesion. In five patients with osteoid osteoma, prostaglandin E2 (PGE2) and prostacyclin (PGI2) synthesis in the nidus yielded 1155.6 +/- 496.5 (mean +/- SD) and 245.2 +/- 89.8 pg/mg respectively, values which are 33 and 26 times higher than in fragments of normal bone. The sclerotic bone around the nidus produced both prostaglandins at the same rate as normal bone. In three patients the excretion rate of the major urinary metabolite of systemic PGI1 was reduced to 50% one month after removal of the tumour. The urinary excretion rate of 6-keto-PGF1 alpha, reflecting intrarenal PGI2 synthesis, was not changed after operation. These results offer new insight into the pain mechanism in osteoid osteoma.

Technical Considerations in CT-Guided Radiofrequency Thermal Ablation of Osteoid Osteoma: Tricks of the Trade

“…The patient may even move and cause a loss of position. The reaction subsequently normalizes when the lesion is completely destroyed and seems compatible with theories suggesting a neurogenic origin for the pain associated with an osteoid osteoma [18][19][20]. We routinely ask our anesthetist to look for this reaction because it is useful confirmation that we have entered a nidus.…”

Intraarticular Osteoid Osteoma Associated with Synovitis: A Possible Role of Cyclooxygenase-2 Expression by Osteoblasts in the Nidus

“…Later, Markley et al (12), Greco et al (13,14,28), and one of the authors of the present study (TH) (3) demonstrated an increase in PGE2 level in the nidus by radioimmunoassay (RIA) and immunohistochemical studies using anti-PGE2 antibodies. PG produced within the nidus has been proposed to be a mediator of synovitis in intraarticular OO (7,23,29).…”

“…Because Markley et al (12) and Greco et al (13,14) demonstrated a higher level of PGs in the nidus of OO, PGE2 has been suspected as a mediator that contributes to synovitis in the involved joint of intraarticular OO. As is well known, PGs are produced from phospholipids catalyzed by cytosolic phospholipase A2 (cPLA2) and cyclooxygenase (COX)-2 through arachidonic acid metabolism.…”

Osteoid osteoma: the results of surgical treatment

“…Prostaglandins produced by the tumour result in a chronic inflammatory response in the surrounding tissues which is demonstrated by a periosteal reaction and synovitis. These regress spontaneously after removal of the nidus [9,17].…”