The Hip: Preservation, Replacement and Revision

Osteoblastoma



- Bone Tumor Menu

- Discussion:
    - unusual benign osseous tumor;
    - it resembles osteoid osteoma in some respects buts is larger ( >2 cm);
    - unlike osteoid osteoma:
           - occurs in older adolescents and young adults;
           - osteoblastoma usually does not cause localized night pain, and when pain occurs, pain is usually not relieved by ASA;
           - intense bony reaction  that is seen w/ osteoid osteoma, does not occur with osteoblastoma;
           - osteoblastoma more often located in the posterior elements of vertebra;
           - osteoblastoma will not resolve spontaneously;
    - sites of involvement: spine, femur, bone of the foot;
    - an associated soft tissue mass may be seen in about 25% of patients;
    - in rare cases, malignant transformation is possible;


- Radiographic Studies:
    - X-rays:
         - show radiolucent lesion which is surrounded by a thin margin of reactive bone that may have expanded - aneurysmal appearance;
         - radiographic diff dx: osteoid osteoma, ABC, EOG, GCT, & Osteosarcoma.
    - bone scan: shows intense radioisotope uptake that helps localize the lesion;
    - CT Scan: confirms preoperative diagnosis and helps determine surgical approach;
    - angiography: is used for staging aggressive tumors of spine;


- Histology:
    - reveals scattered mitotic figures;
    - proliferation of immature plump osteoblasts;
    - prominent vascular & stromal tissue component & giant cells and broad osteoid seams


- Treatment:
    - en bloc marginal excision is treatment of choice;
    - active tumors are more likely to recur if intracapsular resection is performed;
    - risk of recurrance after marginal excision of aggresive stage 3 is 30-50%;
    - radiation therapy or chemotherapy is not effective



Osteoid-osteoma and osteoblastoma of the spine.

Scoliosis caused by benign osteoblastoma of the thoracic or lumbar spine.

Benign osteoblastoma: range of manifestations.

Osteoblastoma of the spine.

Osteoid osteoma and osteoblastoma. Current concepts and recent advances.

Osteoblastoma of the foot and ankle.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, July 2, 2012 10:01 pm