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Osteoblastoma



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- 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.