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At least 19 recordsLinked to original sources
PubMed1999

Large cell, epithelioid, telangiectatic osteoblastoma: a unique pseudosarcomatous variant of osteoblastoma.

A previously undescribed large-cell, epithelioid, and aneurysmal variant of osteoblastoma with minimal osteoid-production--simulating telangiectatic osteosarcoma, epithelioid angiosarcoma, and metastatic carcinoma is reported. The tumor occurred in the mandible of a 14-year-old girl. The light microscopic, immunohistochemical, ultrastructural, cell proliferation, and DNA-ploidy studies, as well as the 7-year disease-free follow-up period all indicate a benign osteoblastic tumor. Cytogenetically, the tumor had a pseudodiploid karyotype, distinguished by a complex t(1;5;17;22) and a terminal 1q deletion. Recognition of this unique, pseudomalignant variant of osteoblastoma is important to avoid an erroneous diagnosis of malignancy.

Adolescent↗
PubMed2003

Osteoid osteomas and osteoblastomas of the spine.

OBJECT: Osteoid osteomas and osteoblastomas are rare primary bone tumors that usually do not arise in the spine. In this report the authors analyze 16 cases of osteoid osteoma or osteoblastoma of the spine that were surgically treated over a 27-year period. METHODS: A retrospective study was conducted in which the following data were found: five patients had osteoid osteomas (two male and three female patients) and 11 had osteoblastomas (seven male and four female patients). The site of the tumor was the cervical spine in four, thoracic in six, and lumbar spine in six. In 14 patients, the tumor involved the posterior vertebral elements, with lumbar and thoracic levels being the most common. Only two patients had tumors in the body of a cervical vertebra. The mean age of the patients was 20 years for osteoid osteoma and 19 years for osteoblastoma. The most common symptom was local pain in the area of the tumor. Among 11 patients with osteoblastoma, six (two with paraparesis, four with monoparesis) had neurological deficits caused by extradural compression. None of the patients with osteoid osteoma had neurological deficits. The diameters of osteoblastomas were 3 to 8 cm (mean 4 cm), and those of osteoid osteomas were 1.5 to 2 cm (mean 1.7 cm). Although the peritumoral bone was normal in patients with osteoblastoma, a sclerotic rim was observed in all patients with osteoid osteoma. All patients were treated with resection; tumor excision was complete in 15 cases. Follow-up periods ranged from 2 months to 13 years (mean 36 months). Complete pain relief was achieved in 15 patients; the other patient described mild pain with activity. There was no tumor recurrence except one regrowth in a patient with osteoblastoma who then received radiation therapy. There were two complications: one surgery was performed at the wrong level, and there was one instrument failure that required revision. CONCLUSIONS: With the help of modern imaging modalities that aid in diagnosis and surgical planning, a complete removal and cure may be achieved for most of these rare tumors.

Adolescent↗
PubMed1984

Borderline osteoblastic tumors: problems in the differential diagnosis of aggressive osteoblastoma and low-grade osteosarcoma.

A series of 102 benign osteoblastic tumors of multiple skeletal sites was reviewed, and on the basis of their clinical, radiologic, and pathologic features they were classified into three diagnostic categories: osteoid osteoma, osteoblastoma, and aggressive osteoblastoma. A historic review of the development of the nomenclature of benign osteoblastic tumors, with special emphasis on the evolving concept of aggressive and malignant behavior, is presented. Histologic criteria for the recognition of aggressive osteoblastoma are presented and illustrated in connection with the 15 cases so classified in the present series. The differential diagnosis of aggressive osteoblastoma and low-grade osteosarcoma is discussed. In defining the problem of differentiating locally aggressive osteoblastic lesions from potentially metastasizing tumors, the authors propose that four categories of these osteoblastic tumors can be defined: (1) Innocuous-appearing low-grade osteosarcomas that resemble osteoblastomas histologically. This mimicry accounts for most errors in diagnosis. (2) Rare osteoblastomas that have undergone spontaneous transformation into osteosarcomas. (3) Very rare, clinically and radiologically typical osteoblastomas that show pseudosarcomatous histologic features but pursue a benign course. (4) Locally aggressive osteoblastomas that are likely to recur, do not metastasize, and show characteristic and recognizable histologic features.

Adolescent↗
PubMed1985

Osteosarcoma resembling osteoblastoma.

A series of 17 patients with osteosarcomas that histologically resembled osteoblastomas was studied. The ages of the 9 male and 8 female patients ranged from 11 to 58 years. The roentgenographic appearance was suggestive of malignancy in most cases. Two histologic features seemed most important in differentiating osteosarcoma from osteoblastoma. In the former, there is permeation of surrounding tissues and lack of "maturation" toward the edges, whereas osteoblastoma tends to show maturation peripherally and is circumscribed. Osteoblastoma-like osteosarcoma should be considered to be a malignant tumor because 7 of the 17 patients died of their disease. The authors believe that malignant osteoblastoma and aggressive osteoblastoma are really osteosarcomas that resemble osteoblastomas.

Adolescent↗
PubMed1985

Spongious and cortical osteoblastoma of the axial skeleton.

Eleven cases of osteoblastoma (spongious osteoblastoma) and four cases of osteoid osteoma (cortical osteoblastoma) involving the spine, diagnosed at Hadassah Hospital between 1970 and 1983 were analyzed. The age range was 7 to 34 years and the average clinical follow up was 63 months. The cervical spine was involved in four patients, thoracic in four, lumbar in six and the sacrum in one patient. Back or neck pain associated with stiffness was present in all cases and was often accompanied by scoliosis or torticollis. All the patients with osteoid osteoma were symptom relieved by surgery without recurrence. Seven of the patients with benign osteoblastoma presented with neurological signs or symptoms and three of these had recurrence following primary surgery. Although cortical and spongious osteoblastoma are considered as members of the same family of benign tumors of osteoblastic derivation, spongious osteoblastoma does not seem to be limited in growth potential as is cortical osteoblastoma.

Adolescent↗
PubMed2006

Osteoblastoma of the maxilla and mandible: a report of 24 cases, review of the literature, and discussion of its relationship to osteoid osteoma of the jaws.

Osteoblastoma is a benign neoplasm of bone characterized by a proliferation of osteoblasts forming bone trabeculae set in a vascularized fibrous connective tissue stroma. We report 24 examples of this neoplasm arising in the maxilla and mandible and compare the clinical and radiographic characteristics of this neoplasm to 53 previously reported examples of osteoblastoma and osteoid osteoma in the jaws. Our results reveal more females reported in the new examples of osteoblastoma than in the previously reported examples of osteoblastoma and osteoid osteoma. This raises the overall female percentage from 47.2% to 58.4%. In addition, significantly fewer patients reported pain, tenderness, and discomfort associated with their neoplasms than in previously reported cases. When all cases are combined, a predominant trend is observed whereby osteoblastoma occurs predominantly on the left side of the posterior mandible and is associated with pain, tenderness, and discomfort. We also provide a rationale for use of the term "osteoblastoma" for any benign osteoblastic neoplasm arising in the jaws.

Adolescent↗
PubMed1999

Vertebral osteoblastoma: are radiologic structural changes necessary for diagnosis?

BACKGROUND: A case of osteoblastoma localized at the pedicle of the 10th thoracic vertebra is presented. CASE DESCRIPTION: The patient complained of nocturnal back pain not relieved by salycilates, a typical symptom of osteoblastoma. Bone scintigraphy showed a lower thoracic focus of increased osteoblastic activity; however, X-rays, computed tomography, and magnetic resonance images (MRI) were within normal limits, showing only obscure changes that were also noted in the rest of the spine. Repeat MRI with contrast revealed a focal enhancement. After pediculectomy, histopathologic examination confirmed the diagnosis of osteoblastoma. Fifteen months postoperatively, the patient is symptom-free. CONCLUSION: Our case demonstrates that some cases of osteoblastoma may not have the classical radiological appearance. Although non-contrast computed tomography and T1-weighted MRI are mildly positive in some instances, osteoblastoma is best visualized on MRI with gadolinium. Like any other neoplasm, osteoblastoma should be detected and removed early, before it can cause structural bony changes.

Adult↗
PubMed2000

Periosteal osteoblastoma: a case report and a review of the literature.

Osteoblastomas located on the surface of cortical bone, so-called periosteal (juxtacortical) osteoblastomas, are extremely rare. A 24-year-old man complained of pain and swelling in the left knee. The clinical and radiological investigation showed a tumor located in the posterior portion of the distal shaft of the femur. The radiological differential diagnosis included parosteal osteosarcoma, periosteal chondroma and periostitis ossificans. A frozen section was obtained and histology revealed an osteoblastoma with large epithelioid-appearing osteoblasts consistent with an aggressive osteoblastoma. An en bloc resection of the tumor was performed and the definitive histology of the whole specimen revealed a typical osteoblastoma. The authors draw attention to the fact that periosteal osteoblastoma is a rare tumor that could be mistaken clinically and histologically for other and more common tumors at this location.

Adult↗
PubMedDate not supplied

Pediatric osteoblastoma of the sternum: a new surgical technique for reconstruction after removal: case report and review of the literature.

Benign osteoblastoma is a rare tumor of bone that has been reported in a variety of skeletal locations. A case of an isolated benign osteoblastoma in the sternum of an 11-year-old boy is described. In the chest wall, osteoblastoma has been reported in the ribs, and rarely in the sternum. To the authors' knowledge, this is the first report of an isolated sternal osteoblastoma in a child presented in the literature. The clinical and radiologic presentation of osteoblastoma is discussed, as well as an approach for reconstruction of the sternal defect following removal of the tumor. Experience with sternal reconstruction in the pediatric population is limited. This case demonstrates that osteoblastoma of the sternum can be successfully treated with wide resection and that sternal defect reconstruction can be accomplished successfully in a child.

Biocompatible Materials↗
PubMed1996

Aggressive osteoblastoma with focal malignant transformation and development of pulmonary metastases. A case report with a review of literature.

We report the case of a 57-year-old woman with an unusually fast-growing and destructive osteoblastic tumor affecting the left humeral head. On histopathologic examination, most of the initial tumor revealed the characteristic morphologic features of a benign-appearing aggressive osteoblastoma. Based upon the presence of a few small scattered areas composed of atypical osteoblasts in abundant lace-like osteoid showing vascular permeation, the definitive diagnosis was that of an osteoblastoma with focal malignant transformation to well-differentiated osteosarcoma. Molecular biologic analysis revealed a splice mutation at the exon 5 donor site of the p53 gene, clearly indicating a malignant potential of the tumor. The proximal third of the humerus was resected en bloc and replaced by an uncemented modular endoprosthesis. Five months after surgery, an extensive local soft tissue recurrence occurred. Eight months postoperatively, a further massive recurrent tumor had developed an multiple pulmonary metastases became evident. Chemotherapy caused a marked decrease in the size of the soft tissue recurrences and the lung metastases showed no further increase of their number and size. Osteoblastomas with conversion to osteosarcoma should be considered a separate clinicopathologic tumor entity to be distinguished from genuine osteosarcoma. All cases of malignantly transformed conventional and aggressive osteoblastomas reported to date have shown a conversion to low- or high-grade osteosarcomas only in recurrent tumors. The present case supports the concept that osteoblastomas may primarily undergo early malignant transformation. Osteoblastomas with conversion to osteosarcoma require an aggressive surgical approach followed by chemotherapy in the hope of prolonging life expectancy or obtaining a cure.

Bone Neoplasms↗
PubMed1993

Aggressive osteoblastoma of the calcaneus.

Aggressive osteoblastoma of the left calcaneus in 29-year-old Japanese woman is reported. Her initial symptom was heel pain while walking. This was a primary calcaneal tumor, initially diagnosed as a benign osteoblastoma. After a 5-year follow-up (from the initial curettage), there was local recurrence. The histologic findings of aggressive osteoblastoma were confirmed after right lower leg amputation. The recurrent tumor was mildly aggressive to the talocalcanean joint and the retrocalcaneal area, without distant metastasis. The characteristics of the primary and recurrent tumors were examined by the radiologic, histologic, and electron microscopic procedures. Although there are questions about aggressive osteoblastoma, the authors believe that there are osteoblastic tumors of borderline malignancy between benign osteoblastoma and low-grade osteosarcoma. The current case was an example compatible with an aggressive osteoblastoma with the proposed name of Dorfman classification Group 4.

Adult↗
PubMed1992

[An electron microscopic study on osteoblastoma--ultrastructure and fine localization of alkaline phosphatase].

Three cases of osteoblastoma were studied by electron microscopy. They included two cases of conventional osteoblastoma and one case of aggressive osteoblastoma. In conventional osteoblastoma, ultrastructural features and location of alkaline phosphatase activity of the osteoblast-like cell were similar to those of normal osteoblast. On the other hand, aggressive osteoblastoma cell (case 3) showed different structure from those of a normal osteoblast; the nucleus of the tumor cell showed irregular surface with a small degree of heterochromatin, and poorly developed cytoplasmic organellae. Cytochemically, alkaline phosphatase activity was noted not only on the cytoplasmic membrane, but on the abundant vesicles in the cytoplasm. From these findings we conclude that the aggressive osteoblastoma cells are more immature in morphology and show increased synthesis of alkaline phosphatase.

Adolescent↗
PubMed1990

Osteoblastomas of the cervical spine.

Osteoblastomas of the cervical spine frequently occur with anterior vertebral body involvement despite the classical teaching, which suggests that involvement is usually confined to the posterior elements. A review of osteoblastomas that involved the cervical spine was conducted at a single institution over 20 years. Four patients were identified with osteoblastoma of the cervical spine from a total of 13 spinal osteoblastomas, and their conditions were assessed to determine the anatomic extent of neoplastic involvement, the surgical margins obtained at resection, methods of spinal stabilization, and local recurrence rate. A mean follow-up time of 11.4 years was obtained. Posterior surgical extirpation of the neoplasm can successfully be accomplished with good long-term results by achieving intralesional margins. Patients with cervical spine osteoblastomas represent a separate subset from patients with other spinal osteoblastomas because of their unique appearances.

Adolescent↗
PubMed2006

Fine-needle aspiration of spinal osteoblastoma in a patient with lymphangiomatosis.

Diagnosis of osteoblastoma by fine-needle aspiration (FNA) is rare, as in most patients, excisional biopsy is performed. We report a case of FNA diagnosis of a spinal osteoblastoma in a lymphangiomatosis patient. The patient had a history of lymphangiomatosis since birth with lymphangiomas removed from various locations, and had radiograph evidence of multifocal vertebral involvement. He presented with an enlarging C3 posterior element vertebral lesion. Clinically and radiologically, it was suspicious for lymphangiomatosis involvement. A computed tomography (CT)-guided FNA yielded a moderately cellular specimen. Lesional cells exhibited plasmacytoid features, fine chromatin, smooth nuclear membranes, and binucleation, in a background of occasional osteoclastic cells, spindle cells, and osteoid matrix. A cytological diagnosis of osteoblastoma was favored and confirmed with follow-up surgical biopsy. We believe that this is the first case reporting an osteoblastoma diagnosed by FNA in a lymphangiomatosis patient. We describe the clinical and cytological findings of osteoblastoma and its differential diagnosis.

Adolescent↗
PubMed2004

Periosteal osteoblastoma of the distal femur.

Osteoblastomas located on the surface of the cortical bone, so-called periosteal osteoblastomas, are extremely rare. We report on a case of periosteal osteoblastoma arising from the posterior surface of the right distal femur in a 17-year-old man. Roentgenographic, computed tomographic, magnetic resonance imaging, and histologic features of the case are presented. Periosteal osteoblastoma should be radiologically and histologically differentiated from myositis ossificans, avulsive cortical irregularity syndrome, osteoid osteoma, parosteal osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. Although periosteal osteoblastoma is rare, this tumor should be included in the differential diagnosis of surface-type bone tumors.

Adolescent↗
PubMed1999

Spinal osteoblastoma: CT and MR imaging with pathological correlation.

OBJECTIVES: To illustrate the CT and MRI features of spinal osteoblastomas and correlate the imaging with histological findings. DESIGN: In a retrospective review the CT and MRI features of spinal osteoblastomas with respect to mineralisation, signal intensity (SI), adjacent reactive changes, enhancement following gadolinium-DTPA (5 cases) and adjacent soft tissue masses were compared and correlated with the histological findings including the degree of osteoid formation and matrix mineralisation, vascularity and surrounding reactive changes in bone and soft tissue. PATIENTS: Eleven patients (7 males and 4 females; age range 8-43 years, mean age 19.5 years) with 12 osteoblastomas (1 patient suffered a recurrence) were studied. RESULTS: All lesions showed classical features on CT with varying degrees of matrix mineralisation, whereas MRI identified mineralisation in only eight of 12 cases. MRI showed low signal intensity of the lesion on both T1- and T2-weighted sequences in several cases in the absence of heavy mineralisation. In these cases, histological examination revealed diffuse osteoid production by the tumour. All patients given gadolinium showed enhancement within the tumour on MRI. Reactive bone marrow changes were identified on MRI in 10 cases, and in five of these the changes were at multiple levels. An adjacent soft tissue mass was demonstrated in five cases, but extraosseous tumour was present histologically in only two of these. CONCLUSIONS: The MRI appearances of spinal osteoblastomas are varied and show no characteristic features. MRI may also overestimate the extent of the lesion due to extensive reactive changes and adjacent soft tissue masses. CT should continue to be the investigation of choice for the characterisation and local staging of suspected spinal osteoblastomas.

Adolescent↗