Osteoid osteoma of the zygoma: report of an unusual case

BACKGROUND: Osteoid osteoma is a benign tumor of bone characterized by pain, usually occurring at night, that shows a dramatic response to aspirin. The literature contains reports of only a few cases in the head and neck region. CASE DESCRIPTION: The authors present an unusual case of an osteoid osteoma of the craniofacial bones. The patient sought an evaluation of pain in the area of the right zygoma. One of the authors, an oral and maxillofacial surgeon, noted a small area of swelling. The patient underwent radiographic, computed tomographic and nuclear medicine studies. On the basis of the images and the biopsy report, the authors made a diagnosis of osteoid osteoma. In this article, they describe the treatment of and new modalities of therapy for this condition. CLINICAL IMPLICATIONS: The general dentist should be aware of any lesion that is not common. If the generalist has any doubt about the nature or management of an unusual oral lesion, referral to appropriate specialists is mandatory.     

肋骨骨样骨瘤1例

患者男,32岁,1个月前无明显诱因右背部持续性胀痛.胸部X线示:右侧第9后肋骨明显变形呈皂泡样膨胀性改变,但骨皮质连续、完整,范围长约11 cm,呈梭形,肺野未见异常,心膈正常.     

Osteoid osteoma simulating osteomyelitis: Differentiation with Tc-99m HIG scintigraphy

We present a case of osteoid osteoma with a history of mild pain, local swelling and point tenderness on the right lower leg. The diagnosis of osteoid osteoma was difficult due to the atypical clinical history and misleading radiological and bone scan findings. When it is difficult to differentiate an osteoid osteoma from osteomyelitis using CT, MRI or bone scan; HIG scintigraphy can be used to exclude an infection.     

鼻窦骨化纤维瘤手术探讨

目的　探讨鼻窦骨化纤维瘤的手术进路 ,分析各种手术的方法和特点。方法　回顾性分析我院 1994年 8月～ 2 0 0 1年 7月治疗的鼻窦骨化纤维瘤 35例的临床资料。结果　 35例中男 2 3例 ,女 12例 ,年龄 2～ 4 5岁 ,平均 17 1岁。手术方式包括鼻侧切开手术、鼻内镜下手术、冠状切口颅骨切开手术 (包括冠状切口颅骨切开联合鼻内镜下手术及冠状切口颅骨切开联合鼻侧切开手术 )、Caldwell Luc进路手术。鼻内镜下手术 2 2例 ,彻底切除 8例 ,部分切除 14例。 2例在影像导航辅助下手术。鼻侧切开手术 6例 ,彻底切除 4例 ,部分切除 2例。冠状切口颅骨切开手术 5例 ,彻底切除 2例 ,部分切除 3例 ,有 2例联合鼻内镜下手术 ,1例联合鼻侧切开手术。Caldwell Luc进路手术 2例 ,均为部分切除。 35例患者随访 33例 ,失访 2例 ,平均随访时间 3 5年。结果 14例无复发 ,14例带瘤生存 ,5例复发后再次手术。结论　鼻窦骨化纤维瘤手术进路的选择主要依据病变范围 ,同时要考虑器官结构的功能、美容、手术的难易程度以及术者的经验和习惯等。     

Endo180 at the cutting edge of bone cancer treatment and beyond

Skeletal bone is an attractive site for secondary tumour growth and is also home to spontaneous primary cancer. Treatment of bone metastasis is focused on limiting the vicious cycle of bone destruction with bisphosphonates or inhibition of receptor activator of nuclear factor‐κB ligand (RANKL) with the fully human monoclonal antibody denosumab. The estimated 1 million deaths/year where bone metastasis is present, and the high healthcare costs required for its management, have ignited intensive research into the cellular and molecular pathology of osteolysis, involving interplay between tumour cells, bone‐forming osteoblasts and bone‐degrading osteoclasts. Compared to bone metastasis, knowledge about the pathology of primary bone cancers is limited. In recent work published in this journal, Engelholm et al provide a unique insight into how this poorly understood disease manifests and destroys bone. For the first time they have demonstrated that a mouse monoclonal antibody targeting the collagen receptor Endo180 (CD280, MRC2 uPARAP) can prevent osteolysis and bone destruction in a syngeneic model of advanced osteosarcoma. Their convincing findings make an important contribution towards Endo180‐based therapy being developed as an option for the treatment of bone cancer amongst other malignancies. © 2015 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.     

非颌骨骨化性纤维瘤(附10例病理活检及X线资料)

非颔骨的骨化性纤维瘤极为少见。我们教研室自1975年至1982年七年间的59395例活检例中仅见10例。关于本组肿瘤的病理学及X线的特点,国外报道不多,国内仅见个别专题报道,现将我们的10例报道如下。材料和方法10例患者均为我校附属一院骨科住院     

Technical aspects of osteoid osteoma ablation in children using MR-guided high intensity focussed ultrasound

Background: Osteoid osteoma (OO) is a painful bone tumour occurring in children and young adults. Magnetic resonance imaging-guided high intensity focussed ultrasound (MR-HIFU) allows non-invasive treatment without ionising radiation exposure, in contrast to the current standard of care treatment with radiofrequency ablation (RFA). This report describes technical aspects of MR-HIFU ablation in the first 8 paediatric OO patients treated in a safety and feasibility clinical trial (total enrolment of up to 12 patients).

Materials and methods: OO lesions and adjacent periosteum were treated with MR-HIFU ablation in 5–20 sonications (sonication duration?=?16–48?s, frequency?=?1.2?MHz, acoustic power?=?20–160?W). Detailed treatment workflow, patient positioning and coupling strategies, as well as temperature and tissue perfusion changes were summarised and correlated.

Results: MR-HIFU ablation was feasible in all eight cases. Ultrasound standoff pads were shaped to conform to extremity contours providing acoustic coupling and aided patient positioning. The energy delivered was 10?±?7?kJ per treatment, raising maximum temperature to 83?±?3?°C. Post ablation contrast-enhanced MRI showed ablated volumes ranging 0.46–19.4?cm³ extending further into bone (7?±?4?mm) than into soft tissue (4?±?6?mm, p?=?0.01, Mann–Whitney). Treatment time ranged 30–86?min for sonication and 160?±?40?min for anaesthesia. No serious treatment-related adverse events were observed. Complete pain relief with no medication occurred in 7/8 patients within 28 days following treatment.

Conclusions: MR-HIFU ablation of painful OO appears technically feasible in children and it may become a non-invasive and radiation-free alternative for painful OO. Therapy success, efficiency, and applicability may be improved through specialised equipment designed more specifically for extremity bone ablation.     

Radiofrequency ablation of a misdiagnosed Brodie's abscess

Radiofrequency ablation (RFA) therapy is recognised as a safe and effective treatment option for osteoid osteoma. This case report describes a 27-year-old man who underwent computed tomography (CT)-guided percutaneous RFA for a femoral osteoid osteoma, which was diagnosed based on his clinical presentation and CT findings. The patient developed worsening symptoms complicated by osteomyelitis after the procedure. His clinical progression and subsequent MRI findings had led to a revised diagnosis of a Brodie's abscess, which was further supported by the eventual resolution of his symptoms following a combination of antibiotics treatment and surgical irrigations. This case report illustrates the unusual MRI features of osteomyelitis mimicking soft tissue tumours following RFA of a misdiagnosed Brodie's abscess and highlights the importance of a confirmatory histopathological diagnosis for an osteoid osteoma prior to treatment.