ABSTRACT
Our aim was to describe the technique and clinical results of preoperative embolization of cervical spine osteoblastomas. We treated 3 patients with these tumors with transarterial embolization and subsequent surgical excision. In all 3 patients, distal access to the tumor-supplying vessels was gained with a microcatheter and embolization was performed with polyvinyl alcohol particles. No complications occurred. Surgical resection was performed in all patients without relevant bleeding. The postoperative course was uneventful in all patients. Preoperative embolization is a valuable adjunct to the surgical treatment of osteoblastomas of the cervical spine.
Subject(s)
Cervical Vertebrae/blood supply , Neoadjuvant Therapy , Osteoblastoma/blood supply , Spinal Neoplasms/blood supply , Adult , Angiography , Cervical Atlas/blood supply , Cervical Atlas/diagnostic imaging , Cervical Atlas/surgery , Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/surgery , Combined Modality Therapy , Female , Hemostasis, Surgical , Humans , Male , Middle Aged , Osteoblastoma/diagnostic imaging , Osteoblastoma/surgery , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/surgery , Tomography, Spiral Computed , Vertebral Artery/diagnostic imagingABSTRACT
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.