The CT and MRI features of benign calvarium and skull base osteoblastoma.

OBJECTIVE: We retrospectively reviewed the CT and MRI features of patients with benign osteoblastoma in the calvarium and skull base (CSBOB). METHODS: Nine cases of pathologically confirmed benign CSBOB were analysed retrospectively. The patients had undergone CT and/or MRI. Tumour location, size, and imaging features were reviewed and recorded. RESULTS: The patients included four males and five females with a mean age of 27.0 years (age 14-40 years). The tumours were located in the frontal bone in 3 patients, the occipital bone in 3 patients, and in the parietal bone, sphenoid bone, and skull base in 1 patient each. On CT, the tumours measured 5.1 ± 3.3 (1.8-8.4) cm. Seven tumours were shown to have caused expansile bony destruction with an eggshell appearance and varying degrees of calcification or matrix mineralization. Multiple septa were observed in 5 tumours. Intracranial growth was observed in 5 tumours. On MRI, 7 tumours showed heterogeneous hypo- to isointensity on T1WI. Heterogeneous high signal patterns with low signal rims and septa were observed in 6 tumours on T2WI, and 4 showed a fluid-fluid level. On contrast-enhanced imaging, 6 tumours showed peripheral and septal enhancement, and 2 showed the dural tail sign. CONCLUSIONS: Benign CSBOB is a rare tumour characterized by expansile bony destruction, septa, a sclerotic rim and calcification or matrix mineralization on CT and MRI. ADVANCES IN KNOWLEDGE: The findings from this study contribute to a better understanding of benign CSBOB and provide valuable imaging features that can aid in its diagnosis and differentiation from other tumours in the calvarium and skull base.

Chronic neck pain in a child: a case of osteoblastoma of the C5 cervical vertebra.

Osteoblastoma is a primary bone-forming tumour that usually occurs in the second decade with an affinity to the posterior elements when found in the spine. Its occurrence in the early first decade is uncommon and often causes a diagnostic dilemma. It usually has a late presentation and the symptoms may be non-specific which may lead the clinician to overlook this particular entity. We present a case of osteoblastoma of the posterior elements of the C5 vertebra in a pre-adolescent child who was diagnosed and successfully managed with surgical resection in a timely fashion that led to favourable recovery postoperatively.

Large skull osteoblastoma presented as aneurysmal bone cyst (ABC).

Aneurysmal bone cysts (ABCs) are rare benign vascular bony lesions mostly encountered in young patients. These cysts can occur as primary lesions or, less frequently, secondary to other pathologies such as osteoblastomas. Skull ABCs are rare and can extend intracranially, presenting with hydrocephalus and bleeding. Here we illustrate the case of a 9-year-old male who presented with headache, nausea, and vomiting, without neurological deficit. Radiological investigations showed a soap-bubble lesion with mass effect over the right cerebellum. The patient underwent right sub-occipital craniotomy with marginal wide resection of the cystic lesion. The patient had excellent outcomes. The histopathological report was consistent with osteoblastoma with an aneurysmal bone cyst.

New kids on the block: FOS and FOSB gene.

FOS and FOSB proto-oncogens are involved in a wide variety of tumourigenic processes. FOS and FOSB gene rearrangements are observed in epithelioid haemangioma, pseudomyogenic haemangioendothelioma, osteoid osteoma/osteoblastoma/cementoblastoma and proliferative myositis/fasciitis. In this review, we provide an overview of FOS and FOSB, including their functions and the differences between lesions with known FOS/FOSB gene rearrangements. Additionally, we discuss the use of FOS/FOSB immunohistochemistry as a diagnostic tool for these lesions.

Benign Brain and Spinal Tumors Originating from Bone or Cartilage.

Benign osseocartilaginous tumors of the spine are overall uncommon, representing between 1 and 13% of all primary bone tumors and less than 10% of all spinal tumors. Tumors in this category include osteoblastic lesions such as the related osteoid osteoma and osteoblastoma, and cartilage-forming lesions including osteochondroma, chondroma, and chondroblastoma. Aneurysmal bone cysts, giant cell tumors of bone, and eosinophilic granulomas also comprise benign tumors of the spine arising from bone. There is significant heterogeneity in the epidemiology, molecular biology, imaging features, and optimal treatment of these lesions. For example, osteoid osteoma is characterized by high expression of the cyclooxygenase enzymes, making it amenable to treatment with anti-inflammatory drugs initially, whereas other lesions such as osteoblastoma may require intralesional curettage or en bloc resection sooner. Generally, en bloc resection is preferred when possible to minimize risk of recurrence. Further, some tumors may arise in the setting of syndromic conditions, such as multiple chondromas arising in Ollier disease or Maffucci syndrome, or as part of genetic disorders, such as osteochondromas in the context of hereditary multiple exostosis. These lesions may present with local pain, cause neurological compromise or be discovered incidentally on routine imaging. The Enneking classification and Weinstein-Boriani-Biagini system are routinely used to classify lesions and assist in surgical planning. More novel techniques such as radiofrequency ablation and laser photocoagulation have been applied for the treatment of osteoid osteoma and may have utility in the treatment of other lesion types. A multidisciplinary approach is critical in the management of benign lesions of the spine, and both chemotherapeutic and surgical approaches are routinely used.

Neonatal osteoblastic tumor with a novel PTBP1::FOSB fusion.

Congenital/neonatal bone neoplasms are extremely rare. We present the case of a patient with a neonatal bone tumor of the fibula that had osteoblastic differentiation and a novel PTBP1::FOSB fusion. FOSB fusions are described in several different tumor types, including osteoid osteoma and osteoblastoma; however, these tumors typically present in the second or third decade of life, with case reports as young as 4 months of age. Our case expands the spectrum of congenital/neonatal bone lesions. The initial radiologic, histologic, and molecular findings supported the decision for close clinical follow-up rather than more aggressive intervention. Since the time of diagnosis, this tumor has undergone radiologic regression without treatment.

Differential diagnosis of an osseous cranial tumor from Hellenistic Mugla, Turkey.

OBJECTIVE: This project evaluates a cranial lesion from a Hellenistic-era individual excavated by the Mugla Archaeological Museum in Gülagzi, Turkey. MATERIALS: An osseous tumor measuring 3.02 × 3.54 × 2.98 cm originating from the occipital bone of a probable young adult male. METHODS: The tumor was examined using gross morphological inspection, plain radiography (x-ray), and computed tomography (CT) imaging to identify potential differential diagnoses for the osseous cranial tumor. RESULTS: The lesion in question displays features highly consistent with both osteoid osteoma and osteoblastoma. The tumor had a non-sclerotic, sharply demarcated border, a radiolucent nidus measuring less than 2 centimeters in diameter, and homogeneous sclerotic bone surrounding the nidus. CONCLUSIONS: Differential diagnosis determined the osseous tumor to be a benign neoplasm, and in this case the features of the tumor are highly consistent with a diagnosis of either osteoblastoma or osteoid osteoma. SIGNIFICANCE: The identification of novel neoplastic cases in paleopathology represents an important contribution to ongoing discussions regarding the temporality and regional variability of neoplastic conditions in the past. Additionally, a rigorous diagnostic study augmented by x-ray, CT scans, and 3D modeling provides data that can be utilized in future paleopathological studies. LIMITATIONS: Diagnostic interpretation would be aided by histological examination of the tumor, which was impossible in this case. Histological examination would provide a definitive diagnosis. SUGGESTIONS FOR FURTHER RESEARCH: Given the high incidence of benign tumors in the clinical literature but a paucity of reports in the paleopathological record, further research is indicated to better understand the implications of benign neoplasms in antiquity.

18 F-FDG PET/CT of a Rare Sternal Osteoblastoma in a Man With History of Lymphoma.

ABSTRACT: A 27-year-old man, with a history of non-Hodgkin lymphoma 8 years ago, was admitted due to 9 months of persistent sternal pain. Chest CT revealed a mass in the sternum. 18 F-FDG PET/CT was performed, demonstrating a radioactive accumulation mass in the sternum, accompanied by massive osteogenesis and osteolysis. Histological and immunohistochemical analysis of ultrasound-guided fine-needle aspiration biopsy samples confirmed the diagnosis of aggressive osteoblastoma. We present a rare case of aggressive sternal osteoblastoma, instead of lymphoma recurrence, on 18 F-FDG PET/CT in an adult with history of lymphoma.

The malignant transformation of osteoid osteoma in the cervical spine to high-grade osteosarcoma: a case report and review of literature.

PURPOSE: Osteoid osteoma occasionally occur in the spine, but their malignant transformation is not common. We present an extremely rare case of the malignant transformation of an osteoid osteoma to high-grade osteosarcoma that formed in the pedicle and spread to the lateral mass of the cervical spine. CASE PRESENTATION: We report the case of an 18-year-old man who suffered from neck pain as an initial symptom. The size of the radiolucent lesion was 12 mm in diameter at the time of diagnosis. Intralesional tumour resection and autologous bone grafting were performed. The remaining tumour grew gradually for 40 months after the surgery; therefore, the tumour had grown rapidly till 51 months after the initial diagnosis. At this stage, the tumour size was approximately 6-fold larger than the initial size, and resulted in progressive paraplegia. A biopsy revealed that the tumour had transformed into a high-grade osteosarcoma. Heavy charged particle irradiation was performed to control tumour growth. CONCLUSIONS: There is a possibility of malignant transformation of osteoid osteoma. Patients with osteoid osteoma or osteoblastoma should be carefully observed, especially for recurrent tumours after an intralesional resection.

Multimodal Imaging Evaluation and Clinical Progress of Spinal Osteoblastoma: A Comprehensive Review.

Spinal osteoblastoma is rare clinically, with insidious onset, atypical symptoms, and various imaging manifestations, which can easily lead to misdiagnosis and delayed diagnosis. It can cause severe neurological dysfunction in patients with intermediate to advanced stages and may easily recur after surgery. Imaging examinations such as radiography, computed tomography, magnetic resonance imaging, and positron emission tomography have different value for the diagnosis of spinal osteoblastoma, but they lack specificity. The preferred treatment is surgical resection, which is technically difficult, and in some cases, osteoblastoma cannot be completely removed. New clinical approaches such as radiofrequency ablation, radiotherapy, targeted chemotherapy, and other comprehensive treatments have emerged and are progressing rapidly, but no unified norms have yet been developed. This manuscript provides a systematic review of the literature and provides an extensive and comprehensive review of this rare tumor in terms of multimodality imaging manifestations and clinical progress.

Osteoblastoma of the maxilla: A case report and review of the literature.

Osteoblastoma is a benign tumour with aggressive trait usually seen in young males between 10 and 40 years of age. This condition is quite rare in children. Here, we report one such rare osteoblastoma occurring in the maxilla of a 4-year-old boy and discuss the clinical presentation, radiologic and histologic features, and treatment of this patient, and a brief review.

Osteoid Osteoma of Retromolar Trigone: Report of a Rare Case.

Osteoid osteoma is a rare benign bone lesion that is often confused with the osteoblastoma. The osteoid osteoma comprises of 3% of all the primary bone tumours usually found in the long bones and vertebrae with the facial skeleton being the most infrequent site. The lesion usually presents with the swelling and pain that resolves with non-steroidal anti-inflammatory drugs (NSAIDs). Here, we report a case of osteoid osteoma of retromolar trigone, the site which has not been reported in the literature, in a 50-year male patient with a complaint of hard swelling on retromolar trigone associated with the mild intermittent localised pain that aggravated at night and on mastication. Excision of the lesion was carried out with chisel and mallet under local anesthesia with uneventful recovery and no recurrence at the 6 months follow-up. Key Words: Benign, Osteoid osteoma, Retromolar trigone.

Osteoblastoma em osso zigomático - relato de caso raro / Osteoblastoma in zygomatic bone ­ rare case report

O osteoblastoma é um tumor frequentemente visto em ossos longos, com pouco envolvimento maxilofacial e raramente localizado em osso zigomático. Devido à sua semelhança clínica e histológica com outros tumores ósseos, o osteoblastoma representa um desafio de diagnóstico para o profissional. A ressecção cirúrgica total é recomendada, sendo que a ausência de recidiva se deve ao diagnóstico correto e tratamento adequado. O objetivo deste artigo é relatar o manejo de um paciente com osteoblastoma envolvendo o osso zigomático e realizar uma breve revisão da literatura.

Osteoblastoma is a tumor often seen in long bones, with little maxillofacial involvement and rarely located in zygomatic bone. Due to its clinical and histological similarity with other bone tumors, osteoblastoma represents a diagnostic challenge for the professional. Total surgical resection is recommended, and the absence of recurrence is due to correct diagnosis and adequate treatment. The aim of this article is to report the management of a patient with osteoblastoma involving the zygomatic bone and to carry out a brief review of the literature.

[Case report of the substantial nasal mass in children and literature review].

In this article we reported 13 cases of the substantial nasal mass in children. Among 13 these patients, 3 cases were septal hemangioma, 2 cases were maxillary hemangioma, 1 case was nasal infantile fibromatosis, 1 case was osteoblastoma of the nasal cavity and sinuses, 2 cases were lymphoma of nasopharynx, 1 case was maxillary lymphoma, 1 case was rhabdomyosarcoma of nasopharynx, 1 case was maxillary squamous-cell carcinoma, 1 case was squamous-cell carcinoma of nasopharynx.All 13 cases were treated with surgery, 1 case with nasal infantile fibromatosis, 2 cases with lymphoma of nasopharynx, 1 case with rhabdomyosarcoma of nasopharynx, 1 case with nasopharyngeal carcinoma and 1 case with maxillary carcinoma were taken postoperative radiotherapy and chemotherapy. The most common substantial nasal mass in children was hemangioma. This study included 2 cases with nasal invasive benign tumors, 1 case with nasal infantile fibromatosis and 1 case with osteoblastoma of the nasal cavity and sinuses. The functional nasal endoscopic surgery of mass resection was the main method for the treatment of mass in this area and had achieved satisfied effect. Lymphoma and rhabdomyosarcoma were the most common nasal malignant tumor in children. Nasopharyngeal carcinoma and maxillary carcinoma were not uncommon.

Methylation and copy number profiling: emerging tools to differentiate osteoblastoma from malignant mimics?

Rearrangements of the transcription factors FOS and FOSB have recently been identified as the genetic driver event underlying osteoid osteoma and osteoblastoma. Nuclear overexpression of FOS and FOSB have since then emerged as a reliable surrogate marker despite limitations in specificity and sensitivity. Indeed, osteosarcoma can infrequently show nuclear FOS expression and a small fraction of osteoblastomas seem to arise independent of FOS/FOSB rearrangements. Acid decalcification and tissue preservation are additional factors that can negatively influence immunohistochemical testing and make diagnostic decision-making challenging in individual cases. Particularly aggressive appearing osteoblastomas, also referred to as epithelioid osteoblastomas, and osteoblastoma-like osteosarcoma can be difficult to distinguish, underlining the need for additional markers to support the diagnosis. Methylation and copy number profiling, a technique well established for the classification of brain tumors, might fill this gap. Here, we set out to comprehensively characterize a series of 77 osteoblastomas by immunohistochemistry, fluorescence in-situ hybridization as well as copy number and methylation profiling and compared our findings to histologic mimics. Our results show that osteoblastomas are uniformly characterized by flat copy number profiles that can add certainty in reaching the correct diagnosis. The methylation cluster formed by osteoblastomas, however, so far lacks specificity and can be misleading in individual cases.