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Introduction: Osteoid osteoma is a benign bone tumor that accounts for roughly 2-3% of primary bone tumors and up to 10-12% of benigns bone neoplasms. It is most commonly seen in young adults, and shows male predominance. Over the last years, minimally invasive thermal ablation techniques such as radiofrequency ablation have gained popularity over classical surgery. In this study we evaluate results and complications of CT guided osteoid osteoma radiofrequency ablation. Materials and methods: In this retrospective cohort study all patients that were diagnosed with osteoid osteoma and treated using radiofrequency ablation between January 2014 and December 2022 were included. Pain was assessed using Visual Analog Scale (VAS) pre and post procedure. Technical success was established as positioning of the radiofrequency electrode in the nidus. Primary clinical success was defined as absence of pain after one radiofrequency session. All patients that required a second radiofrequency ablation were included in the overall clinical success group. Results: During the studied period, 61 osteoid osteoma radiofrequency ablations were performed. Fiftyseven of them were included in this study, 32 were men and 25 female. Pre procedure median pain was 9 according to VAS score. Only 23 patients were treated as outpatient, the rest stayed in hospital for 24 hours. Median follow up time was 21,7 months (SD 8,3). Biopsy was performed in 52 patients. Technical success was accomplished in 57 patients (100%). Primary clinical success was 80,7% (46 patients). Those who continued with pain or had recurrence after a symptoms free period (11 patients), were treated with a second radiofrequency ablation, achieving an overall success rate of 94,7%. Only one patient suffered a minor complication (1,7%). Conclusion: CT guided osteoid osteoma radiofrequency ablation is a safe, effective and low complication rate procedure, that can be performed on an outpatient basis. We believe it should be considered as a first line treatment option for osteoid osteoma.

Introducción: El osteoma osteoide es un tumor óseo benigno, que representa el 2-3% de las neoplasias óseas primarias y hasta el 10-12% de los tumores óseos benignos. Tiene mayor incidencia en adultos jóvenes, con predominancia masculina. En los últimos años las técnicas de termoablación mínimamente invasivas han sido utilizadas para el tratamiento del osteoma osteoide, como alternativa a la cirugía clásica. En este estudio evaluaremos los resultados y complicaciones de ablación por radiofrecuencia de osteoma osteoide. Materiales y métodos: Se analizó una cohorte de pacientes en forma retrospectiva con diagnóstico de osteoma osteoide tratados con radiofrecuencia en el Hospital Italiano de Buenos Aires desde Enero del año 2014 hasta Diciembre del año 2022. Todos los pacientes fueron evaluados con la Escala Visual Analógica del dolor (EVA) pre y post procedimiento. El éxito técnico del procedimiento fue considerado como el correcto posicionamiento del electrodo de radiofrecuencia en el nido de la lesión, y el éxito clínico primario como ausencia de dolor post procedimiento. Mientras que los pacientes que requirieron de una segunda sesión de radiofrecuencia para controlar los síntomas serán incluidos como éxito clínico secundario. Resultados: Durante el período mencionado se realizaron 61 ablaciones percutáneas de osteoma osteoide. Se incluyeron en el análisis 57 pacientes, 32 fueron hombres y 25 mujeres. La media de dolor medido por EVA pre procedimiento fue 9. Del total de los pacientes, 23 fueron tratados de manera ambulatoria, el resto permanecieron internados durante 24hs. El tiempo medio de seguimiento fue de 21,7 meses (DS8,3). Se realizó biopsia de la lesión durante el procedimiento en 52 pacientes. Se logró el éxito técnico en 57 pacientes (100%), de ellos el éxito clínico primario se logró en 46 pacientes (80,7%). Los 11 pacientes que continuaron con dolor o presentaron recurrencia de los síntomas luego de un período asintomáticos fueron tratados con una segunda sesión de radiofrecuencia, logrando un éxito clínico secundario 94,7%. Un solo paciente presentó complicaciones post procedimiento (1,7%), correspondiente a hematoma en la planta del pie. Conclusión: Podemos concluir que la ablación percutánea por radiofrecuencia de OO guiada por tomografía en manos de expertos, es un procedimiento seguro, de alta efectividad y baja tasa de complicaciones que puede realizarse de manera ambulatoria. Por lo que consideramos que debe ser tenida en cuenta como primera elección para el tratamiento de esta patología.

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We report the case of a 64-year-old male patient with a 5 month history of proptosis, motility limitation and vision loss in OD. Visual acuity (VA) was 20/200 in OD and 20/20 in OS. CT showed a large, round, intraconal lesion, with bony density and no apparent connection to adjacent orbital walls. MRI showed a T1-weighted hypointense lesion surrounded by a contrast enhancing capsule. The orbital tumor was excised through a lateral orbitotomy revealing a nodular, round, osseous structure. Histological examination disclosed well-formed lamellar bone trabeculae, with no necrosis or mitosis figures. Immunohistochemical staining was negative for MDM2 and CDK4. After 3 years, there was no evidence of tumor recurrence and VA had improved to 20/30. Intraconal osteomas with no clear attachment to orbital walls are extremely rare. We are aware of a few reported cases in the lid, hand, thigh, tongue, pterygopalatine fossa and brain. To the authors' knowledge, this is the first report in English literature of an orbital intraconal osteoma without any visible relation to the orbital walls.

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BACKGROUND: Osteoma is a benign tumor of the bones, which can be classified as central or peripheral. The occurrence in the jawbones is uncommon, but when it occurs, there is a greater prevalence of the mandible. The etiology is still unknown, and the hypothesis of its development is debated. CASE PRESENTATION: A 35-year-old Caucasian man presenting a tumor lesion in the right jawbone that had been growing for 8 years sought medical service complaining of speaking impairment. According to the patient, the tumor appeared shortly after a minor trauma caused by tooth extraction. The diagnosis of the lesion was made through clinical, radiographic, and histological methods, and the surgical treatment was successful and satisfactory for the patient as well as the surgical team, despite a short follow-up. CONCLUSION: Etiopathogenesis of osteoma is not determined in the majority of cases. In the present report, it was possible to hypothesize the association between a minor trauma and the development of the tumor, reinforcing the reactive theory of tumor development. The uncommon location of the osteoma, as well the possibility of identifying the possible cause of the lesion, makes this case particularly interesting.

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RESUMEN Introducción: La osificación heterotópica (OH) es una complicación descrita en los pacientes con daño neurológico. Reporte de caso: Paciente que sufrió un politraumatismo y traumatismo encéfalo craneano (TEC), con fracturas y déficit neurológico secundario al TEC, quien presentó varias osificaciones heterotópicas durante su evolución, que comprometieron el logro de los objetivos funcionales. Presentó como principal manifestación tumefacción y limitación del rango articular (RA) para la extensión de cadera y rodilla izquierda, lo que mantenía el miembro inferior izquierdo (MI) flexionado, impidiendo la bipedestación y marcha. Fue diagnosticado como osteoma secundario a trauma neurológico y recibió un manejo médico estructurado, que incluyó la intervención quirúrgica: "resección del osteoma y tenotomía en isquiotiobiales", obteniendo mejora del rango articular, logrando la bipedestación y marcha con apoyo biomecánico. Discusión: La fisiopatología se cree que está relacionada a la liberación sistémica de sustancias estimulantes de células madre pluripotenciales, que se diferencian como osteoblastos. Conclusión: Un manejo integral multidisciplinario provee mejores resultados funcionales, lo que contribuye a la meta de la independencia.

ABSTRACT Introduction: Heterotopic ossification (OH) is a complication described in patients with neurological damage. Case report: Patient who suffered a multiple trauma and traumatic brain injury (TBI), with fractures and neurological deficit secondary to TBI, who presented several heterotopic ossifications (OH) during his evolution that compromised the achievement of functional objectives. The main manifestation was swelling and limitation of the articular range (RA) for the extension of the left hip and knee, which kept the lower left limb (MI) flexed, preventing standing and walking. He was diagnosed as osteoma secondary to neurological trauma and received structured medical management, which included surgical intervention: "resection of the osteoma and tenotomy in hamstrings", obtaining improvement of the joint range, chieving standing and walking with biomechanical support. Discussion: The pathophysiology is believed to be related to the systemic release of stimulating substances from pluripotent stem cells, which differentiate as osteoblasts. Conclusion: A multidisciplinary comprehensive management provides better functional results, which contributes to the goal of the independence.

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Introducción: El osteoma osteoide es un tumor óseo benigno, que no tiene potencial de crecimiento por lo que su tamaño no supera 1,5 cm pese a que la esclerosis que lo rodea le da un aspecto mayor. Afecta con mayor frecuencia a los varones jóvenes, y la mayoría de las veces aparece en las tres primeras décadas de la vida. Objetivos: Mostrar las repercusiones biomecánicas derivadas de un osteoma osteoide en el trayecto de la cintilla iliotibial y sus influencias por cadenas musculares descendentes sobre el miembro inferior. Presentación del caso: Se presenta una paciente de 24 años que acude a la consulta por presentar dolor a nivel de la cara externa del fémur derecho desde hace dos años; que se agudiza fundamentalmente con la marcha. Tras realizar las pertinentes exploraciones y pruebas diagnósticas por imagen, no se observan hallazgos clínicos significativos, por tanto se pauta tratamiento antiinflamatorio por vía oral y se efectúa estudio biomecánico y postural en el cual se detecta pie valgos bilaterales, inestables, con mayor relevancia en el pie derecho. La paciente acude nuevamente al no encontrar mejoría, se realiza telemetría del miembro inferior y resonancia magnética del fémur derecho. La imagen para diagnóstico da como resultado la presencia de una masa compatible con un osteoma osteoide de 11 x 4 mm en el tercio proximal lateral del fémur derecho. Conclusiones: Una lesión neoplásica que afecte al trayecto de un grupo muscular con repercusión biomecánica puede realizar compensaciones a diferentes niveles, por tanto, es necesaria la actuación de un equipo multidisciplinario para restablecer la marcha. Las sinergias entre el tratamiento conservador y quirúrgico provocan un mayor porcentaje de éxito(AU)

Introduction: Osteoid osteoma is a benign bone tumor, which has no growth potential, consequently its size does not exceed 1.5 cm despite the fact that the surrounding sclerosis gives it a larger appearance. It most often affects young men, most often appearing in the first three decades of life. Objectives: To show the biomechanical repercussions derived from an osteoid osteoma in the trajectory of the iliotibial band and its influences by descending muscle chains on the lower limb. Case report: We report a 24-year-old female patient who came to the consultation due to pain on the external face of her right femur for two years. This pain worsened mainly by walking. After carrying out the pertinent explorations and diagnostic imaging tests, no significant clinical findings were observed, therefore, oral anti-inflammatory treatment was prescribed and biomechanical and postural study was carried out, which showed bilateral, unstable valgus foot, with higher relevance on the right foot. The patient came again when she had no improvement, telemetry of her lower limb and magnetic resonance imaging of her right femur were performed. The diagnostic image revealed the presence of a mass compatible with an 11 x 4 mm osteoid osteoma in the proximal lateral third of her right femur. Conclusions: A neoplastic lesion that affects the trajectory of a muscle group with biomechanical repercussions can carry out compensations at different levels, therefore, the action of a multidisciplinary team is necessary to restore gait. Synergies between conservative and surgical treatment lead to a higher success rate(AU)

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Resumen El osteoma de oído medio es un tumor poco común, de crecimiento lento y características benignas. Frecuentemente cursa de forma asintomática y su diagnóstico suele ser casual como en el caso que exponemos. Se presenta el caso de un varón de 26 años, que consultó por odinofagia y otalgia derecha en el contexto de una infección de vía aérea alta. Al explorarlo mediante otoscopia se visualizó en el oído izquierdo una lesión blanquecina y redondeada retrotimpánica compatible con osteoma de oído medio. El tratamiento de elección en pacientes con osteomas de oído medio sintomáticos es la cirugía. Sin embargo, en pacientes asintomáticos el seguimiento es la opción más recomendada.

Abstract The middle ear osteoma is a benign, infrequent, slow-growing tumor. This lesion is frequently asymptomatic and its diagnosis is usually accidental, as the case presented here. We present a case of a 26-year-old man who consulted for odynophagia and right ear pain in the context of an upper airway infection. By otoscopy in the left ear, we observed a whitish retrotympanic lesion that was compatible with a middle ear osteoma. To manage symptomatic patients with middle ear osteomas, surgery is the treatment of first choice. Nevertheless, for asymptomatic patients, follow up is recommended.

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The aim of this article is to report the presence of choroidal loculation of fluid and choroidal cavern in a case of choroidal osteoma, previously undescribed in this disease.

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Common symptoms such as axial pain or nocturnal pain, associated with warning signs that are often worrisome in addition to nonspecific radiological findings, can characterize benign lesions in the spine, and osteoid osteoma is among them. We describe here a clinical case of a pediatric patient with an expansive bone lesion in the thoracic spine discovered after investigation for thoracic pain, mainly at night, which, despite a good response to simple analgesics, evolved in the short term with global spinal deformity. After a multidisciplinary evaluation, she underwent surgical resection using a pioneering endoscopic technique that allowed the definitive anatomopathological diagnosis of osteoid osteoma and guaranteeing very satisfactory treatment and evolution. Although there are already several therapeutic techniques described and with good results in specific cases of osteoid osteomas and other benign neoplastic lesions of the spine, full-endoscopic resection appears as an innovative and potentially promising option for diagnosis and treatment, especially since it is a safe, effective, and not too morbid intervention.

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RESUMEN Se presentó el caso de una paciente femenina de 40 años de edad que acudió a consulta por presentar aumento de volumen en la región parotídea izquierda. Se realizó ortopantomografía, radiografías simples anteroposterior y lateral de cráneo que revelaron la presencia de una imagen radiolúcida en la región lateral de la rama mandibular izquierda. El diagnóstico clínico fue de osteoma periférico a este nivel, por lo que se realizó remoción quirúrgica total de la lesión. La biopsia confirmó el diagnóstico de osteoma ebúrneo periférico. El osteoma es una neoplasia benigna de tejido óseo, poco frecuente y, rara vez, se localiza de manera aislada en la mandíbula. No se diagnosticaron complicaciones posoperatorias y la paciente mostró satisfacción con la atención estomatológica brindada.

ABSTRACT A 40-year-old female patient came to the consultation due to an increase in volume in the left parotid region. Orthopantomography and simple anteroposterior and lateral skull radiographies were performed, revealing the presence of a radiolucent image in the lateral region of the left mandibular side. The clinical diagnosis at this point was of peripheral osteoma, for which a total surgical removal of the lesion was performed. The biopsy confirmed the diagnosis of peripheral osteoma. An osteoma is a rare benign neoplasm of bone tissue, and is rarely found isolated in the mandible. Postoperative complications were not diagnosed and the patient was satisfied with the dental care provided.

RESUMO Foi apresentado o caso de uma paciente do sexo feminino, 40 anos de idade, que compareceu à consulta por aumento de volume na região da parótida esquerda. Foram realizadas ortopantomografia, radiografias simples ântero-posterior e lateral do crânio, que revelaram a presença de imagem radiotransparente na região lateral do ramo mandibular esquerdo. O diagnóstico clínico foi de osteoma periférico a este nível, para o qual foi realizada a remoção cirúrgica total da lesão. A biópsia confirmou o diagnóstico de osteoma periférico ebúrneo. O osteoma é uma neoplasia benigna do tecido ósseo, pouco frequente e raramente localizada de forma isolada na mandíbula. Complicações pós-operatórias não foram diagnosticadas e o paciente ficou satisfeito com o atendimento odontológico prestado.

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Osteoid osteoma is a painful, benign and common bone tumor that is prevalent in young adults. The typical clinical presentation consists of pain that becomes worse at night and is relieved by nonsteroidal anti-inflammatory drugs. The most common imaging finding is a lytic lesion, known as a nidus, with variable intralesional mineralization, accompanied by bone sclerosis, cortical thickening and surrounding bone marrow edema, as well as marked enhancement with intravenous contrast injection. When the lesion is located in typical locations (intracortical bone and the diaphyses of long bones), both characteristic clinical and radiological features are diagnostic. However, osteoid osteoma is a multifaceted pathology that can have unusual presentations, such as intraarticular osteoid osteoma, epiphyseal location, lesions at the extremities and multicentric nidi, and frequently present atypical clinical and radiological manifestations. In addition, many conditions may mimic osteoid osteoma and vice versa, leading to misdiagnosis. Therefore, it is essential to understand these musculoskeletal diseases and their imaging findings to increase diagnostic accuracy, enable early treatment and prevent poor prognosis.