Osteoid osteoma

All information given here is of general nature only, a tumor therapy always belongs in the hands of an experienced oncologist!

Synonyms

Osteoid osteitis, cortical osteitis, sclerosing osteitis

Definition

An osteoid osteoma is a benign tumor change of the skeleton. The x-ray image typically shows localized bone compression in the area of the hard tubular bone with a central cavity (nidus). Nocturnal pain that responds well to aspirin is characteristically described.

The osteoid osteoma is the third most common benign bone change in adolescence after the non-ossifying fibroma (NOF) and the osteoma. Boys are particularly affected by this tumor. It occurs particularly frequently in the upper part of the thigh bone, but also more frequently in the tibia (shinbone) and in the spine.

All other bones (finger bones) can also be affected. Night pain is typical, as is the immediate relief of pain with aspirin therapy (ASA). Nidus (circled in red) is found centrally, often hypervascularized (increased blood flow) in the nidus cavity. Environmental reaction: Hyperostosis (increased bone formation) with often pronounced asymmetrical bone thickening.

Occurrence

Osteoid osteoma occurs predominantly in the male sex (M>W 3:1). The osteoid osteoma represents 14% of all bone tumors. The tumor usually occurs between the age of 10 and 20 years, an occurrence before the age of 10 is possible, after the age of 30 very rarely.

Localization

Occurrence:

  • Thighbones
  • Femoral neck (neck, greater trochanter)
  • Vertebrae (Pedicules, Processus spinosus)
  • Shinbone close to the knee joint

Causes

The origin of the osteoid osteoma is still unclear today.

Metastasis

The osteoid osteoma is benign and therefore does not metastasize.

Differential diagnoses

Alternative diagnoses to be considered

  • Benign cortical defects
  • Enchondrome
  • Non-ossifying fibroma (NOF)
  • Osteochondrome
  • Solitary bone cyst
  • Osteoblastoma
  • Sclerosing Osteomyelitis
  • Brodie Abscess
  • Stress fracture (fracture) of the tibia

There are no clear symptoms indicating an osteoid osteoma:

  • Pain, especially at night
  • Hip pain and/or knee pain
  • Sudden occurrence
  • Should respond well to acetylsalicylic acid (Aspirin ®) and NSAID
  • Pain is localized in the depth
  • Tumor occasionally palpable
  • Local swelling
  • Back pain
  • Pain, especially at night hip pain and/or knee pain sudden onset should respond well to acetylsalicylic acid (Aspirin ®) and NSAID Pain will be localized in depth tumor occasionally palpable local swelling back pain
  • Pain, especially at night
  • Hip pain and/or knee pain
  • Sudden occurrence
  • Should respond well to acetylsalicylic acid (Aspirin ®) and NSAID
  • Pain is localized in the depth
  • Tumor occasionally palpable
  • Local swelling
  • Back pain

1. imaging diagnostics: 2. pathology: In the fine tissue examination under the microscope, connective tissue with a very good blood supply is found, which is surrounded by sclerotic bone. The 3rd serum blood examination: The tumor does not lead to any blood changes.

  • X-ray image: typical: nidus = central cavity, in the hard tubular bone, which is surrounded by increased bone formation (sclerosis). Bone scintigram: increased absorption of technetium (radioactive marker)