Michaelides Michalis, Pantziara Maria, Petridou Elia, Iacovou Efrosini, Ioannides Cleanthis
MRI/CT Department, Ygia Polyclinic Hospital, 21 Nafpliou str., PO Box 56174, 3305, Limassol, Cyprus.
ECCLabs- Independent Histopathology Cystopathology Services, Nicosia, Cyprus.
Skeletal Radiol. 2017 Mar;46(3):379-383. doi: 10.1007/s00256-016-2555-8. Epub 2016 Dec 20.
Osteoid osteoma and osteoblastoma are rare benign bone-forming tumors with very similar histological features. They are nowadays considered as two distinct entities. Progression of an osteoid osteoma to osteoblastoma is considered very rare with only a few cases reported in the literature. Herein we describe a case of an osteoid osteoma of the thoracic spine in a 29-year-old woman that was initially treated conservatively and progressed to osteoblastoma 5 years following the initial diagnosis. Imaging revealed an increase in the size of the spinal lesion that was surrounded by extensive paraspinal abnormal soft tissue that raised suspicion for sarcomatous transformation. The final diagnosis was established by CT-guided biopsy of both the bone lesion and the paraspinal soft tissue, which excluded malignancy and revealed an osteoblastoma surrounded by plasma cell-rich chronic inflammation. The patient then underwent wide surgical excision of the lesion and paraspinal soft tissue component that confirmed the diagnosis. Follow-up with MRI over the next 12 months was unremarkable, with no signs of recurrence or spinal instability. This unique presentation of an osteoblastoma has not been previously described. This case also demonstrates the importance of follow-up of osteoid osteomas that are treated conservatively.
骨样骨瘤和成骨细胞瘤是罕见的良性成骨性肿瘤，组织学特征非常相似。如今它们被视为两种不同的实体。骨样骨瘤进展为成骨细胞瘤极为罕见，文献中仅报道了少数病例。在此，我们描述一例29岁女性胸椎骨样骨瘤病例，该病例最初接受保守治疗，在初次诊断5年后进展为成骨细胞瘤。影像学检查显示脊柱病变大小增大，周围有广泛的椎旁异常软组织，这引发了对肉瘤样转变的怀疑。最终诊断通过对骨病变和椎旁软组织进行CT引导下活检得以确立，排除了恶性肿瘤，并显示成骨细胞瘤被富含浆细胞的慢性炎症所包围。患者随后接受了病变及椎旁软组织成分的广泛手术切除，这证实了诊断。在接下来的12个月里，通过MRI进行的随访未见异常，没有复发或脊柱不稳定的迹象。这种成骨细胞瘤的独特表现此前尚未有过描述。该病例还证明了对接受保守治疗的骨样骨瘤进行随访的重要性。
