López-Puerta José María, Fernández-Marín María Reyes, Martín Benlloch Juan Antonio, Lorente Rafael
Servicio de Traumatología y Cirugía Ortopédica, Hospital Virgen del Rocío, Sevilla, España.
Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Dr. Peset, Valencia, España.
Neurocirugia (Astur : Engl Ed). 2020 May-Jun;31(3):146-150. doi: 10.1016/j.neucir.2019.06.002. Epub 2019 Sep 2.
We report an uncommon case of osteoid osteoma recurring as an aggressive osteoblastoma of the spine. A 15-years-old male consulted in our department with long-term painful scoliosis. The CT-scans and MRI revealed a sclerotic bone forming tumor of 7mm diameter consistent with a osteoid osteoma. A percutaneous radiofrequency ablation was performed with complete resolution of the symptoms. After 6 months, the symptoms recurred. A new CT and a MRI showed a growth of the nidus on the right L4 lamina, with a size of 15mm. Therefore, a marginal resection by laminectomy of L4 was performed. Pathology confirmed an epithelioid osteoblastoma. A year later, subsequent imaging studies showed a new recurrence with aggressive features and invasion of the spinal canal. The patient then underwent an "in block surgery" needing concurrent stabilization of the spine. Histopathology confirmed the diagnosis of epithelioid osteblastoma.
我们报告了一例罕见的骨样骨瘤复发为脊柱侵袭性骨母细胞瘤的病例。一名15岁男性因长期疼痛性脊柱侧弯前来我科就诊。CT扫描和MRI显示一个直径7mm的硬化性骨形成肿瘤，符合骨样骨瘤。进行了经皮射频消融，症状完全缓解。6个月后，症状复发。新的CT和MRI显示L4右侧椎板上的瘤巢增大，大小为15mm。因此，行L4椎板切除术进行边缘切除。病理证实为上皮样骨母细胞瘤。一年后，后续影像学检查显示新的复发，具有侵袭性特征并侵犯椎管。患者随后接受了“整块手术”，同时需要进行脊柱稳定术。组织病理学确诊为上皮样骨母细胞瘤。
