Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.
Br J Neurosurg. 2023 Oct;37(5):1023-1027. doi: 10.1080/02688697.2020.1842326. Epub 2020 Nov 3.
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.
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.
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.
骨样骨瘤偶尔发生于脊柱，但恶变并不常见。我们报告 1 例极其罕见的骨样骨瘤恶变为高级别骨肉瘤的病例，该肿瘤发生于椎弓根并向颈椎侧块扩散。
我们报告 1 例 18 岁男性，以颈痛为首发症状。诊断时，透亮性病变直径为 12mm。行肿瘤内切除术和自体骨移植。术后 40 个月时，残留肿瘤逐渐生长；因此，肿瘤在最初诊断后 51 个月时迅速生长。此时，肿瘤大小约为初始大小的 6 倍，导致进行性截瘫。活检显示肿瘤已转化为高级别骨肉瘤。采用重离子照射控制肿瘤生长。
骨样骨瘤有恶变的可能。骨样骨瘤或骨母细胞瘤患者应密切观察，尤其是对于肿瘤内切除后复发的患者。
