Department of Surgery, University Hospital of Ioannina, Ioannina, Greece;
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, NY, U.S.A.
In Vivo. 2021 Jul-Aug;35(4):1929-1938. doi: 10.21873/invivo.12459.
Osteoid osteoma, the third most common benign bone tumor, usually occurs in the cortex of long bones. It consists of a radiolucent nidus surrounded by reactive osteosclerosis. Generally, osteoid osteoma affects young males. Nocturnal pain that eases with salicylates or nonsteroidal anti-inflammatory drugs (NSAID) is the typical clinical presentation. Sometimes, it remains undiagnosed for a long time. Plain radiography and computed tomography are usually sufficient for the diagnosis of osteoid osteoma. Initial treatment includes salicylates and NSAID because the tumor often regresses spontaneously over 2-6 years. Surgical treatment is indicated in case of unresponsive pain to medical therapy, no tolerance of prolonged NSAID therapy due to side effects, and no willingness to activity limitations. Nowadays, minimally invasive techniques have replaced open surgery and are considered the gold standard of surgical treatment. Although cryoablation seems superior in terms of the nerve damage and immunotherapy effect, radiofrequency ablation is the preferred technique.
骨样骨瘤，第三大常见良性骨肿瘤，通常发生于长骨皮质。其由一个透亮中心和反应性骨硬化环绕组成。通常，骨样骨瘤好发于年轻男性。夜间疼痛，水杨酸类或非甾体抗炎药（NSAID）可缓解，为典型临床表现。有时，其可长期未被诊断。平片和 CT 通常足以诊断骨样骨瘤。初始治疗包括水杨酸类和 NSAID，因为肿瘤常在 2-6 年内自发消退。对于药物治疗无效的疼痛、因副作用不能耐受长期 NSAID 治疗、或不愿接受活动受限，需手术治疗。目前，微创技术已取代开放性手术，被认为是手术治疗的金标准。虽然冷冻消融在神经损伤和免疫治疗效果方面似乎更优，但射频消融是首选技术。
