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老年患者的骨样骨瘤:诊断挑战

Osteoid Osteoma in an Elderly Patient: Diagnostic Challenges.

作者信息

Koga Shunsuke, Du Wei, Cipriano Cara A, Cooper Kumarasen

机构信息

Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

Int J Surg Pathol. 2025 Aug;33(5):1271-1274. doi: 10.1177/10668969241308229. Epub 2025 Jan 8.

Abstract

Osteoid osteoma is a benign bone tumor commonly affecting young individuals, with a rare occurrence in older adults. It typically presents with night pain relieved by nonsteroidal anti-inflammatory drugs and is characterized radiographically by a small, radiolucent nidus surrounded by reactive sclerosis. We present a 70-year-old female patient with persistent right hip pain, initially diagnosed as arthritis, who underwent total hip arthroplasty. Preoperative imaging findings were inconclusive, showing edema and degenerative changes without a definitive lesion. Histopathological examination of the arthroplasty specimen revealed a nodule consistent with osteoid osteoma. This report highlights the diagnostic challenge of osteoid osteoma in elderly patients, where symptoms may be atypical and overlap with other conditions like osteoarthritis.

摘要

骨样骨瘤是一种常见于年轻人的良性骨肿瘤,在老年人中罕见。它通常表现为服用非甾体类抗炎药后可缓解的夜间疼痛,影像学特征为一个小的、透光的瘤巢被反应性硬化所包围。我们报告一例70岁女性患者,因持续右髋部疼痛最初被诊断为关节炎,随后接受了全髋关节置换术。术前影像学检查结果不明确,显示有水肿和退行性改变但无明确病变。关节置换标本的组织病理学检查发现一个符合骨样骨瘤的结节。本报告强调了老年患者骨样骨瘤的诊断挑战,其症状可能不典型且与骨关节炎等其他疾病重叠。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/379b/12181637/843517f45472/10.1177_10668969241308229-fig1.jpg

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