Internal Medicine

Osteoid osteoma

All information given here is only of a general nature, tumor therapy always belongs in the hands of an experienced oncologist!

Synonyms

Osteoid osteoid, cortical iso-osteoid, sclerosing osteitis
English: osteoid osteoma

definition

An osteoid osteoma is a benign tumor change in the skeleton.
X-rays typically show local bone compression in the area of the hard tubular bone with a central cavity (nidus). Nocturnal pain that responds well to aspirin is typically described.

Summary

The osteoid osteoma is the third most common benign bone change in adolescence after the non-ossifying fibrioma (NOF) and the osteoma.
Boys are particularly affected by this tumor.
It occurs particularly frequently in the upper part of the thigh bone, but also more frequently in the tibia (shinbone) and in the spine. All other bones (finger bones) can also be affected.
Night pain is typical and so is the immediate relief of pain with aspirin therapy (ASA).
In the center there is nidus (circled in red), in the nidus cavity often hypervascularized (increased blood supply). Surrounding reaction: hyperostosis (increased bone formation) with often pronounced asymmetrical bone thickening.

Occurrence

The osteoid osteoma occurs predominantly in males (M> W 3: 1).
The osteoid osteoma represents 14% of all bone tumors.
The tumor usually occurs between the ages of 10 and 20; it can occur before the age of 10 and very rarely after the age of 30.

localization

Occurrence:

Thigh bone
Femoral neck (neck, greater trochanter)
Vertebrae (pedicules, spinous process)
Shin near the knee

causes

The origin of the osteoid osteoma are still unclear today.

metastasis

The osteoid osteoma is benign and therefore does not metastasize.

Differential diagnoses

Alternative diagnoses to consider:

benign cortical defects
Enchondroma
non-ossifying fibroma (NOF)
Osteochondroma
solitary bone cyst
Osteoblastoma
sclerosing osteomyelitis
Brodie's abscess
Stress fracture (break) of the tibia

Symptoms

There are no clear symptoms that indicate an osteoid osteoma:

- Pain, especially at night
- Hip pain and / or knee pain
- sudden occurrence
- should respond well to acetylsalicylic acid (Aspirin ®) and NSAIDs
- Pain is localized in depth
- Occasionally palpable tumor
- local swelling
- Back pain

diagnosis

1. Imaging diagnostics:

X-ray image:
typical: nidus = central cavity in the hard tubular bone, which is surrounded by increased bone formation (sclerosis).
Bone scintigram:
increased absorption of technetium (radioactive marker)

2. Pathology:
In the fine tissue examination under the microscope one finds very well perfused connective tissue, which is surrounded by a sclerotic bone. Of the

3. Serum / blood test:
The tumor does not cause any changes in the blood.

therapy

In order to achieve freedom from symptoms, the tumor must be removed as a whole (en bloc resection), since it can form again if the residual tissue is left behind (relapse)

If necessary, a CT-controlled (Computed Tomography) Puncture to obtain a tissue sample for a detailed examination.