Cases reported "Osteoblastoma"

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1/9. Vertebral osteoblastoma: are radiologic structural changes necessary for diagnosis?

    BACKGROUND: A case of osteoblastoma localized at the pedicle of the 10th thoracic vertebra is presented. CASE DESCRIPTION: The patient complained of nocturnal back pain not relieved by salycilates, a typical symptom of osteoblastoma. Bone scintigraphy showed a lower thoracic focus of increased osteoblastic activity; however, x-rays, computed tomography, and magnetic resonance images (MRI) were within normal limits, showing only obscure changes that were also noted in the rest of the spine. Repeat MRI with contrast revealed a focal enhancement. After pediculectomy, histopathologic examination confirmed the diagnosis of osteoblastoma. Fifteen months postoperatively, the patient is symptom-free. CONCLUSION: Our case demonstrates that some cases of osteoblastoma may not have the classical radiological appearance. Although non-contrast computed tomography and T1-weighted MRI are mildly positive in some instances, osteoblastoma is best visualized on MRI with gadolinium. Like any other neoplasm, osteoblastoma should be detected and removed early, before it can cause structural bony changes.
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2/9. osteoblastoma in lumbar vertebral body.

    We report a young man with low back pain suspected to have a disc protrusion. Imaging suggested a tumour of the dorsal portion of the fifth lumbar vertebral body. Operation suggested a giant-cell tumour and subsequent histology showed an osteoblastoma. All typical imaging features of osteoblastoma are demonstrated in this rather uncommon location. Contrast-enhancing bone-marrow oedema on MRI, with mild enhancement of the tumour, together with the CT appearances were the clues to the diagnosis.
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3/9. Ossification of the ligamentum flavum associated with osteoblastoma: a report of three cases.

    We report three cases of spinal osteoblastoma with ossification of the ligamentum flavum (OLF) adjacent to the tumor. The patients in this report, all young adults, had no symptoms except for back pain. Computed tomography (CT) demonstrated a typical radiolucent nidus in the spinal pedicle/lamina with a dense sclerotic rim. In addition, ectopic bone formation at the insertion point of the ligamentum flavum adjacent to the tumor was clearly illustrated. Magnetic resonance imaging (MRI) revealed the tumor and surrounding inflammatory responses, but OLF was not detected clearly. Histological examination revealed endochondral ossification of the ligamentum flavum that is quite unusual for normal young adults. Immunohistochemical assays in one case demonstrated that bone morphogenetic protein (BMP)-2/4 was expressed in the osteoblastic tumor cells. This case raises the possibility that BMPs secreted from the tumor cells triggered ectopic ossification in the spinal ligament.
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4/9. A 16-year-old boy with back pain.

    This case is presented to illustrate the imaging and clinical findings of a condition of interest to orthopaedic surgeons. The initial findings are noted on this page. The clinical and imaging diagnoses are presented on the following pages.
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5/9. osteoblastoma of the lumbar spine as a cause of chronic low back pain.

    We report a case of osteoblastoma in the uncommon location of the L5 lumbar vertebra, detailing the clinical and radiologic aspects. Although the plain radiographs of the patient were normal, computed tomographic scans of the lumbar region confirmed the diagnosis of osteoblastoma or osteoid osteoma of the L5 vertebra. The patient was referred to the orthopedic department for operation. Histologic examination revealed osteoblastoma of the L5 vertebra. Following surgery, the patient's pain resolved completely. Although osteoblastoma is extremely rare in the spine, it should be included in the differential diagnosis as a cause of chronic back pain, especially in young males with painful scoliosis and/or radicular-type leg pain. The tumor is often not readily apparent on plain radiographs. Therefore, advanced radiological investigation is necessary to establish the correct diagnosis.
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6/9. Progression of a lumbar spinal osteoblastoma.

    A 24-year-old woman presented with a lumbar spinal osteoblastoma manifesting as a 5-year history of low back pain radiating to the left foot. neuroimaging showed suspicious hypertrophy of the left L4-5 facet which transformed in 3 years to an expansile mass lesion that compressed the dura mater and neural structures. Primary benign bone tumors such as osteoblastoma and osteoid osteoma should be considered in the differential diagnosis of back pain and the patients should be followed up carefully.
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7/9. Unusual presentation of osteoblastoma in a patient with idiopathic scoliosis after posterior spinal fusion.

    BACKGROUND CONTEXT: Few studies have described the diagnosis of osteoblastoma of the spine as a cause of scoliosis. These reports have described the tumor in conjunction with initial presentation of painful scoliosis. This case report presents a case of osteoblastoma 9 years removed from diagnosis and fusion of idiopathic scoliosis in the thoracic spine. PURPOSE: To report the late presentation of an osteoblastoma of the thoracic spine 9 years after posterior spinal fusion for scoliosis. STUDY DESIGN: Case report. methods: A 25-year-old man presented with thoracolumbar back pain and progressive neurological deficit 9 years after posterior spinal fusion for idiopathic scoliosis. Magnetic resonance imaging of the thoracic spine indicated the presence of a mass in the spinal canal causing cord compression. The patient underwent decompression with resection of the mass which was found to be an aggressive osteoblastoma. RESULTS: The patient enjoyed a full neurological recovery and has subsequently developed a recurrence at 13 months. CONCLUSIONS: We present osteoblastoma as a possible cause of low back pain and neurological deficit postfusion that should be considered in a differential diagnosis.
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8/9. Back pain in children and adolescents.

    Back pain in children is a common problem that is infrequently reported to physicians. Persistent back pain in children is serious, and most conditions can be diagnosed with relatively simple tests, including diagnostic plain radiographs and bone scans. Many cases, including strains and sprains, are relieved with rest and decreased activity. If persistent back pain, increasing pain, fever, or neurologic deficit is present, referral to the orthopedic surgeon should be swift until a specific cause can be found and treated.
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9/9. osteoblastoma of the vertebral body of the third lumbar vertebra.

    The case of a 22-year-old woman presenting with progressive low back pain as a result of a recurrent osteoblastoma of the body of L3, is reported. Total spondylectomy together with anterior and posterior fusion was carried out in a two-stage procedure. We highlight the rarity of the site of occurrence of osteoblastoma, the difficulty in diagnosis and the fact that a radical treatment needs to be performed.
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