Cases reported "Osteoblastoma"

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71/101. Malignant osteoblastoma of the skull.

    A bone tumour of intermediate grade malignancy in the skull is described. These tumours are extremely rare and share several histological features with the benign osteoblastomas and low grade osteosarcomas. They may be associated with local invasion and pulmonary metastases. Treatment of this tumour in the skull poses several problems in view of its proximity to the cerebral cortex. ( info)

72/101. Benign osteoblastoma associated with an aneurysmal bone cyst of the mandibular ramus and condyle.

    This article reviews the clinical behavior, the histologic conditions, and the treatment of a benign osteoblastoma associated with an aneurysmal bone cyst of the mandibular condyle and ramus. A 14-year-old boy, otherwise healthy, was referred for pain and enlargement in his right temporomandibular joint-cheek region. The swelling was firm and tender, a slight facial asymmetry was present, and the mouth-opening capacity was reduced. During a 6-weeks period from the primary examination to surgery the lesion expanded extensively, anesthesia appeared in the right inferior alveolar nerve and a lateral open bite developed on the affected side. Computed tomography displayed a total destruction of the right mandibular condyle and ramus to the level of the mandibular foramen. The lesion was radiolucent without distinct borders to adjacent bone. Surgery revealed a bluish, well-vascularized predominantly cystic tumor. The lesion included the temporomandibular joint disk but without overgrowth to the temporal component. After resection of the lesion, the condyle and the mandibular ramus was reconstructed with the use of an autogenous costochondral graft. The postoperative healing was uncomplicated. At follow-up 2 years after surgery the boy was free of recurrence with normal motor and sensory nerve function. ( info)

73/101. Malignant transformation of osteoblastoma: study using image analysis microdensitometry.

    AIM--To determine if the malignant transformation, as perceived histologically, in a case of osteoblastoma from the right femur, was also expressed as a quantitative change in nuclear dna during tumour progression over five months. methods--Nuclear dna microdensitometry by computer image analysis was used to acquire relative dna distribution patterns. Tissue had been removed on four separate occasions from a lesion in the right femur of an 18 year old man. Retrospective dna analysis was performed on formalin fixed, paraffin wax-embedded tissue. RESULTS--The dna profile of the initial biopsy specimen, which was histologically diagnosed as osteoblastoma, was euploid with a near diploid (2c) modal dna. The second biopsy specimen taken one month later also resembled osteoblastoma but showed an aneuploid dna profile with a diploid modal dna and some nuclei with ploidy greater than 5c. The third biopsy specimen taken four months later showed histological evidence of osteosarcoma and a near pentaploid (5c) modal dna with large number of nuclei exceeding 5c. CONCLUSIONS--dna microdensitometry confirmed the initial and final diagnosis. The technique also seems to be capable of detecting aneuploidy before malignancy is morphologically evident. ( info)

74/101. osteoblastoma of the nasal cavity.

    The clinicopathological features of a rare case of osteoblastoma of the nasal cavity arising from the nasal turbinate are reported and compared with four reported cases of osteoblastoma with nasal cavity involvement. Two of the five tumours involved the nasal cavity and paranasal sinuses. The remaining three tumours were confined in the nasal cavity; one arose from nasal bone and two from nasal turbinate periosteum. Four tumours were successfully treated with local excision. One tumour recurred locally after excision; the recurrence was apparently controlled by further local excision. ( info)

75/101. CT and MRI of aggressive osteoblastoma of thyroid cartilage.

    We present a unique case of aggressive osteoblastoma arising from thyroid cartilage. A 52-year-old man presented with a 10 month history of neck discomfort but without frank pain. CT and MR examinations disclosed a well defined mass arising from the thyroid cartilage. This lesion had areas of coarse calcifications and a central area of lucency. The appearance suggested chondrosarcoma. Hemilaryngectomy was performed to remove the mass en bloc. Surgical pathology diagnosed aggressive osteoblastoma arising from thyroid cartilage. ( info)

76/101. Bone tumours in childhood.

    The author gives a survey of literature on bone tumours in childhood and a comparison with his own work. Introducing four cases he concluded, that the survival rate of malignant bone tumours are increasing, the autologous bone transplantation seems to take priority against prosthesis in childhood, and the autologous bone transplantation is more reliable method, than the homologous one. ( info)

77/101. osteoblastoma in the anterior maxilla mimicking periapical pathosis of odontogenic origin.

    A patient with a 6-yr history of chronic orofacial pain and periapical pathosis in the anterior maxilla presented for evaluation and treatment. Previous root canal therapy had failed to resolve the persistent pain. Further evaluation suggested a non-odontogenic etiology of the patient's symptoms. Exploratory surgery revealed an osseous cavity across the maxillary anterior palatal midline filled with osteoid and early mineralized bone. The tumor was surgically removed in toto. A diagnosis of benign osteoblastoma was made. ( info)

78/101. 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. ( info)

79/101. Aggressive osteoblastoma with focal malignant transformation and development of pulmonary metastases. A case report with a review of literature.

    We report the case of a 57-year-old woman with an unusually fast-growing and destructive osteoblastic tumor affecting the left humeral head. On histopathologic examination, most of the initial tumor revealed the characteristic morphologic features of a benign-appearing aggressive osteoblastoma. Based upon the presence of a few small scattered areas composed of atypical osteoblasts in abundant lace-like osteoid showing vascular permeation, the definitive diagnosis was that of an osteoblastoma with focal malignant transformation to well-differentiated osteosarcoma. Molecular biologic analysis revealed a splice mutation at the exon 5 donor site of the p53 gene, clearly indicating a malignant potential of the tumor. The proximal third of the humerus was resected en bloc and replaced by an uncemented modular endoprosthesis. Five months after surgery, an extensive local soft tissue recurrence occurred. Eight months postoperatively, a further massive recurrent tumor had developed an multiple pulmonary metastases became evident. Chemotherapy caused a marked decrease in the size of the soft tissue recurrences and the lung metastases showed no further increase of their number and size. Osteoblastomas with conversion to osteosarcoma should be considered a separate clinicopathologic tumor entity to be distinguished from genuine osteosarcoma. All cases of malignantly transformed conventional and aggressive osteoblastomas reported to date have shown a conversion to low- or high-grade osteosarcomas only in recurrent tumors. The present case supports the concept that osteoblastomas may primarily undergo early malignant transformation. Osteoblastomas with conversion to osteosarcoma require an aggressive surgical approach followed by chemotherapy in the hope of prolonging life expectancy or obtaining a cure. ( info)

80/101. Unusual imaging findings in association with spinal osteoblastoma.

    This paper describes four patients with spinal osteoblastoma that had unusual imaging features. Two cases arose in the cervical spine and two in the thoracic spine. Three tumours were associated with diffuse sclerosis of the vertebral body (an 'ivory vertebra'). All of these lesions either arose in the vertebral body or extended into the body from the adjacent pedicle. Reactive sclerosis at multiple levels was seen in three cases (one involving adjacent vertebral bodies, two involving adjacent pedicles or laminae and one involving multiple ribs). osteophyte formation was identified bridging the disc space on the concave side of a scoliosis in two cases. Another case had an unusual scintigraphic appearance with an area of linear activity adjacent to the tumour. The finding of an 'ivory vertebra' in a child or young adult should raise the possibility of osteoblastoma involving the vertebral body, especially if there is an associated scoliosis. ( info)
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