FAQ - Osteoma, Osteoid
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Radio Frequency Ablation of An Osteoid Osteoma?


An Osteoid Osteoma is basically a benign bone tumor yet causes tremendous pain due to inflammation. One of the means of removing this tumor is through Radio Frequency Ablation (RFA). Basically this bone tumor is cooked off the bone using radio frequency. My question is where does the bits of the bone go? I would assume that it is excreted through the urine, but I am not sure. If this is true, could the bits of bone (though microscopic) going through the kidneys cause kidney stones?

Any help would be much appreciated.
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Can Osteoid Osteoma be cancerous ?


I had an x-ray done 2 days ago.I was diagnosed with osteoid osteoma. A tumor in my shin bone. Now the doctor basically said it "shouldn't" be cancerous, and that we would need an MRI to know for sure.Now im scheduled for one in 4 days,and im just wondering if it can really be cancerous.Since the doctor and my dad ( also a doctor ) kept the matter kind of quiet and didn't say much and i would like to know. I'm 15 by the way.
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There is no way to know if this tumor is benign or malignant without a biopsy. Your doctor is relying on what is considered 'the most common' approach . . that cancer is rare in 15 year olds and that the body can have benign tumors in this location. Further testing is warranted because no one is 100 percent sure . . the MRI will give them a bit more information and the doctor figures he can go from there . . if the MRI indicates further testing they may decide to remove the tumor and do a biopsy at that time. The problem with this approach is that if this turns out to be a malignancy like osteosarcoma or Ewings sarcoma than only a sarcoma specialist should be doing this surgery. If your father is a doctor he should have known all this . .but if he doesn't than you need to speak up. This is your life and your leg. But first things first . . go for the MRI and see what the results are before jumping to conclusions.

And, you need to open up a dialogue with your father and let him know that you need the truth at all times. Hopefully this will turn out to be a benign osteoid osteoma that can easily be removed. Good luck.

What is osteosarcoma
http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_is_osteosarcoma_cancer_52.asp

What is ewings sarcoma
http://www.cancer.org/docroot/NWS/content/NWS_1_1x_What_is_Ewing_s_Sarcoma_.asp

Types of cancer in teens
http://kidshealth.org/teen/diseases_conditions/cancer/types_of_cancer.html  (+ info)

osteoid osteoma?


my brother's dr. thinks he might have osteoid osteoma, but there isn't alot of info. online because it's so rare, can anyone give me the basic information on it?
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Osteoid osteomas are benign bone neoplasms, occuring usually in the adolescent years, causing pain, often at night, usually relieved by anti-inflammatory drugs.

They are not difficult to diagnosis, though lesions in the neck of the femur and spine can be difficult. A combination of plain radiographs, MRI and thin-section, high-resolution CT, is usually enough.

Though surgery is the standard method of treatment, there is considerable morbidity. For some years now, radiofrequency thermal ablation (RFA) has been used to ablate (cook) these lesions, with considerable success and minimal morbidity.

Hope this info helps!  (+ info)

Osteoid Osteoma?


I was dx with an osteoid osteoma last July. I have had the osteoma for at least 4 years. I have read things on the internet that say they usually resolve within 33 months but mine has not. It is painful, mostly at night, and aspirin helps. But, anytime it is touched or bumped it causes severe pain, and I work with kids all day so it gets bumped a lot. It is on the front of my lower leg--I think this bone is called the tibia. My questions are: has anyone had this and did it resolve on its own? How do I deal with the pain--is there some type of protective cover to keep it from being hit? Can and how is it removed surgically? Any other info is appreciated.
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call your medical center and ask for advice with this problem .they should be able to answer all your questions.  (+ info)

questions about Osteoid Osteoma ?


The Doctor said that there is Osteoid Osteoma in my knee near the Cartilage area and he can't operate there.

He said to use crutches and take naproxen, unitl it goes away and does not recommended surgery.

My questions:
How Long does it take for the tumor to go away?? ( like 2-3 years?)
How would crutches actually help with the pain?
Would doing exercises or sport activities make the pain go worse?
How is operating near a cartilage dangerous? Can't he use Radiofrequency ablation to heat it?


Plz, help me out here with any info. I don't have knowledge about the inner working of the knee.
I really appreciate it.
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These are things you should have asked the doctor.
Get a second opinion and this time ask questions.  (+ info)

Do I have Osteoid osteoma?


My seconed toe is very red and swolen, it is almost larger then my big toe. My toe nail practialy goes OVER the whole toe, and it hurts really bad. My mom says it is a Black Widow bite, but I think I would be dead by now, you know? It hurts twice as much at night. Please someone tell me what is wrong. I am 12 years old, by the way.
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It sounds like a terrible infection. Why isn’t your mother taking you to a doctor?  (+ info)

Does this sound like Osteoid Osteoma?


I have a sharp pain at night when lifting my leg
However the pain i have, typically is relieved for some time when i take asprin
I walk with a limp, because it hurts to walk regular
I have a lump, it seems like a hard ball of fat on the top of my femur. Less than a half inch in diameter

Im not jumping to conclusion, but should i go to the doctor? I just want to find out all i can before i go, just to make sure its not nothing. Thanks for your help, please no links to any medication.


And i don't know if this has anything to do with it, but my left leg is freezing compared to my right leg.
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please go to the doctor as soon as possible sounds like a possible blood clot do no hesitate go usually blood clots back of leg but anything is possible you said your leg is freezing which is indicative of circulation problems go to doctor now  (+ info)

Cranial Osteoma treatment, do you have to shave your whole head?


I have a cranial osteoma that probly has a subdural portion that will have to be removed with neurosurgery. Will i have to shave my whole head or just the part they have to cut into it at?
I have hair almost to by waist it will be so sad to cut it all
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they will probably decide that, however when my sister had emergency surgery they shaved only that portion where they went in at, but a nurse came and shave the rest so that it would all be even!, hope that help!  (+ info)

Is there a cure (other than surgery) for Facial Osteoma (on the forehead).?


I would be even more glad if you can tell me if there's a homeopathic treatment.
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I would like to hear from anyone who has knowledge of the rare skin disorder, osteoma cutis. And treatments.?


Osteoma cutis is little bits of calcium deposits under the skin (mine is where I had acne when I was younger.) I had dermabrasion many years ago, but the condition recurred because of the time it took for healing...it forms in scar tissue.
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Osteoma Cutis
Last Updated: February 15, 2005 Rate this Article
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Synonyms and related keywords: bone in the skin, Albright hereditary osteodystrophy, Albright's hereditary osteodystrophy, miliary osteomas

AUTHOR INFORMATION Section 1 of 9
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Author: Kevaghn P Fair, DO, Consulting Staff, Department of Pathology, Dominion Pathology Laboratories

Kevaghn P Fair, DO, is a member of the following medical societies: American Osteopathic Association, American Society of Clinical Pathologists, American Society of Dermatopathology, and College of American Pathologists

Editor(s): James W Patterson, MD, Director of Dermatopathology, Professor of Pathology and Dermatology, Departments of Pathology and Dermatology, University of Virginia Medical Center; David F Butler, MD, Professor, Texas A&M University College of Medicine; Director, Division of Dermatology, Scott and White Clinic; Rosalie Elenitsas, MD, Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System; Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University; and William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System

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INTRODUCTION Section 2 of 9
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Background: Strictly defined, osteoma cutis refers to the presence of bone within the skin in the absence of a preexisting or associated lesion, as opposed to secondary types of cutaneous ossification that occur by metaplastic reaction to inflammatory, traumatic, and neoplastic processes.


Pathophysiology: Bone arises in skin and soft tissues through mesenchymal (membranous) ossification without cartilage precursors or models (enchondral ossification, as in the skeletal system).

The lesions of osteoma cutis differ from tumoral calcinosis in that they represent bone formation, and calcinosis refers to calcium salt deposits.

In addition to colonic polyposis, epidermal cysts of the face and the scalp, and multiple fibromas, osteomatosis in the form of intraosseous (not cutaneous) osteomas may develop within the membranous bones of the head in Gardner syndrome.


Frequency:


In the US: Although said to be rare, with no well-defined data on the incidence, a plethora of conditions and syndromes may be found in association with osteoma cutis, and the frequency of its occurrence varies accordingly. Primary lesions with no underlying cause are even more rare, but they account for approximately 20% of all cases.
Mortality/Morbidity: Osteoma cutis is not life threatening, although local discomfort and/or disfigurement may lead the patient to seek consultation.

Race: No race is predisposed to develop osteoma cutis.

Sex: Generally, no distinct sexual predominance exists. However, one cause of osteoma cutis, Albright hereditary osteodystrophy, occurs with a female-to-male ratio of 2:1.

Age: Osteoma cutis may occur at any age.



CLINICAL Section 3 of 9
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History:

Patients may report having hard areas in the skin.
A familial occurrence of Albright hereditary osteodystrophy may be present.
Physical:

The presentations of osteoma cutis can be highly variable, with clinical entities that are defined by the number, the form, and the location of the lesions.
Osteomas may present as single or multiple, extremely hard nodules, plaques, or miliary tumors.
The face, the extremities, the scalp, the digits, and the subungual regions are the most commonly affected sites.
Causes: Osteoma cutis is a feature in several groups of patients.

Albright hereditary osteodystrophy, which includes most patients with pseudohypoparathyroidism and pseudopseudohypoparathyroidism, is due to an autosomal dominant defect in the alpha subunit of intracellular guanyl nucleotide-binding protein (G protein).
The characteristic phenotype includes short stature, a round face, defective teeth, mental retardation, brachydactyly, and osteomas of the soft tissue and the skin.
Tetany is often the presenting sign of pseudohypoparathyroidism, formerly called Albright hereditary osteodystrophy. In addition to skeletal system abnormalities, lesions of osteoma cutis are frequently observed.
Single, small osteomas, arising later in life, sometimes with transepidermal elimination of bony fragments may be a cause.
Multiple, miliary osteomas of the face, following acne, neurotic excoriation, or dermabrasion is a possible cause.
Congenital plaquelike osteomatosis or limited dermal ossification is generally present from birth; the skin of the scalp or the extremities is often affected.
Fibrodysplasia ossificans heteroplasia and fibrodysplasia ossificans progressiva are possible causes.
Miscellaneous rare disorders with or without cartilaginous elements include osteomas of the distal extremities and multiple osteomas of childhood unrelated to Albright hereditary osteodystrophy.
DIFFERENTIALS Section 4 of 9
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Calcinosis Cutis



Other Problems to be Considered:

Cartilaginous tumors of the skin
Foreign body
Gouty tophus
Myositis ossificans
Secondary (heterotopic) ossification

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WORKUP Section 5 of 9
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Lab Studies:


Serum calcium and parathyroid hormone (PTH) levels help to define Albright hereditary osteodystrophy.
Imaging Studies:


Plain radiographs demonstrate lesions but are not necessary for diagnosis.
Procedures:


Excisional biopsy for diagnosis, relief of discomfort, or cosmesis may be performed.
Histologic Findings: Small spicules to large masses of mature bone are found in the dermis or extend into the subcutaneous tissue. Spicules of bone may enclose areas of mature fat, recapitulating a medullary cavity, but hematopoietic elements are seldom observed (see Image 3).
TREATMENT Section 6 of 9
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Medical Care:

Removal by excision or laser resurfacing to unroof overlying skin may be performed. Treatment with the Er:YAG laser may result in less hypopigmentation and scarring than with the carbon dioxide laser.
Other reported treatments with unproven efficacy include the following:
Topical application of tretinoin to provoke transepidermal elimination
Etidronate disodium taken orally
Consultations: When several lesions are noted, especially in pediatric patients, evaluation for associated syndromes may be warranted. FOLLOW-UP Section 7 of 9
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Prognosis:


Osteosarcoma or other malignancies have not been reported to arise within osteoma cutis.
PICTURES Section 8 of 9
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Caption: Picture 1. Solitary nodule on the frontal part of the scalp.
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Caption: Picture 2. Miliary cutaneous osteomata. Multiple, small, bluish, stony-hard nodules in an acneiform distribution along the cheeks.
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Caption: Picture 3. A microscopic view of osteoma cutis shows well-formed mature trabecular bone just beneath the epidermis. Note the absence of hematopoietic elements in the medullary spaces.
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BIBLIOGRAPHY Section 9 of 9
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Altman JF, Nehal KS, Busam KJ, Halpern AC: Treatment of primary miliary osteoma cutis with incision, curettage, and primary closure. J Am Acad Dermatol 2001 Jan; 44(1): 96-9[Medline].
Burgdorf W, Nasemann T: Cutaneous osteomas: a clinical and histopathologic review. Arch Dermatol Res 1977 Dec 12; 260(2): 121-35[Medline].
Cohen AD, Chetov T, Cagnano E, et al: Treatment of multiple miliary osteoma cutis of the face with local application of tretinoin (all-trans-retinoic acid): a case report and review of the literature. J Dermatolog Treat 2001 Sep; 12(3): 171-3[Medline].
Ragsdale BD: Lever's Histopathology of the Skin. Philadelphia, Pa: Lippincott-Raven; 1997: 965-7.
Roth SI, Stowell RE, Helwig EB: Cutaneous ossification. Report of 120 cases and review of the literature. Arch Pathol 1963; 76(1): 44-54[Medline].
Watsky KL: In: Arndt KA, ed. Cutaneous Medicine and Surgery. Philadelphia, Pa: WB Saunders; 1996: 1828-31.
Weedon D, ed: Skin Pathology. 2nd ed. New York, NY: Churchill Livingstone; 2002: 355-7.  (+ info)

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