Difference between revisions of "Osteoid osteoma"

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'''Osteoid osteoma''', abbreviated '''OO''', is benign primary [[bone tumour]].
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Osteoid osteoma - low mag.jpg
| Width      =
| Caption    = Osteoid osteoma. [[H&E stain]].
| Micro      = anastomosing bony [[trabeculae]] with variable mineralization, osteoblast rimming, no nuclear atypia of osteocytes
| Subtypes  =
| LMDDx      = [[osteoblastoma]], [[osteosarcoma]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[bone]] (femur > tibia > spine > elsewhere)
| Assdx      =
| Syndromes  =
| Clinicalhx = pain relieved by [[NSAIDs]]
| Signs      =
| Symptoms  = extremely painful
| Prevalence =
| Bloodwork  =
| Rads      = <= 2.0 cm (larger lesions ''[[osteoblastoma]]'')
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    = [[osteosarcoma]]
}}
'''Osteoid osteoma''', abbreviated '''OO''', is benign primary [[bone tumour]]. It is grouped with the [[chondro-osseous tumours]].
 
It should '''not''' be confused with an ''[[osteoma]]''.


==General==
==General==
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*Bone: femur > tibia > spine > elsewhere.<ref name=uthscsa>URL: http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html]. Accessed on: 7 May 2012.</ref><ref name=radiologyassistant>URL: [http://www.radiologyassistant.nl/en/494e15cbf0d8d http://www.radiologyassistant.nl/en/494e15cbf0d8d]. Accessed on: 7 May 2012.</ref>
*Bone: femur > tibia > spine > elsewhere.<ref name=uthscsa>URL: http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html]. Accessed on: 7 May 2012.</ref><ref name=radiologyassistant>URL: [http://www.radiologyassistant.nl/en/494e15cbf0d8d http://www.radiologyassistant.nl/en/494e15cbf0d8d]. Accessed on: 7 May 2012.</ref>
*Most common location (in bone): diaphysis.<ref name=uthscsa>URL: http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html]. Accessed on: 7 May 2012.</ref>  
*Most common location (in bone): diaphysis.<ref name=uthscsa>URL: http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html]. Accessed on: 7 May 2012.</ref>  
*'''Must''' be less than 2 cm - as per WHO definition.<ref name=pmid25224389>{{Cite journal  | last1 = Yalcinkaya | first1 = U. | last2 = Doganavsargil | first2 = B. | last3 = Sezak | first3 = M. | last4 = Kececi | first4 = B. | last5 = Argin | first5 = M. | last6 = Basdemir | first6 = G. | last7 = Oztop | first7 = F. | title = Clinical and morphological characteristics of osteoid osteoma and osteoblastoma: a retrospective single-center analysis of 204 patients. | journal = Ann Diagn Pathol | volume = 18 | issue = 6 | pages = 319-25 | month = Dec | year = 2014 | doi = 10.1016/j.anndiagpath.2014.08.006 | PMID = 25224389 }}</ref> ‡
**Larger lesions with the same microscopy are ''[[osteoblastoma]]s''.
*Central nidus with surround sclerotic bone.<ref name=pmid24093694>{{Cite journal  | last1 = Boscainos | first1 = PJ. | last2 = Cousins | first2 = GR. | last3 = Kulshreshtha | first3 = R. | last4 = Oliver | first4 = TB. | last5 = Papagelopoulos | first5 = PJ. | title = Osteoid osteoma. | journal = Orthopedics | volume = 36 | issue = 10 | pages = 792-800 | month = Oct | year = 2013 | doi = 10.3928/01477447-20130920-10 | PMID = 24093694 }}</ref>
Note:
*‡ Previously, the [[diagnostic size cutoffs|diagnostic size cutoff]] was <=1.5 cm.<ref name=Ref_Sternberg4_286>{{Ref Sternberg4|286}}</ref>


Images:
Images:
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**Variable mineralization.  
**Variable mineralization.  
***Mineralization (calcium '''p'''hosphate) = '''p'''urple on [[H&E stain]].
***Mineralization (calcium '''p'''hosphate) = '''p'''urple on [[H&E stain]].
**Osteoblasts rimming.
**Osteoblast rimming.
***Cells line-up at edge of bone.
***Cells line-up at edge of bone.


Note:
Note:
*Histomorphologically near identical/indistinguishable from ''[[osteoblastoma]]'';<ref name=Ref_Sternberg4_286>{{Ref Sternberg4|286}}</ref> one needs some history to make the diagnosis.
*Histomorphologically near identical/indistinguishable from ''[[osteoblastoma]]'';<ref name=Ref_Sternberg4_286>{{Ref Sternberg4|286}}</ref> one needs some history to make the diagnosis.
DDx:
*[[Osteosarcoma]] - lace-like osteoid, no nidus.
*[[Osteoblastoma]] - larger lesion, clinical features different.


===Images===
===Images===

Latest revision as of 12:04, 20 June 2016

Osteoid osteoma
Diagnosis in short

Osteoid osteoma. H&E stain.
LM anastomosing bony trabeculae with variable mineralization, osteoblast rimming, no nuclear atypia of osteocytes
LM DDx osteoblastoma, osteosarcoma
Site bone (femur > tibia > spine > elsewhere)
Clinical history pain relieved by NSAIDs
Symptoms extremely painful
Radiology <= 2.0 cm (larger lesions osteoblastoma)
Clin. DDx osteosarcoma

Osteoid osteoma, abbreviated OO, is benign primary bone tumour. It is grouped with the chondro-osseous tumours.

It should not be confused with an osteoma.

General

  • Benign bone lesion.

Clinical:[1]

  • Extremely painful.

Gross

  • Bone: femur > tibia > spine > elsewhere.[2][3]
  • Most common location (in bone): diaphysis.[2]
  • Must be less than 2 cm - as per WHO definition.[4] ‡
  • Central nidus with surround sclerotic bone.[5]

Note:

Images:

Microscopic

Features:[1]

  • Anastomosing bony trabeculae with:
    • Variable mineralization.
      • Mineralization (calcium phosphate) = purple on H&E stain.
    • Osteoblast rimming.
      • Cells line-up at edge of bone.

Note:

  • Histomorphologically near identical/indistinguishable from osteoblastoma;[6] one needs some history to make the diagnosis.

DDx:

Images

  • Osteoid osteoma - low mag. (WC)

  • Osteoid osteoma - intermed. mag. (WC)

  • Osteoid osteoma - high mag. (WC)

  • Osteoid osteoma - very high mag. (WC)

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BONE, RIGHT FEMUR, EXCISION:
- OSTEOID OSTEOMA.

Micro

The sections show anastomosing bony trabeculae with variable mineralization and osteoblastic rimming. Multinucleated osteoclasts are scattered through the lesion. Hemosiderin-laden macrophages are present. No osteocyte nuclear atypia is apparent. Mitotic activity is not apparent. The osteoid is not lace-like.

See also

References

  1. ↑ 1.0 1.1 Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 285. ISBN 978-0781740517.
  2. ↑ 2.0 2.1 URL: http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html]. Accessed on: 7 May 2012.
  3. ↑ URL: http://www.radiologyassistant.nl/en/494e15cbf0d8d. Accessed on: 7 May 2012.
  4. ↑ Yalcinkaya, U.; Doganavsargil, B.; Sezak, M.; Kececi, B.; Argin, M.; Basdemir, G.; Oztop, F. (Dec 2014). "Clinical and morphological characteristics of osteoid osteoma and osteoblastoma: a retrospective single-center analysis of 204 patients.". Ann Diagn Pathol 18 (6): 319-25. doi:10.1016/j.anndiagpath.2014.08.006. PMID 25224389.
  5. ↑ Boscainos, PJ.; Cousins, GR.; Kulshreshtha, R.; Oliver, TB.; Papagelopoulos, PJ. (Oct 2013). "Osteoid osteoma.". Orthopedics 36 (10): 792-800. doi:10.3928/01477447-20130920-10. PMID 24093694.
  6. ↑ 6.0 6.1 Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 286. ISBN 978-0781740517.
  7. ↑ URL: http://njms2.umdnj.edu/tutorweb/gross.htm. Accessed on: 7 May 2012.
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