E-ISSN: 1305-9327 ISSN: 1305-9319
Is Biopsy Absolutely Necessary For Osteoid Osteomas Treated with Percutaneous Ablation?
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Research
VOLUME: 15 ISSUE: 4
P: 352-356
December 2019

Is Biopsy Absolutely Necessary For Osteoid Osteomas Treated with Percutaneous Ablation?

Med J Bakirkoy 2019;15(4):352-356
DOI: 10.4274/BTDMJB.galenos.2019.20181010013541
Barış Gülenç 1
Zeynep Güngören 2
Cengiz Erol 2
Ahmet Murat Bülbül 1
1. Bağcılar Medipol Mega Üniversite Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye
2. Bağcılar Medipol Mega Üniversite Hastanesi, Radyoloji Kliniği, İstanbul, Türkiye
No information available.
No information available
Received Date: 10.10.2018
Accepted Date: 17.02.2019
Publish Date: 20.12.2019
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ABSTRACT

Objective:

Osteoid osteoma is a common bone tumor with a benign character. Patients present to orthopedics clinic with irritating nocturnal pain and many of them have a long history of complaints at the time of diagnosis. Its management is mainly conservative although surgical treatment is more effective at alleviating pain and removing tumor. In the last 20 years percutaneous ablation has been safely used with minimum risk, especially for bony regions that are risky for surgical access. Whereas some radiologists perform ablation after taking biopsy from nidus, some others directly proceed with ablation. The aim of the present study was to assess the effect of biopsy result on osteoid osteoma management and its implication on clinical practice.

Methods:

This study retrospectively involved 10 patients who underwent percutaneous ablation for osteoid osteoma at our clinic between January 2013 and December 2016. All patients were biopsied before the intervention. Those who did not undergo biopsy sampling before the intervention, who were lost to follow-up, and who were diagnosed with conditions other than osteoid osteoma were excluded. Biopsy results and images were obtained retrospectively. The clinical outcomes, recurrence rates, and treatment costs were compared between patients with positive and negative biopsy results.

Results:

This study involved 10 patients with a mean age of 17.3 (4-35) years. All patients were followed for at least 2 years, and the recurrence and symptom statuses were questioned via telephone interview. A nidus establishing the diagnosis of osteoid osteoma was seen in 7 out of 10 patients. No patient developed lesion recurrence by the end of a 2-year follow-up period, nor any of them suffered persistent pain after the procedure. Patients with and without nidus showed no significant differences with respect to clinical course and recurrence rate.

Conclusion:

Percutaneous ablation is associated with a high curative potential and can be effectively used for the treatment of osteoid osteoma. The result of pre-procedural biopsy had no effect on patients’ clinical course and recurrence rates.

Keywords: Osteoid osteoma, percutaneous ablation, biopsy, recurrence

References

1
Unni KK. Osteoid osteoma. In: Unni KK, ed. Dahlin’s Bone Tumors: General Aspects and Data on 11,087 Cases. 5th ed. Philadelphia, PA: Lippincott Raven Publishers; 1996:121-130. 3.
2
Campanacci M. Osteoid osteoma. In: Campanacci M, ed. Bone and Soft Tissue Tumours. Padova, Italy: Piccin Nuova Libraria S.p.A.; 1999:391-414.
3
Frassica FJ, Waltrip RL, Sponseller PD, Ma LD, McCarthy EF Jr. Clinicopathologic features and treatment of osteoid osteoma and osteoblastoma in children and adolescents. Orthop Clin North Am 1996;27:559-74.
4
Gitelis S, Schajowicz F. Osteoid osteoma and osteoblastoma. Orthop Clin North Am 1989;20:313-25.
5
Boscainos PJ, Cousins GR, Kulshreshtha R, Oliver TB, Papagelopoulos PJ. Osteoid Osteoma. Orthopedics 2013;36:792-800.
6
Greco F, Tamburrelli F, Ciabattoni G. Prostaglandins in osteoid osteoma. Int Orthop 1991;15:35-7.
7
Peyser AB, Makley JT, Callewart CC, Brackett B, Carter JR, Abdul-Karim FW. Osteoma of the long bones and the spine. A study of eleven patients and a review of the literature. J Bone Joint Surg Am 1996;78:1172-80.
8
Filippiadis DK, Tutton S, Mazioti A, Kelekis A. Percutaneous image-guided ablation of bone and soft tissue tumours: a review of available techniques and protective measures. Insights Imaging 2014;5:339-46.
9
Moser T, Buy X, Goyault G, Tok CH, Irani F, Gangi A. Imageguided ablation of bone tumors: review of current techniques. J Radiol 2008;89:461-71.
10
Lindner NJ, Ozaki T, Roedl R, Gosheger G, Winkelmann W, Wörtler K. Percutaneous radiofrequency ablation in osteoid osteoma. J Bone Joint Surg (Br) 2001;83:391-6.
11
Vanderschueren GM, Taminiau AHM, Obermann WR, Bloem JL. Osteoid osteoma: clinical results with thermocoagulation. Radiology 2002;224:82-6.
12
Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ. Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 2003;229:171-5.
13
Jaffe H. “Osteoid osteoma”: a benign osteoblastic tumor composed of osteoid and atypical bone. Arch Surg 1935;31:709-28.
14
Moberg E. The natural course of osteoid osteoma. J Bone Joint Surg Am 1951;33:166-70.
15
Golding JS. The natural history of osteoid osteoma; with a report of twenty cases. J Bone Joint Surg Br 1954;36:218-29.
16
Kneisl JS, Simon MA. Medical management compared with operative treatment for osteoid-osteoma. J Bone Joint Surg Am 1992;74:179-85.
17
Israeli A, Zwas St, Horozowski H, Farine I. Use of radionuclide method in preoperative and intraoperative diagnosis of osteoid osteoma of the spine. Case report. Clin Orthop Relat Res 1983;194-6.
18
Ghelman B, Thompson FM, Arnold WD. Intraoperative radioactive localization of an osteoid-osteoma. Case report. J Bone Joint Surg Am 1981;63:826-7.
19
Ayala AG, Murray JA, Erling MA, Raymond AK. Osteoid-osteoma: intraoperative tetracycline-fluorescence demonstration of the nidus. J Bone Joint Surg Am 1986;68:747-51.
20
Ziegler DN, Scheid DK. A method for location of an osteoid-osteoma of the femur at operation. A case report. J Bone Joint Surg Am 1992;74:1549-52.
21
Lee DH, Malawer MM. Staging and treatment of primary and persistent (recurrent) osteoid osteoma. Evaluation of intraoperative nuclear scanning, tetracycline fluorescence and tomography. Clin Orthop Relat Res 1992;229-38.
22
Lanza E, Thouvenin Y, Viala P, Sconfienza LM, Poretti D, Cornalba G, et al. Osteoid osteoma treated by percutaneous thermal ablation: when do we fail? A systematic review and guidelines for future reporting. Cardiovasc Intervent Radiol 2014;37:1530-9.
23
Glanzmann MC, Imhoff AB, Schwyzer H-K. Osteoid osteoma of the shoulder and elbow: from diagnosis to minimally invasive removal. Int Orthop 2013;37:2403-8.
24
Prud’homme C, Nueffer JP, Runge M, Dubut J, Kastler B, Aubry S. Prospective pilot study of CT-guided microwave ablation in the treatment of osteoid osteomas. Skeletal Radiol 2017;46:315-23.
25
Donkol RH, Al-Nammi A, Moghazi K. Efficacy of percutaneous radiofrequency ablation of osteoid osteoma in children. Pediatr Radiol 2008;38:180-5.
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