WordNet

a slow growing benign tumor of consisting of bone tissue; usually on the skull or mandible

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/02/20 16:02:43」(JST)

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An osteoid osteoma is a benign bone tumor that arises from osteoblasts and was originally thought to be a smaller version of an osteoblastoma. Osteoid osteomas tend to be less than 1.5 cm in size. The tumor can be in any bone in the body but are most common in long bones, such as the femur and tibia. They account for 10 to 12 percent of all benign bone tumors. "Osteoid osteomas may occur at any age, and are most common in patients between the ages of 4 and 25 years old. Males are affected approximately three times more commonly than females." ^[1]

Presentation

Characterized by less than 1.5 cm in diameter, osteoid osteomas most frequently occur in young men (Male:Female ratio 3:1) and may occur in any bone of the body, most frequently around the knee but often also seen in the vertebrae, in the long bones and less commonly in the mandible or other craniofacial bones.

Severe pain typically occurs at night.^[2] The chief complaint may only be of dull pain which is non radiating and persistent throughout 24 hours but increases significantly at night.

Histological Findings

Micrograph of an osteoid osteoma showing the characteristic anastomosing bony trabeculae and osteoblastic rimming. H&E stain.

On histological examination osteoid osteoma consists of a small (< 1.52 cm), yellowish to red nidus of osteoid and woven bone with interconnected trabeculae, and a background and rim of highly vascularized, fibrous connective tissue. Varying degrees of sclerotic bone reaction may surround the lesion. Benign osteoblastoma is virtually indistinguishable from osteoid osteoma. The usual appearance included a fibrovascular stroma with numerous osteoblasts, osteoid tissue, well-formed woven bone, and giant cells. The osteoblasts were generally small and regular in shape. "http://www.medscape.com/viewarticle/465365_2"

Symptoms

The most common symptoms of an Osteoid Osteoma are:

dull pain that escalates to severe at night
limping
muscle atrophy
bowing deformity
swelling
increased or decreased bone growth

^[3] ^[4] The most common symptom is pain that can be relieved with over the counter pain medication in the beginning. After the benign tumor develops further the pain can not be alleviated with medication and minor to severe swelling starts to occur. The tumor is often found through x-ray imaging. "Conventional radiographs reveal a well-demarcated lytic lesion (nidus) surrounded by a distinct zone of sclerosis" that allow doctors to identify the tumor. ^[5]

Diagnosis

Radiographs in osteoid osteoma typically show a round lucency, containing a dense sclerotic central nidus (the characteristic lesion in this kind of tumor), surrounded by sclerotic bone. The nidus is seldom larger than 1.5 cm.

The lesion can easily be detected on CT scan. Plain radiographs are not always diagnostic. MRI adds little to the CT findings which are useful for localisation. Radionuclide scanning shows intense uptake which is useful for localisation at surgery using a hand held detector, and for confirmation that the entire lesion has been removed. ^[6]

Treatment

Pain may be relieved by aspirin or other nonsteroidal antiinflammatory drugs.

Osteoid osteoma will resolve spontaneously in approximately 33 months, the reason for this is unknown. The type of treatment may also vary based on the health of the individual with the tumor. If an individual is healthy and is willing to endure the pain, pain relievers are given until the tumor resolves. If the patient does not want to endure the pain or to be treated with non-steroidal anti-inflammatories, surgical or percutaneous ablation may be considered. ^[7] If surgery is preferred, the individual may be referred to an orthopedic surgeon to perform the ablation. Post-surgery therapy and strengthening may be needed, depending on the tumor location and health of the individual. Recently, percutaneous radiofrequency ablation is the preferred treatment option. "This is a minimally invasive procedure in which radio frequencies are passed beneath the skin through a needle to kill the tumor cells by heating them to a high temperature."^[8] This technique is performed by a radiologist and is preferred because it is done under general anesthesia and does not weaken the bone as much as surgery does. The recovery time is also shorter for this treatment.

Ablation is performed in some cases.^[9]^[10]

References

^ http://orthoinfo.aaos.org/topic.cfm?topic=A00507
^ Mungo DV, Zhang X, O'Keefe RJ, Rosier RN, Puzas JE, Schwarz EM (January 2002). "COX-1 and COX-2 expression in osteoid osteomas". J. Orthop. Res. 20 (1): 159–62. doi:10.1016/S0736-0266(01)00065-1. PMID 11853083.
^ "Osteoid Osteoma". Knol. http://knol.google.com/k/osteoid-osteoma#Symptoms%7Cpublisher=Knol.
^ "Bone and Soft Tissue Tumors: Benign Tumors". Dana-Farber Cancer Institute. http://www.dana-farber.org/pat/pediatric-care/pediatric-programs/bone-and-soft-tissue-tumors/osteoma.html#faq_3.
^ Singh, Arun Pal. "Osteoid Osteoma-Diagnosis And Treatment". http://boneandspine.com/musculoskeletal-tumours/osteoid-osteomadiagnosis-treatment/.
^ http://emedicine.medscape.com/article/392850-overview
^ http://www.bonetumor.org/tumors-bone/osteoid-osteoma
^ "Bone and Soft Tissue Tumors: Benign Tumors". http://www.dana-farber.org/pat/pediatric-care/pediatric-programs/bone-and-soft-tissue-tumors/osteoma.html.
^ Lindner NJ, Ozaki T, Roedl R, Gosheger G, Winkelmann W, Wörtler K (April 2001). "Percutaneous radiofrequency ablation in osteoid osteoma". J Bone Joint Surg Br 83 (3): 391–6. doi:10.1302/0301-620X.83B3.11679. PMID 11341426. http://www.jbjs.org.uk/cgi/pmidlookup?view=long&pmid=11341426.
^ Donkol RH, Al-Nammi A, Moghazi K (February 2008). "Efficacy of percutaneous radiofrequency ablation of osteoid osteoma in children". Pediatr Radiol 38 (2): 180–5. doi:10.1007/s00247-007-0690-z. PMID 18040677.

External links

UpToDate Contents

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1. 小児および思春期における良性骨腫瘍：概要 benign bone tumors in children and adolescents an overview
2. 小児および思春期における腰痛：原因の概要 back pain in children and adolescents overview of causes
3. 小児における股関節痛の概要 overview of hip pain in childhood
4. 脊髄腫瘍 spinal cord tumors
5. 関節痛の画像診断技術による評価 imaging techniques for evaluation of the painful joint

English Journal

Imaging features of osteoid osteoma of the phalanges.

Kotnis N1, James SL.
Skeletal radiology.Skeletal Radiol.2015 Oct;44(10):1461-6. doi: 10.1007/s00256-015-2191-8. Epub 2015 Jun 21.
OBJECTIVES: Osteoid osteoma (OO) of the phalanges is regarded as a difficult diagnosis to make, both clinically and radiologically. Our aim was to assess the imaging features of this relatively rare entity to assess for consistent imaging features.MATERIALS AND METHODS: Retrospective analysis of dat
PMID 26093538

Radiofrequency Ablation Under 3D Intraoperative Iso-C C-arm Navigation for the Treatment of Osteoid Osteomas.

Yu F1, Niu XH1, Zhang Q1, Zhao HT1, Xu LH1, Deng ZP1.
The British journal of radiology.Br J Radiol.2015 Sep 29:20140535. [Epub ahead of print]
BACKGROUND: To evaluate the efficacy of intraoperative 3D Iso-C C-arm navigated percutaneous radiofrequency ablation (RFA) of osteoid osteomas.METHODS: 35 patients (20 male, 15 female) with osteoid osteomas underwent treatment with intraoperative 3D Iso-C C-arm navigation-guided RFA. The tumor was f
PMID 26415989

Paediatric musculoskeletal interventional radiology.

Natali GL1, Paolantonio G1, Fruhwirth R1, Alvaro G1, Parapatt GK1, Toma' P2, Rollo M1.
The British journal of radiology.Br J Radiol.2015 Sep 23:20150369. [Epub ahead of print]
Interventional radiology technique is now well established and widely used in the adult population. Through minimally invasive procedures, it increasingly replaces surgical interventions that involve higher percentages of invasiveness and, consequently, of morbidity and mortality. For these advantag
PMID 26235144

Japanese Journal

軸椎椎間関節近傍のosteoid osteomaに対する術中ナビゲーションを用いたpin-point approachによる治療経験 (日本脊椎・脊髄神経手術手技学会特集号)

森幹士,西澤和也,西川淳一 [他]
Journal of spine research : official journal of the Japanese Society for Spine Surgery and Related Research 4(7), 1210-1212, 2013-07
NAID 40019774994

臨床室診断に難渋した大腿骨頚部類骨骨腫の1例

大村佳之,野上重治,安田剛敏 [他]
整形外科 = Orthopedic surgery 64(4), 336-338, 2013-04
NAID 40019635348

有鉤骨に発生した類骨骨腫の1例

鈴鹿智章,香月憲一,米田昌弘,高松聖仁,青野勝成
中部日本整形外科災害外科学会雑誌. 中部日本整形外科災害外科学会抄録 55(5), 1145-1146, 2012-09-01
NAID 10031128740

Related Pictures

★リンクテーブル★

リンク元	「類骨骨腫」
関連記事	「osteo」

「類骨骨腫」

Osteoid osteoma
	Classification and external resources
	; Osteoid osteoma of the trochanter minor: X-ray and MRI with marked sclerosis around the nidus.
ICD-O:	9191/0
DiseasesDB	31488
eMedicine	article/392850
MeSH	D010017

　　[★]

英: osteoid osteoma
同: 類骨腫
関: 骨腫瘍

疫学

10,20歳代が大半を占める

好発部位

70%以上は下肢骨(大腿骨、脛骨、腓骨)の骨幹に発生。
大腿骨(頚部)、脛骨に好発 (SOR.305)

病理

類骨を盛んに形成しており、腫瘍間質は血管に富む線維性結合組織からなる。これがX線写真上nidusとして認められる領域であり、この周囲は反応性の骨硬化が見られる。

症候

夜間痛、アスピリンが奏効する疼痛

検査

単純X線写真：著明な反応性骨硬化像に囲まれた透明な病巣(nidus)が存在する。
CT

[show details]

治療

nudusの摘出

国試

105D029

「osteo」

　　[★]

骨

関: bone、os、osseous

[1] ttp://orthoinfo.aaos.org/topic.cfm?topic=A00507

[pmid11853083-2] Mungo DV, Zhang X, O'Keefe RJ, Rosier RN, Puzas JE, Schwarz EM (January 2002). "COX-1 and COX-2 expression in osteoid osteomas". J. Orthop. Res. 20 (1): 159–62. doi:10.1016/S0736-0266(01)00065-1. PMID 11853083.

[3] "Osteoid Osteoma". Knol. http://knol.google.com/k/osteoid-osteoma#Symptoms%7Cpublisher=Knol.

[4] "Bone and Soft Tissue Tumors: Benign Tumors". Dana-Farber Cancer Institute. http://www.dana-farber.org/pat/pediatric-care/pediatric-programs/bone-and-soft-tissue-tumors/osteoma.html#faq_3.

[5] Singh, Arun Pal. "Osteoid Osteoma-Diagnosis And Treatment". http://boneandspine.com/musculoskeletal-tumours/osteoid-osteomadiagnosis-treatment/.

[6] http://emedicine.medscape.com/article/392850-overview

[7] http://www.bonetumor.org/tumors-bone/osteoid-osteoma

[8] "Bone and Soft Tissue Tumors: Benign Tumors". http://www.dana-farber.org/pat/pediatric-care/pediatric-programs/bone-and-soft-tissue-tumors/osteoma.html.

[pmid11341426-9] Lindner NJ, Ozaki T, Roedl R, Gosheger G, Winkelmann W, Wörtler K (April 2001). "Percutaneous radiofrequency ablation in osteoid osteoma". J Bone Joint Surg Br 83 (3): 391–6. doi:10.1302/0301-620X.83B3.11679. PMID 11341426. http://www.jbjs.org.uk/cgi/pmidlookup?view=long&pmid=11341426.

[pmid18040677-10] Donkol RH, Al-Nammi A, Moghazi K (February 2008). "Efficacy of percutaneous radiofrequency ablation of osteoid osteoma in children". Pediatr Radiol 38 (2): 180–5. doi:10.1007/s00247-007-0690-z. PMID 18040677.

匿名

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案内

案内

osteoid osteoma