A recurring osteoblastoma that initially presents as a typical osteoid osteoma: a case report

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Figure 1: a, b, c and d: Initial X-ray and computed tomography scan showing osteocondensation in the upper third of the femur, consistent with a nidus
Published Mar 30, 2025
https://doi.org/10.62438/tunismed.v103i4.5558
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Vol. 103 No. 4 (2025): Tunis Med Apr 2025

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Mohamed Achraf Ferjani
Pediatric Orthopedic Department, Kassab Orthopedic Institute, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Mohamed Taghouti
Pediatric Orthopedic Department, Kassab Orthopedic Institute, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Leila Abid
Anatomopathology Department, Kassab Orthopedic Institute, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Mourad Jenzri
Pediatric Orthopedic Department, Kassab Orthopedic Institute, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Khaled Kamoun
Pediatric Orthopedic Department, Kassab Orthopedic Institute, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia

Abstract

Introduction: Osteoid osteoma and osteoblastoma are benign bone tumors with similar histologic features, often distinguished by size and clinical behavior. Their relationship remains a topic of debate.


Observation: An 8-year-old boy presented with a femoral diaphyseal lesion initially diagnosed as osteoid osteoma based on resection biopsy. However, within six months, the boy experienced increased pain and rapid growth, with subsequent biopsy revealing aggressive osteoblastoma. This suggests the initial lesion may have been an early-stage osteoblastoma.


Conclusion: This case challenges the concept of osteoid osteoma transforming into osteoblastoma. While histologically similar, these tumors should be considered distinct entities, and size alone may not be a reliable differentiating factor. Careful clinical and pathological correlation, with attention to growth rate, is crucial for accurate diagnosis and management.


 

Keywords:

Biopsy, Bone Neoplasms, Child, Diagnosis, Differential, Recurrence

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Frassica FJ, Waltrip RL, Sponseller PD, et al. Clinicopathologic features and treatment of osteoid osteoma and osteoblastoma in children and adolescent. Orthop Clin North Am. 1996;27:559-574.
  2. Dahin DC. Bone tumors (Ed. 3). Charles C Thomas, Springfield, Illinois; 1967.
  3. Schajowicz F, Lemos C. Osteoid osteoma and osteoblastoma. Closely related entities of osteoblastic derivation. Acta Orthop Scand. 1970;41:272.
  4. Gitelis S, Schajowicz F. Osteoid osteoma and osteoblastoma. Orthop Clin North Am. 1989;20:313-325.
  5. Jaffe HL. Benign osteoblastoma.Bull Hosp Joint Dis.1956 Oct;17(2):141-51.
  6. Dale S, Breidahl WH, Baker D, Robbins PD, Sundaram M. Severe toxic osteoblastoma of the humerus associated with diffuse periostitis of multiple bones. Skeletal Radiol. 2001;30(8):464-8.
  7. McLeod RA, Dahin DC, Beabout JW. The spectrum of osteoblastoma. AJR. 1976;126:321-335.
  8. Atesok KI, Alman BA, Schemitsch EH, Peyser A, Mankin H. Osteoid osteoma and osteoblastoma. J Am Acad Orthop Surg. 2011;19:678-689.
  9. Shields DW, Sohrabi S, Crane EO, Nicholas C, Mahendra A. Radiofrequency ablation for osteoid osteoma - Recurrence rates and predictive factors. Surgeon. 2018;16(3):156-162.
  10. Bruneau M, Polivka M, Cornelius JF, George B. Progression of an osteoid osteoma to an osteoblastoma. Case report. J Neurosurg Spine. 2005;3:238-241.
  11. Cappuccio M, De Iure F, Amendola L, Corghi A, Gasbarrini A. Cervical osteoid osteoma progression to osteoblastoma. Spine J. 2014;14(6):1070-1.
  12. Jackson RP, Reckling FW, Mants FA. Osteoid osteoma and osteoblastoma. Similar histologic lesions with different natural histories. Clin Orthop Relat Res. 1977;(128):303-13
  13. Dunlop JA, Morton KS, Eliott GB. Recurrent osteoid osteoma. Report of a case with a review of the literature. J Bone Joint Surg Br. 1970;52(1):128-33.
  14. Morton KS, Quenville NF, Beauchamp CP. Aggressive osteoblastoma. A case previously reported as a recurrent osteoid osteoma. J Bone Joint Surg Br. 1989;71(3):428-31.