Nerve Fibers in Osteoid Osteoma

Schulman, Larry L.; Dorfman, Howard D.

doi:10.2106/00004623-197052070-00008

Cited by 130 publications

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“…In our case, the lack of nerve endings in the otic capsule could explain this unusual clinical feature. 7 Vertigo, tinnitus, and hearing loss described in our patient might be related to the particular location of the tumor. Indeed, these symptoms may be related to the posterior labyrinth involvement and especially the endolymphatic duct.…”

Section: Discussionmentioning

confidence: 58%

Osteoid Osteoma Invading the Posterior Labyrinth of the Petrous Bone

Dugert¹,

Lagleyre²,

Brouchet³

et al. 2010

AJNR Am J Neuroradiol

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SUMMARY:We report a painless osteoid osteoma of the inner ear in an elderly woman presenting with hearing loss, tinnitus, and vertigo. CT showed a heterogeneous mass containing calcifications involving the posterior labyrinth, which heterogeneously enhanced on postcontrast MR images. Osteoid osteoma should be included in the differential diagnosis of an osteolytic petrous bone lesion with central calcification and enhancement.ABBREVIATIONS: OO ϭ osteoid osteoma O steoid osteoma is a benign osteoblastic tumor, most frequently diagnosed in young men presenting with characteristic pain at the site of the lesion, increasing at night and relieved by salicylates. On CT, the lesion is characterized by a zone of bony sclerosis surrounding a central radiolucent area. 1 OO usually involves long bones and the vertebral column and extremities and is very uncommon in the skull.2 Temporal bone OO is even rarer, with only 4 cases described in the literature, none of which were located in the inner ear.3-5 We report here the first case of a pathologically proved OO invading the posterior labyrinth and review the relevant literature. Case ReportA 77-year-old healthy woman presented with a several-months' history of right hearing loss, vertigo, and tinnitus. There was no associated pain. Physical examination confirmed hearing loss and an estimated vestibular deficiency of 70% on the right side. CT showed an osteolytic, heterogeneous, rounded, well-demarcated petrous lesion, measuring 11 ϫ 6 mm, with central calcifications (Fig 1A). Although such calcifications have been interpreted as newly produced osteoid trabeculae, remnants of destroyed bone might have been possible as well. The lesion spared the cochlea but invaded the posterior labyrinth and the endolymphatic duct. There was a close relationship with the facial nerve (Fig 1B). No sclerotic bone was seen surrounding the lesion. At MR imaging, the lesion demonstrated intermediate signal intensity on T1 and high signal intensity on T2-weighted images and enhanced intensely and heterogeneously after intravenous gadolinium administration (Fig 2). Technetium Tc99m scintigraphy showed a corresponding increased uptake in the petrous bone. The preoperative diagnosis was hemangioma.A surgical approach through a mastoidectomy revealed a gray lesion. The center of the lesion was soft and hemorrhagic, but its periphery was hard and indistinguishable from the surrounding normal bone. Because of the anatomic contact with the tympanic segment of the facial nerve, the lesion was only partially excised. Definitive pathologic examination revealed a nidus formed by a hypervascular young conjunctival stroma with osteoblasts, multinucleated giant cells, and thin osteoid trabeculae, consistent with osteoid osteoma (Fig 3). The postoperative course was uneventful, with normal facial nerve function. At 6-month follow-up, the vertigo had disappeared but the tinnitus remained unchanged. DiscussionOO is a frequent, benign, primary bone tumor accounting for approximately 10% of all primary bone tumors....

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Section: Discussionmentioning

confidence: 58%

Osteoid Osteoma Invading the Posterior Labyrinth of the Petrous Bone

Dugert¹,

Lagleyre²,

Brouchet³

et al. 2010

AJNR Am J Neuroradiol

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“…Since Jaffe (20,21) first reported OO as "a particular lesion of probable neoplastic nature" in 1935, the tumor has been recognized as a benign bone tumor manifesting characteristic inflammatory symptoms such as nocturnal pain and marked aspirin responsiveness (22)(23)(24). Intraarticular OO was first described by Sherman et al (25) in 1947, and COX-2, cyclooxygenase-2; cPLA2, cytosol phospholipase 2; IL-1␤, interleukin-1 beta; TNF␣, tumor necrosis factor alpha; GAPDH, glyceraldehyde-3-phosphate dehydrogenase.…”

Section: Discussionmentioning

confidence: 99%

Intraarticular Osteoid Osteoma Associated with Synovitis: A Possible Role of Cyclooxygenase-2 Expression by Osteoblasts in the Nidus

Kawaguchi

Sato

Hasegawa³

et al. 2000

Modern Pathology

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To clarify the condition of development of synovitis associated with intraarticular osteoid osteoma (OO), expressions of cyclooxygenase-2 (COX-2) protein and its messenger ribonucleic acid were investigated both in the nidus and the synovial tissue using immunohistochemical and reverse transcription-polymerase chain reaction analyses. Diffuse and strong COX-2 immunoreactivity was found in osteoblast-like tumor cells in the nidus of all six cases of OO (three of six cases were intraarticular OO associated with synovitis) and one case of osteoblastoma associated with synovitis. Expression of COX-2 messenger ribonucleic acid was demonstrated in one case of OO associated with synovitis, and was higher in the nidus than that in the inflamed synovial tissue. However, there were no significant difference between the nidus and synovium in the expression of cytosolic phospholipase A2, one of the enzymes involved in arachidonic acid metabolism, and inflammatory cytokines such as interleukin-1␤ and tumor necrosis factor alpha. Finally, as there was only one case in which the examinations of gene expression were performed, no definitive overall conclusions could be reached; rather it is suggested that COX-2 expressed primarily by osteoblasts in the nidus of intraarticular OO may play a role in activating the pathway of arachidonic acid metabolism, resulting in synovitis of the involved joint.

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“…There is also reactive bone formation surrounding the lesion due to the high pressure exerted by the tumor on the surrounding normal bone. [14] Schulman and Dorfman [15] demonstrated abundant nerve fibres located within the matrix of the nidus adjacent to areas rich in arterioles. Pain in osteoid osteoma is due to high levels of prostaglandin synthesis within the nidus of the tumor which have been proven in several studies, which further explains the rapid relief of pain seen on intake of salicylate group of drugs [9].…”

Section: Discussionmentioning

confidence: 99%

Ischium: A Rare Location for Osteoid Osteoma

Kumar¹,

L²

2017

JCR

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Background: Osteoid osteoma is a benign osteoblastic tumor of unknown etiology constituting 10-12% of benign bone tumors. Pelvic involvement has been described mostly in acetabulum. Case Report: 42 years old male patient presented with history of fall and pain in right hip region. X-ray showed a well-circumscribed lytic lesion with central rounded radiolucent nidus in the right ischial tuberosity with surrounding bone sclerosis. Conclusion: Osteoblastoma is a distinct benign tumor to be considered as a differential. Ischial tuberosity is a rare location for osteoid osteoma. This unusual location for this tumor combined with altered clinical symptoms leads to late diagnosis.

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Nerve Fibers in Osteoid Osteoma

Cited by 130 publications

References 0 publications

Osteoid Osteoma Invading the Posterior Labyrinth of the Petrous Bone

Osteoid Osteoma Invading the Posterior Labyrinth of the Petrous Bone

Intraarticular Osteoid Osteoma Associated with Synovitis: A Possible Role of Cyclooxygenase-2 Expression by Osteoblasts in the Nidus

Ischium: A Rare Location for Osteoid Osteoma

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