Osteoid Osteoma in Children Younger than 3 Years of Age

Abstract

We present a case series of four children, younger than 3 years old, with osteoid osteoma of the lower limb. Pain and limping were the main symptoms. With careful clinical examination, we could localize the affected area. Radiological evaluation revealed cortical thickening in 3 children. On MRI examination, we found extensive edema, with normal bony cortices. The central nidus was found in 3 children. CT scan was the most accurate examination which revealed the central nidus with surrounding sclerosis. Bone scans had positive uptake in the affected area. Our patients were treated with an intralesional excision biopsy, with simultaneous radiofrequency ablation in those affected in the femur. Pathological specimens confirmed the diagnosis of osteoid osteoma. There was uneventful recovery of our patients. This case series contributes to the limited description of osteoid osteoma diagnosed and treated in very young children.

Another Rare differential diagnosis of infant limping: A case of talar osteoid osteoma

“…9 In their series of 4 children under the age of 3 years, Laliotis et al reported the presence of OO in the lesser trochanter of one of the children without the appearance of the central nidus on X rays or MRI. 4 In such instances, where the nidus is obscured by the surrounding sclerosis, CT scan is the modality of choice to help differentiate OO from other lesions such as chronic osteomyelitis with a Brodie's abscess, eosinophilic granuloma, and small round blue cell tumor such as Ewing sarcoma or metastatic neuroblastoma. 5,9 Furthermore, when the central nidus diameter exceeds 1.5 cm, osteochondroma should be considered in the differential diagnosis.…”

“…In most cases it shows increased uptake in the affected area with the classical double density sign. 4,5,7 This highlights the importance of combination of different imaging modalities when one of them is inconclusive.…”

“…3 When presented in the pediatric patient, the most commonly reported symptoms are nocturnal pain and limping. 4 Radiologic evaluation is usually sufficient to establish the diagnosis. On plain X-rays, OO appears as a characteristic small lesion (<1.5 cm) with a sclerotic margin and radiolucent nidus.…”

Benign Bone Tumors: An Overview of What We Know Today

“…Introduction A bone-forming tumor is a benign osteoblastic tumor, accounting for 12% of benign tumors of the bone [4]. It can develop at any age, even before 3 years old [5,6], but its typical presentation is in the second decade, more frequently in boys (two to four times more than girls) [7]. Usually solitary, there have been reports about rare metachronous presentations [8].…”

Recent advances on diagnosis and treatment of osteoid osteoma

“…Osteoid osteoma in microscopic examination shows a focus(nidus) build-up with osteoid tissue, surrounded with reactive sclerotic bone with elements of inflammation [9]. Usually, nidus does not exceed 1cm in diameter.…”