Treatment of Osteoid Osteoma by Computed Tomography Guided Excision in the Pediatric Patient

Voto, Stephen J.; Cook, Albert J.; Weiner, Dennis S.; Ewing, John W.; Arrington, Eugene L.

doi:10.1097/01241398-199010040-00017

Cited by 66 publications

(8 citation statements)

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“…D'erme et al reported 10 primary cures out of 11 patients [6]. Similar results were described by Voto et al, who use a CORB biopsy system [22]. Baunin and coworkers had a 100% success rate in eight children with osteoid osteoma by using a 7-mm diameter toothed drill [4].…”

Section: Discussionsupporting

confidence: 73%

Percutaneous CT-guided curettage of osteoid osteoma with histological confirmation: a retrospective study and review of the literature

Fenichel¹,

Garniack²,

Morag³

et al. 2006

International Orthopaedics (SICO

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Osteoid osteoma is a benign bone tumour usually occurring in young individuals (10-30 years). It presents with intense pain (typically nocturnal), which can be alleviated by salicylates. Treatment consists of surgical excision or destroying the nidus and it is curative. In the past, surgery was performed in an "open" fashion and the nidus had to be removed with a bone block. This extensive type of surgery could be associated with some rates of both failure and complication. There is growing evidence to suggest that percutaneous CT-guided removal or destruction of the nidus is a good alternative and it is indeed gaining worldwide popularity. We present a series of 18 consecutive patients with osteoid osteoma of the pelvis, femur, and tibia, treated percutaneously under CT guidance. Removal of the nidus was performed using a 4.5-mm cannulated drill and a cannulated curette of our own design. Tissue samples for histological evaluation were obtained in the same way. The mean follow-up time was 29 months. Sixteen patients were initially cured. The procedure had to be repeated in two patients and was eventually successful (primary and secondary success rates 88 and 100% respectively). The diagnosis was histologically confirmed in 14 cases out of 18 (77%). In four cases no histological confirmation of osteoid osteoma could be achieved. There were only two minor complications, one case of femoral neuropraxia and one case of skin abrasion. Percutaneous CT-guided removal seems to be efficient and safe for the treatment of osteoid osteoma. The use of a cannulated drill and a cannulated curette facilitates efficient removal of the tumour and procurement of tissue for diagnosis.

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Section: Discussionsupporting

confidence: 73%

Percutaneous CT-guided curettage of osteoid osteoma with histological confirmation: a retrospective study and review of the literature

Fenichel¹,

Garniack²,

Morag³

et al. 2006

International Orthopaedics (SICO

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“…In 1990, Voto et al reported the successful treatment of OO by percutaneous CT-guided resection [13]. Over the past two decades, several CT-guided percutaneous treatments have been described, including drilling, radiofrequency ablation (RFA), ethanol injection, and a combination of these methods.…”

Section: Discussionmentioning

confidence: 99%

Osteoid osteoma of the acetabulum successfully treated with computed tomography-guided resection and ablation using a standard electrosurgical generator: a case report

et al. 2016

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BackgroundOsteoid osteoma accounts for approximately 10% of all benign bone tumors. The most common sites of osteoid osteoma are the subcortical shaft and metaphyses of long bones, but any other skeletal bone site can be involved. The acetabulum is a rare site according to past reports. This site presents challenges to optimal management because it is anatomically difficult to approach, and because its rarity leads to limited experience with therapeutic procedures. Here, we report for the first time a rare case of osteoid osteoma in the acetabulum that was successfully treated via resection of the nidus and ablation using a standard electrosurgical generator under computed tomographic guidance. Case presentationA 9-year-old Japanese girl presented at a clinic with left hip pain without apparent cause for 1 month. She was diagnosed as having coxitis simplex. However, her pain did not change for 1 year and she was admitted to another hospital where osteoid osteoma in her left acetabulum was suspected. She was then referred to our hospital approximately 1 year after first symptom presentation, where she presented with severe left hip pain and was completely unable to walk. Computed tomography examinations revealed a well-demarcated 5 mm mass with bone sclerosis in her left acetabulum. The mass was characterized by low intensity on T1 and high intensity on T2 magnetic resonance images. These findings were consistent with osteoid osteoma of left acetabulum. She underwent computed tomography-guided resection of nidus and ablation using a standard electrosurgical generator. A histological examination confirmed acetabular osteoid osteoma. Complete pain relief was achieved after the procedure and she experienced no complications. She could walk without any pain at the final follow-up 1 year post-treatment and no local recurrence was observed.ConclusionsWe successfully treated acetabulum osteoid osteoma without any symptom recurrence by computed tomography-guided resection and ablation using a standard electrosurgical generator. In addition, we preserved our patient’s sciatic nerve and triradiate cartilage. Our report provides evidence that a computed tomography-guided procedure should be considered the treatment of choice for osteoid osteoma of the acetabulum because it is a less invasive alternative to en bloc resection.

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“…[12] The traditional treatment of osteoid osteoma consists of surgical en bloc excision. [234] The major drawback of this traditional approach is prolonged surgery and hospital stay, weakening of the bone requiring a prophylactic fixation, and its subsequent removal and additional time off school due to open surgery. To overcome this drawback, different minimally invasive techniques have been described as alternative therapeutic options (radiofrequency ablation, laser photocoagulation, and percutaneous resection).…”

Section: Introductionmentioning

confidence: 99%

“…To overcome this drawback, different minimally invasive techniques have been described as alternative therapeutic options (radiofrequency ablation, laser photocoagulation, and percutaneous resection). [34567] Computed tomography (CT) guidance has become a very useful and easy method for the percutaneous treatment of these lesions. [8] We started using CT guided radiofrequency ablation for osteiod osteoma 5 years ago and immediately noted many beneficial effects in terms of duration of hospital stay, morbidity, and overall patient comfort prompting us to do this study.…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency ablation of osteoid osteoma in common and technically challenging locations in pediatric population

Garge

Keshava

Moses

et al. 2017

Indian Journal of Radiology and Imaging

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Context:Percutaneous radiofrequency ablation (RFA) of osteoid osteoma has a high technical and clinical success rate. However, there is limited data on its use in the pediatric population, especially in technically challenging locations.Objective:To assess the safety and efficacy of computed tomography (CT)-guided percutaneous RFA of osteoid osteoma in pediatric population.Patients and Methods:From June 2009 to May 2014, 30 patients with osteoid osteoma were treated with CT-guided RFA in common (25 cases) and technically challenging (five cases: four near articular surface and one in sacrum) locations. Therapy was performed under general anesthesia with a three-array expandable RF probe for 6 min at 90°C and power of 60–100 W. The patients were discharged next day under instruction. The treatment success was evaluated in terms of pain relief before and after (1 day, 1 month, and 6 months) treatment.Results:Technical success was achieved in all patients (100%). Primary clinical success was 96.66% (29 of total 30 patients), despite the pediatric population and atypical location. One patient had persistent pain after 1 month and was treated successfully with a second procedure (secondary success rate was 100%). One patient had immediate complication of weakness of right hand and fingers extension. No delayed complications were observed.Conclusions:CT-guided RFA is relatively safe and highly effective for treatment of osteoid osteoma in pediatric population, even in technically difficult locations.

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Treatment of Osteoid Osteoma by Computed Tomography Guided Excision in the Pediatric Patient

Cited by 66 publications

References 0 publications

Percutaneous CT-guided curettage of osteoid osteoma with histological confirmation: a retrospective study and review of the literature

Percutaneous CT-guided curettage of osteoid osteoma with histological confirmation: a retrospective study and review of the literature

Osteoid osteoma of the acetabulum successfully treated with computed tomography-guided resection and ablation using a standard electrosurgical generator: a case report

Radiofrequency ablation of osteoid osteoma in common and technically challenging locations in pediatric population

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