Medizinische Universität Graz - Research portal
Selected Publication:
Meszarics, M.
Clinicopathological characterization of osteoid osteomas treated in a single institution and comparison of two treatment modalities – a retrospective study
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 60
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- Authors Med Uni Graz:
- Advisor:
- Brcic Iva
- Igrec Jasminka
- Altmetrics:
- Abstract:
- Introduction: Osteoid osteoma (OO) is a benign bone-producing tumor. Radiologically, it is characterized by an intracortical nidus, with calcification and cortical thickening, sclerosis, and bone marrow edema. The nidus has self-limiting growth, with time it becomes asymptomatic and heals spontaneously. The characteristical clinical presentation is the night pain that relieved by salicylates. On computed tomography (CT) and magnetic resonance imaging (MRI) findings, OO can be classified according to their location as: medullary, endosteal, intracortical and subperiosteal. CT-guided percutaneous radiofrequent ablation (RFA) is a safe, minimally invasive, technique for treatment of OOs. Surgical resection/curettage is reserved for spinal lesions or unclear cases. The aim of our study was to summarize epidemiological, clinical, and radiological data of patients with OOs treated in our institution. In addition, we wanted to evaluate the treatment results. Methods: We retrospectively studied 122 patients with OO in the period from January 2005 to September 2019. Patients were selected from a tumor database using either histological (for those patients undergoing surgery) or radiological diagnosis of OO. Available imaging examinations performed were analyzed for the presence of typical imaging findings of OO. Results: The study included 43 (35%) females and 79 (65%) males; mean patient age was 21.2 years. The OOs were most frequently located in the femur (n=39; 32%), the tibia (n=37; 30,3%), the humerus (n=9; 7,4%), and the radius (n=4; 3,3%). The rest (n=34, 27,9%) were found in sacrum, spine, scapula, feet, hands, ulna, fibula, patella, and acetabulum. Lesions arose cortically in 79.5% of patients. In one case, the tumors were multifocal. CT was performed in 108 and MRI in 106 patients. The mean nidus size was 8.65±5,0 mm (range 2 –25 mm). The tumors were diagnosed with a delay of 13.3±17.4 months. Finally, a total of 118 patients were treated in our institution: 71 (60.2%) were treated with RFA and 42 (35.6%) underwent surgery. 5(4.2%) patients underwent both treatments. Last four patients received only conservative treatment. The primary clinical success rate was 90,1%, and 81,0% for RFA and surgery, respectively, while the secondary clinical success was 100% in both groups. In 9,9% of the patients undergoing RFA complications developed. Conclusion: OO is more frequently arising in male patients, is usually found in the lower extremities, and is most commonly located cortically. The delay in the diagnosis is significant in patients with OO – this could be prevented by good clinical history and proper radiological methods. When compared to surgical treatment, RFA is a safe, reliable and efficient method for OO treatment.