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CT-guided percutaneous cryoablation of an osteoid osteoma of the rib^☆.

ABSTRACT: An osteoid osteoma is a benign bone tumor that arises from osteoblastic dysfunction and usually presents as nonspecific, nocturnal pain located in the diaphysis of long bones, with <1% occurring in the ribs. It is most commonly treated with nonsteroidal anti-inflammatory drugs or merely observed; when these treatments do no prove efficacious, either open surgery or interventional ablation are pursued. Herein, we report a rare case of an osteoid osteoma located in the rib of a 19-year-old male that was histologically diagnosed through computed tomography (CT)-guided biopsy. Using CT guidance, the tumor was ablated by creating an artificial pneumothorax in order to induce a margin of space safe enough for cryoablation. It is important to be aware of the possibility that an osteoid osteoma may be present in the ribs, as the differential diagnosis includes costochondritis, pneumonia, osteoblastoma, enchondroma, osteosarcoma, cyst, and Brodie abscess. In addition, we have shown that CT-guided cryoablation can be an effective and less invasive treatment when compared to open en bloc resection, highlighting the role of interventional radiology in bone tumor ablation.

SUBMITTER: Basappa E

PROVIDER: S-EPMC6321969 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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CT-guided percutaneous cryoablation of an osteoid osteoma of the rib<sup>☆</sup>.

Basappa Eric E Rabang Joshua J Anderson William W Richardson Randy R Scott Ryan R

Radiology case reports 20190104 3

An osteoid osteoma is a benign bone tumor that arises from osteoblastic dysfunction and usually presents as nonspecific, nocturnal pain located in the diaphysis of long bones, with <1% occurring in the ribs. It is most commonly treated with nonsteroidal anti-inflammatory drugs or merely observed; when these treatments do no prove efficacious, either open surgery or interventional ablation are pursued. Herein, we report a rare case of an osteoid osteoma located in the rib of a 19-year-old male th ...[more]

PMID: 30627298

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Project description:BackgroundThe traditional treatment for osteoid osteoma is the nidus' surgical resection, which was difficult to eradicate with more invasive and complications because of osteosclerosis surrounding the nidus. This study aimed to analyze the efficacy and safety of percutaneous CT-guided cryoablation of osteoid osteoma at different sites (especially refractory sites such as the spine).MethodsFifteen patients with osteoid osteoma who underwent cryoablation at our institution were analyzed retrospectively on their imaging data and clinical visual analog scale (VAS) pain scores before and after the procedure. Fifty-three patients underwent surgical resection during the period were also included in this study as a control group. Treatment efficacy was assessed primarily by comparing the differences in VAS scores at different time points in each group of patients by paired-sample t-test. Differences in length of hospital stay and complications between the two groups were also compared.ResultsThe technical success rate was 100% in both the cryoablation and surgical resection group. Cryoablation had a significantly shorter hospitalization time than surgery (p = 0.001). Clinically, the post-operative VAS scores were all significantly improved compared to the pre-operative period, and the clinical cure was achieved in both groups. Surgical operations had more complications than cryoablation, although there was no significant difference. In the group of cryoablation, only one patient had mild numbness of the left lower extremity, which relieved itself; two patients had mild post-operative pain. No patients in the cryoablation group experienced recurrence during the follow-up period. In the surgery group, three of the patients experienced massive bleeding (>500 ml), and two underwent transfusion therapy. Only one patient in the surgical resection group experienced a recurrence at 29 months postoperatively and underwent a second resection. All patients had local scars on the skin after surgical resection.ConclusionCryoablation is a minimally invasive, safe, and effective treatment strategy for osteoid osteoma, and is fully comparable to surgical resection.

Dataset Information

CT-guided percutaneous cryoablation of an osteoid osteoma of the rib^☆.

Publications

CT-guided percutaneous cryoablation of an osteoid osteoma of the rib<sup>☆</sup>.

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Dataset Information

CT-guided percutaneous cryoablation of an osteoid osteoma of the rib☆.

Publications

CT-guided percutaneous cryoablation of an osteoid osteoma of the rib<sup>☆</sup>.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

CT-guided percutaneous cryoablation of an osteoid osteoma of the rib^☆.