Comparison of Osteoid Osteoma (OO) and Osteoblastoma (OB)

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Similarities

  • the most common cause of painful scoliosis in adolescence, OO>OB
  • histologically similar and related
  • majority involve the posterior elements, vertebral body destruction is rare
  • majority lie within the lumbar spine >thoracic>cervical and sacral
  • most diagnosed within 2 years of symptoms
  • Radiographic evaluation: bone scan is most sensitive. CT to examine bone borders and MRI for neurological deficits.

Differences

Osteoid Osteoma

Osteoblastoma

Percent of Primary bone tumor

11%

<5%

Percent occurring in spine

10%

>40%

Size

< 2 cm

> 2 cm

Patient age at Diagnosis

6-17 years

10-15 years

Pain

May occur at night

No definite time

Relief of pain

May be relieved by aspirin or non-steroidal anti-inflammatory

Not relieved by anything consistently

Radiculopathy

Rare

Can occur

Myelopathy

Rare

Can occur

Destruction of bone, expansion into spinal canal or involvement of adjacent VB

Rare

Can occur

Radiographic appearance

Radiolucent nidus surrounded by sclerosis

Slow growing expansile, destructive lesion. Calcifications are present

Malignant transformation

No

Yes. Osteosarcoma differentiation or metastasis may occur.

Treatment

Treatment of pain may be sufficient. Otherwise complete surgical removal. Redo extirpation for recurrence.

Surgical Extirpation. Redo extirpation for recurrence. Radiation is last resort.

Recurrence rate with “total resection”

Almost 0%

10%

Improvement in scoliosis after treatment

If less than 15 months

unknown

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