Osteoid osteoma

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  1. Benign skeletal neoplasms with a central nidus of interlacing osteoid and woven bone mixed with loose fibrovascular stroma; sharply demarcated from surrounding bone and surrounded by osteosclerosis
  2. Patients are usually young with a male preponderance
  3. 10% of osteoid osteomas are found in the spine most commonly the lumbar spine in the neural arch
  4. pain is present in over 95% of cases that usually improves with salicylates
  5. different from hamangioblastomas which typically present in the vertebral body and are a polka dot like lesion
  6. different from osteoblastomas (also benign) which also occur in the neural arch but are expansile lytic masses with matrix mineralization; also presents with pain but does not occur at night nor does it respond to aspirin; osteoblastomas are also larger; radiographically see well demarcated lytic lesion with smooth calcified rim that resemble eosinophilic granulomas however some degree of mineralization is often present in the center of the lesion that gives it the appearance of a button lesion
    1. cells between scattered bony trabeculae tend to have an epithelioid appearance
  7. different from aneurysmal bone cysts which are multiloculated, expansile, with eggshell like rims and blood products with fluid fluid levels
  8. different from osteomas which are composed of lamellar bone (most commonly seen in the facial skeleton) and look like the cap on a shunt reservoir on plain film
  9. different from osteogenic sarcoma which is the second most common primary malignant tumor of bone after multiple myeloma
    1. osteogenic sarcoma usually presents as a painful mass in the mandible and maxilla; shows bone production, destruction, and periosteal reaction; requires amputation if occurring in the extremities
    2. has many pleomorphic, hyperchromatic cells with irregular shape

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

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