Osteoblastomas
What is it?
Osteoblastomas are benign, locally aggressive bone-forming tumors commonly found in the posterior elements of the spine. It accounts for about 1% of all primary bone tumors and 10% of all osseous spinal neoplasms. Compared to their histological sibling, the osteoid osteoma, they are larger (>2 cm) and more frequently affect the spine. Patients typically present around the second to third decades of life, with men approximately two times more commonly affected than women. Osteoblastomas are usually well-defined tumors macroscopically.
Symptoms
Osteoblastomas commonly present with a dull pain, worse at night, with poor response to analgesics. The area is characteristically swollen and tender with a decreased range of motion, and muscle spasms.
Diagnosis
Spinal lesions often present with painful scoliosis or neurological symptoms. In addition to taking a complete medical history and performing a full physical examination, doctor will use combination of the following tests to diagnose osteoblastoma: x-rays, computerized tomography scan (CT), magnetic resonance imaging (MRI), and the bone scan.
Treatment
Treatment is surgical with the selection of procedures depending on the macroscopic and microscopic characteristics of the tumor. Intralesional curettage combined with cryotherapy can be performed in most cases. Surgical excision is associated with fewer recurrence rates; however, it needs to be performed at a very short time interval after diagnosis in order to avoid reconstitution of collateral blood supply, otherwise lesions are prone to extensive intraoperative bleeding.