A rare case of giant osteoblastoma of the sacrum

Der seltene Fall eines Riesenosteoblastoms im Os sacrum

Abstract

Background

An osteoblastoma is a rare benign bone tumor characterized by formation of osteoid tissue and primitive bone and occurs more often in men than in women. They are often secondary to an osteoid osteoma and can be located at any site on the skeleton. Lesions generally involve the posterior elements of the spine, such as the pedicle and the lamina.

Case presentation

This study reports the case of a 25-year-old female who suffered from an osteoblastoma of the right sacrum with repeated swelling and pain in the right lumbosacral region for approximately 6 months. Computed tomography (CT) and magnetic resonance imaging (MRI) of the pelvis revealed a segmented, expansive, multiseptate lesion. Resection with wide margins was performed and a huge cavity of approximately 15 × 8 × 4.4 cm in the right sacrum and pelvis was formed after complete curettage of the tumor. The pathological analysis of the resected tissue was consistent with a benign osteoblastoma. A follow-up was performed 2 years later and the patient was eventually relieved of the pain, the mobility of the right leg was improved and the CT scan demonstrated no evidence of recurrence.

Conclusion

Osteoblastomas most commonly occur in the spine but rarely also in the sacrum. Large core needle biopsies play an important role in the diagnostics. Intralesional surgery can be performed for treatment of osteoblastomas.

Zusammenfassung

Hintergrund

Das Osteoblastom ist ein seltener benigner Knochentumor, der durch die Bildung von Osteoidgewebe und primitivem Knochen gekennzeichnet ist. Er ist bei Männern häufiger als bei Frauen. Osteoblastome treten oft sekundär zu einem Osteoidosteom auf und können sich an jeder Stelle im Skelett befinden. Die Läsionen betreffen i. d. R. die hinteren Elemente der Wirbelsäule, beispielsweise die Pedikel und die Lamina.

Kasuistik

Wir präsentieren den Fall einer 25-jährigen Frau, die etwa 6 Monate lang an einem Osteoblastom des rechten Kreuzbeins mit wiederkehrenden Schwellungen und Schmerzen in der rechten Lumbosakralregion litt. Die Computer- und die Magnetresonanztomographie (CT, MRT) des Beckens zeigten eine segmentierte, expansive, vielfach septierte Läsion. Nach großzügiger Resektion und vollständiger Kürettage des Tumors war eine sehr große Kavität von etwa 15 × 8 × 4,4  cm im rechten Os sacrum und im Becken entstanden. Die histopathologische Befundung war vereinbar mit einem gutartigen Osteoblastom. Ein Follow-up wurde 2 Jahre später durchgeführt. Schließlich litt die Patientin nicht mehr unter Schmerzen, die Beweglichkeit des rechten Beins war verbessert und in der Kontroll-CT zeigten sich keine Hinweise für ein Rezidiv.

Schlussfolgerung

Osteoblastome treten am häufigsten in der Wirbelsäule auf, selten auch im Os sacrum. Von Relevanz für die Diagnose ist eine Kernbiopsie mit einer großlumigen Nadel. Intraläsionale Operationen sind eine Option zur Behandlung von Osteoblastomen.

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Fig. 1
Fig. 2

Abbreviations

MRI:

Magnetic resonance imaging

CT:

Computed tomography

T1WI:

T1 weighted image

T2WI:

T2 weighted image

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Acknowledgements

The authors thank the Engineering Technology Research Center construction project of Jiangxi Province for assisting in this paper.

Funding

All research costs were supplied by the three projects, NSFC (No. 81460341), Gan-Po Talents Project 555 of Jiangxi Province, Jiangxi Provincial Department of Science and Technology (20171BAB205059) and Jiangxi provincial department of education (GJJ160127)

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Corresponding author

Correspondence to Dr. Bin Zhang.

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Conflict of interest

Q. Lai, Q. Wang, H. Liu, D. Chen, Z. Wan, X. Yu, R. Guo, X. Liu, M. Dai and B. Zhang declare that they have no competing interests.

This study was approved by the ethical review committee of The First Affiliated Hospital of Nanchang University Medical School and written informed consent was obtained from the patient.

Additional information

Authors’ contributions

The authors Q. Lai, Q. Wang and Hucheng Liu share the first authorship.

Q. Lai and Q. Wang wrote the initial draft. X. Yu, X. Liu, R. Guo, M. Dai reviewed the literature. B. Zhang and H. Liu were the surgeons who treated the patient. All authors read and approved the final manuscript.

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Cite this article

Lai, Q., Wang, Q., Liu, H. et al. A rare case of giant osteoblastoma of the sacrum. Orthopäde 48, 343–347 (2019). https://doi.org/10.1007/s00132-018-3638-0

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Keywords

  • Osteoid osteoma
  • Curettage
  • Aneurysmal bone cyst
  • Surgical procedures, operative
  • Resection

Schlüsselwörter

  • Osteoidosteom
  • Kürettage
  • Aneurysmatische Knochenzyste
  • Operative chirurgische Interventionen
  • Resektion