An osteoid osteoma is a benign tumor change in the skeleton. Complaints are rarely caused by the benign bone tumor.
What is osteoid osteoma?
Osteoid osteoma is the name for a tumor that originates in osteoblasts (special bone cells). The bone tumor is up to two centimeters in diameter. It is particularly common on tubular bones. These primarily include the thigh bone (femur) and the shin bone (tibia). See theinternetfaqs for Helicobacter Pylori Infection Basics.
Osteoid osteoma ranks third in the frequency of noncancerous (benign) bone changes, behind osteoma and nonossifying fibroma. The bone tumor appears mainly in adolescence. The upper part of the thigh bone is particularly affected. But the tibia and spine are also often affected by the changes.
The proportion of osteoid osteomas in bone tumors is around 14 percent. In most cases, it shows up in male adolescents between the ages of 10 and 20. Sometimes the tumor occurs before the age of 10. From the age of 30 it is only very rarely recorded.
The osteoid osteoma originates in the outer hard cortex of the bone tissue. It has not yet been possible to find out what causes the benign bone tumor. Osteoma is inherited in some cases. In the discussion about the triggers of the tumor are external physical and chemical influences. Injuries and nuclear radiation are also considered conceivable triggering factors.
Benign bone tumors often appear when the bones grow too rapidly. Growth hormones are also considered a possible risk factor. In the case of bone tumors, medicine distinguishes between osteoid osteomas, osteomas and osteoblastomas that originate in bone cells, osteochondromas, chondroblastomas and chondromas that originate in cartilage tissue, osteoclastomas and bone fibromas that originate in connective tissue, and bone hemangiomas that originate in vascular tissue.
Symptoms, Ailments & Signs
In many cases, an osteoid osteoma causes no symptoms. However, some patients may experience pain, which occurs mainly during the night hours. They usually start suddenly and appear on the knee, hip or back. However, the symptoms do not clearly point to an osteoid osteoma.
They occur independently of movement and come from the depths. The pain usually improves after taking acetylsalicylic acid (ASA). Occasionally, the benign tumor can even be felt, which becomes noticeable as local swelling.
Diagnosis & course of disease
If the pain caused by the osteoid osteoma leads the young patient to see a doctor, the doctor will first take a look at the medical history (anamnesis). The doctor asks since when, how often and where the pain occurs. After the interview, a physical examination is carried out. Occasionally, the doctor can feel the tumor.
Imaging methods are used to obtain further information. This includes, above all, the preparation of X-rays. The images usually show a swelling of the cortical bone (bone bark). There is also a connective tissue compaction that is a few centimeters in size. A round brightening focus can be seen in the center of the densification, which is called the nidus.
Computed tomography (CT) can be used to determine the extent of the tumor. Another diagnostic method is the bone scintigram. In this method, radioactive substances are administered into the bone tissue. This allows the doctor to determine the increased intake of technetium. A bone biopsy (removal of tissue) is performed to confirm the diagnosis.
The sample taken is then examined for histological examination under a microscope in a laboratory. Connective tissue that is well supplied with blood and is surrounded by sclerotic bone is considered an indication of an osteoid osteoma. Blood tests are more suitable for excluding other diseases because the osteoid osteoma does not cause any changes in the blood.
An osteoid osteoma takes a positive course. This prevents the formation of metastases (secondary tumors). Malignant degeneration is also ruled out. If the benign bone tumor is surgically removed, it is usually cured.
The osteoid osteoma itself usually does not cause any complications. It is a benign bone tumor that has no tendency to degenerate. However, the disease manifests itself with pain, which usually occurs at night. Since the pain often becomes chronic, it is essential to treat it.
If left untreated, however, they can trigger various complications such as growth disorders, arthrosis or scoliosis. The pain causes postural damage due to constant avoidance behavior. This consequential damage can lead to restricted mobility and additional chronic pain. Of course, psychological problems such as depression can also occur as further consequences if the patient feels that they can no longer participate in everyday life.
This is particularly serious for the people affected because the disease usually occurs in a particularly sensitive and turbulent phase of growth between the ages of 11 and 20. In order to avoid these serious effects, if an osteoid osteoma is present, an attempt is first made to alleviate the pain symptoms with medication by administering ASA. In some cases, however, this does not help.
Then the tumor needs to be surgically removed. A removal (ablation) of the nidus with the help of toxic substances or radio frequency therapy is also possible. The procedure of curettage, which used to be common in the past, is no longer carried out today because recurrences often occurred here due to incomplete removal.
When should you go to the doctor?
Bone pain, restricted mobility and sensory disturbances in the arms or legs indicate an osteoid osteoma. Specialist medical help is needed if the warning signs persist or become more severe rapidly. A doctor should also be consulted if other symptoms occur. Osteoid osteoma is a serious condition that requires prompt diagnosis and treatment. Otherwise, the tumors can spread and spread to other organs outside of the bones or even affect other bones. Anyone who notices increasing pain that cannot be traced back to a specific cause should speak to their doctor immediately.
This is particularly necessary if cancer has already occurred in the past. Then the sick person must speak to the responsible doctor. The same applies to genetic predispositions or the presence of any risk factors, such as working in a nuclear power plant or contact with other cancer-causing substances. Affected people should talk to their family doctor, an oncologist, or an orthopedist. Depending on the severity of the disease, the tumor must then be removed surgically or by means of radiation or chemotherapy. Therapy and aftercare always take place under strict medical supervision.
Treatment & Therapy
Osteoid osteoma treatment is not always necessary if there are no symptoms and the bone is stable. In addition, the diagnosis must be secured. The aim of therapy is to eliminate the pain and stabilize the bone again.
Osteoid osteoma is treated surgically. The bone tumor must be completely removed in order to achieve freedom from symptoms. Otherwise there is a risk that it will form again later. The surgical procedure depends on the part of the body where the tumor is located.
If it is located in an area where there is only little physical stress, the surgeon operates on it in blocks from the affected bone area, while simultaneously removing the rim. If, on the other hand, the tumor is in an unfavorable position and there is therefore a risk of bone fracture, the bone cortex is first removed until the nidus can be seen in the surgical area.
It is removed with a surgical curette. However, this method has the disadvantage that the tumor may not be completely removed. This applies in particular to surgical areas that are difficult to access. An advantage of the procedure, on the other hand, lies in the load stability of the bone tissue and in the lower risk of bone fracture.
Outlook & Forecast
Although osteoid osteoma is a form of bone cancer, the prognosis is positive. On the one hand, an osteoblastic tumor is very small. Sometimes it’s only the size of a pinhead, sometimes it’s the size of a cherry stone. Second, osteoid osteoma is a benign new bone formation. Metastases therefore do not occur.
Nevertheless, osteoid osteoma is one of the primary tumor types. Young people under the age of 30 are particularly affected. As the third most common bone tumor, osteoid osteomas primarily affect male patients. The prognosis depends on the extent and location of the bone tumor. However, it is very unlikely that osteoid osteomas will become cancerous. After the diagnosis, the patient often waits to see how the tumor develops. This is because 30 percent of osteoid osteomas resolve spontaneously.
If this is not the case, surgical removal of the tiny tumor may have to be considered after unsuccessful pain therapy. This makes sense if the tumor causes too much pain. These tend to occur at night. They can become chronic. In order to prevent chronification and the resulting complications, removal of the osteoid osteoma is recommended. This can prevent pain-related protective postures, growth problems and other consequences of tumor formation.
The previously performed curettage of the tumor often led to tumor recurrences. It is no longer practiced today.
Preventing an osteoid osteoma is not possible. The responsible causes are still unknown.
Follow-up care is an essential part of cancer therapy. Those affected are invited to continuous follow-up checks to prevent the symptoms of a new tumor. An osteoid osteoma is a benign growth. This also requires follow-up care, not only after an intervention, but also if an operation is not carried out.
The latter procedure is usual in the absence of complaints. Observation serves as a precautionary measure to avoid complications. Doctor and patient agree on the place and rhythm of the aftercare. Most examinations take place in a clinic. Six-monthly appointments are usually sufficient for a check.
Quarterly appointments are useful immediately after therapy. Following a surgical procedure, a rehabilitation measure can be useful. In this way, therapists accompany you on your way into your professional and private everyday life. A follow-up examination consists of a detailed discussion in which possible complaints are queried.
Imaging procedures such as X-rays and a CT allow a clear conclusion to be drawn as to whether the tumor has developed further or is newly formed. If movement restrictions have arisen as a result of an osteoid osteoma, physiotherapy can provide a remedy if necessary. After an operation, many patients receive temporary painkillers, the effect of which is gradually reduced.
You can do that yourself
Despite the good prognosis and the fact that these tumors are benign and do not cause any symptoms themselves, patients can experience pain. For example, if the tumor is in a joint or presses on a nerve, movement impairments can also occur. For this reason and other medical considerations, the attending physicians may then recommend surgical removal of the osteoid osteoma.
The physiotherapy and/or occupational therapy sessions prescribed after an operation must be observed, as they are intended to prevent adhesions in the operated areas and thus further restriction of movement. The exercises learned there should also be continued after the therapy. In any case, the patient should be prepared for medical follow-up care for several years, since the osteoid osteoma can come back.
Patients with an unremoved osteoid osteoma must fear that the bone in this area will break more quickly. Therefore, they should carefully protect themselves from accidents. Abrupt loads and compressions should also be avoided. Less accident-prone sports such as hiking, jogging or cycling are recommended instead of soccer or other team sports.
Since the disease is most common between the ages of eleven and eighteen, care must be taken to ensure that no bones or joints are deformed during the growth phase due to the osteoid osteoma. In case of doubt, close medical checks are indicated.