Atipik kansellöz osteoid osteomada floroskopi kılavuzluğunda kemik iliği biyopsi iğnesi ile nidusun kısmi eksizyonu

Amaç: Osteoid osteoma tedavisinde yaygın olarak kabul edilen yöntem nidusun ya tam eksizyonu ya da tahrib edilmesidir. Bu çalımanın amacı, atipik kansellöz osteoid osteoma tedavisinde minimal invasiv teknik olarak kemik iliği biyopsi iğnesi ile kısmi nidus eksizyonu etkinliğini değerlendirmekti.Gereç ve Yöntem: Dört olguda 11-G kemik iliği biyopsi iğnesiyle floroskopi kılavuzluğunda nidusun kısmi eksizyonu uygulandı. Lezyonlar femur başı epifizi, femur boynu posterosüperior tarafı, tibia distal epifizi ve olekranon çıkıntıda yerleşmişlerdi.Bulgular: Hastaların ağrısı nidus eksizyonunu takip eden gece geçti. 72, 36, 32 ve 24. aylardaki takipte nüks görülmedi.Sonuç: Nidusun kısmi eksizyonu özellikle cerrahi girişimin zor olduğu atipik kansellöz osteoid osteoma tedavisinde dikkate değer bir teknik olarak düşünülebilir.

Anahtar Kelimeler:

osteoid osteoma, kısmi eksizyon, floroskopi, biyopsi iğnesi

Partial excision of the nidus of an atypical cancellous osteoid osteoma by use of a bone marrow biopsy needle under fluoroscopic guidance

Aim: The widely accepted method in treatment of osteoid osteoma is either the complete excision or destruction of the nidus. The aim of this study was to evaluate the efficacy of partial nidus excision using a bone marrow biopsy needle as a minimally invasive technique for management of atypical cancellous osteoid osteomas.Material and Method: Partial excision of the nidus was performed in four cases using an 11-G bone marrow biopsy needle under fluoroscopic guidance. The lesions were located in the capital femoral epiphysis, the posterosuperior side of the femoral neck, the distal tibial epiphysis and the olecranon process of the ulna.Results: The patient’s pain resolved the night following excision of the nidus. No recurrence was observed at the 72, 36, 32 and 24 month follow-ups.Conclusion: Partial excision of the nidus may be considered a remarkable technique especially in the treatment of atypical cancellous osteoid osteoma, where surgical intervention is challenging.

Keywords:

osteoid osteoma, partial excision, fluoroscopy, biopsy needle,

PDF

___

Edeiken J. Rontgen diagnosis of diseases of bone. London: Williams & Wilkins; 1981.
Bourgault C, Vervoort T, Szymanski C, Chastanet P, Maynou C. Percutaneous CT-guided radiofrequency thermocoagulation in the treatment of osteoid osteoma: A 87 patient series. Orthop Traumatol Surg Res 2014;100:323-7.
Unni KK, Inwards CY. Dahlin’s Bone Tumors: General Aspects and Data on 10,165 Cases. Philadelphia: Lippincott Williams and Wilkins; 2010.
Yildiz Y, Bayrakci K, Altay M, Saglik Y. Osteoid osteoma: the results of surgical treatment. Int Orthop 2001;25:119-22.
Brody JM, Brower AC, Shannon FB. An unusual epiphyseal osteoid osteoma. AJR 1992;158:609-11.
Kalem M, Şahin E, Kocaoğlu H, Başarır K, Yıldız Y, Sağlık, Y. Osteoİd osteoma: bir ayak ağrısı nedeni. Ortadoğu Tıp Dergisi 2018;10:179-82.
Lisanti M, Rosati M, Spagnolli G, Luppichini G. Osteoid osteoma of the carpus. Case reports and a review of the literature. Acta Orthop Belg 1996;62:195-99.
Mahata KM, Keshava SK, Jacob KM. Osteoid osteoma of the femoral head treated by radiofrequency ablation: a case report. J Med Case Rep 2011;5:115.
Papathanassiou ZG, Petsas T, Papachristou D, Megas P. Radiofrequency ablation of osteoid osteomas: five years experience. Acta Orthop Belg 2011;77:827-33.
Shinozaki T, Sato J, Watanabe H, et al. Osteoid osteoma treated with computed tomography–guided percutaneous radiofrequency ablation: a case series. J Orthop Surg 2005;13:317-22.
Jaffe HL Osteoid osteoma. Proc R Soc Med 1953;46:1007-12.
Ciftdemir M, Tuncel SA, Usta U. Atypical osteoid osteoma. Eur J Orthop Surg Traumatol 2015;25:17-27.
Assoun J, Railhac JJ, Bonnevialle P, et al. Osteoid osteoma: percutaneous resection with CT guidance. Radiology 1993;188:541-7.
Raux S, Kohler R, Canterino I, Cholet F, Abelin-genevois K. Osteoid osteoma of acetabular fossa: five cases treated with percutaneous resection. Orthop traumatol Surg Res 2013;99:341-46.
Khapchik V, O’Donnell RJ, Glick JM. Arhroscopically assisted excision of osteoid osteoma involving the hip. Artroscopy 2001;17:56-61.
Geiger D, Napoli A, Conchiglia A, et al. MR-guided focused ultrasound (MRgFUS) ablation for the treatment of nonspinal osteoid osteoma: a prospective multicenter evaluation. J Bone Joint Surg Am 2014;96:743-51.
Norman A. Persistence or recurrence of pain: a sign of surgical failure is osteoid-osteoma. Clin Orthop Relat Res 1978;130:263-66.
Kneisl JS, Simon MA. Medical management compared with operative treatment for osteoid osteoma. J Bone Joint Surg Am 1992;74:179-85.
Moberg E. The natural course of osteoid osteoma. J Bone Joint Surg Am 1951;33:166-70.
Lee EH, Shafi M, Hui JHP. Osteoid osteoma: a current review. Journal of Pediatric Orthopaedics 2006;26:695-700.
Nielsan GP, Rosenberg AE. Bone forming tumors. In: Folpe AL, Inwards CY (eds). Bone and soft tissue pathology. A volume in the series foundations in diagnostic pathology, 1st ed. Philadelphia: Sounders. 2010:309-29.
Sibenrock KA, Asencio J, Ganz R, Poal-Manresa J. Osteoid osteoma in the femoral head -a report of 3 cases. Acta Orthop Scand 1997;68:70-6.
Van Horn JR, Karthaus RP. Epiphyseal osteoid osteoma. Two case reports. Acta Orthop Scand 1989;60:625-7.
Simon WH, Beller ML. Instrcapsular epiphyseal osteoid osteoma of ankle joint. A case report. Clin Orthop Relat Res 1975;108:200-3.
Dzupa V, Bartonícek J, Sprindrich J, Neuwirth J, Svec A. Osteoid osteoma of olecranon process of ulna in subchondral location. Arch Orthop Trauma Surg 2001;121:117-8.