Osteoblastoma

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Osteoblastoma
Diagnosis in short

Osteoblastoma. H&E stain.

LM anastomosing bony trabeculae with variable mineralization, osteoblastic rimming, no nuclear atypia of osteocytes
LM DDx osteoid osteoma, osteosarcoma
Site bone - vertebral column typically, other bones

Clinical history usu. 15-20 years old, males > females
Symptoms usu. pain
Radiology often >=2.0 cm (similar lesions 1-2 cm may be osteoid osteoma), often well-circumscribed, +/-cortical expansion, +/-cortical destruction
Prognosis benign, may be locally destructive
Clin. DDx osteosarcoma

Osteoblastoma is benign primary bone tumour. It is grouped with the chondro-osseous tumours.

General

  • Benign bone tumour - that can be locally destructive and occasionally recurs.[1]
  • Uncommon.[2]
  • Typically age 15-20 and male (male:female = ~2:1).[3]
    • Very large age range.[1]
  • Treatment: resection.[3]

Gross

  • Bone.
    • Vertebral column and sacrum - most common in one large series.[1]
  • Size important as per WHO definition:[4]
    • >= 2.0 cm: osteoblastoma.
    • <=1.0 cm: osteoid osteoma.
    • >1 cm and <2 cm: clinical and radiologic criteria should be considered.

Note:

Radiology

Features:

  • Often well-circumscribed, +/-cortical expansion, +/-cortical destruction.[1]

Note:

  • May be described as malignant by radiology.[1]

Microscopic

Features:[6]

  • Anastomosing bony trabeculae with:
    • Osteoblastic rimming.
      • Cells line-up at edge of bone.

Notes:

DDx:

Images

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BONE, LEFT FEMUR, EXCISION:
- OSTEOBLASTOMA.

See also

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 Lucas, DR.; Unni, KK.; McLeod, RA.; O'Connor, MI.; Sim, FH. (Feb 1994). "Osteoblastoma: clinicopathologic study of 306 cases.". Hum Pathol 25 (2): 117-34. PMID 8119712.
  2. Khan, IS.; Thakur, JD.; Chittiboina, P.; Nanda, A.. "Large sacral osteoblastoma: a case report and review of multi-disciplinary management strategies.". J La State Med Soc 164 (5): 251-5. PMID 23362588.
  3. 3.0 3.1 Villalobos, CE.; Rybak, LD.; Steiner, GC.; Wittig, JC. (2010). "Osteoblastoma of the sternum--case report and review of the literature.". Bull NYU Hosp Jt Dis 68 (1): 55-9. PMID 20345366.
  4. Yalcinkaya, U.; Doganavsargil, B.; Sezak, M.; Kececi, B.; Argin, M.; Basdemir, G.; Oztop, F. (Dec 2014). "Clinical and morphological characteristics of osteoid osteoma and osteoblastoma: a retrospective single-center analysis of 204 patients.". Ann Diagn Pathol 18 (6): 319-25. doi:10.1016/j.anndiagpath.2014.08.006. PMID 25224389.
  5. 5.0 5.1 Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 286. ISBN 978-0781740517.
  6. Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 285. ISBN 978-0781740517.