Bone & joints

Other osteogenic tumors

Osteoid osteoma



Topic Completed: 1 August 2013

Minor changes: 25 October 2021

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Osteoid osteoma[title]

David R. Lucas, M.D.
Page views in 2020: 10,877
Page views in 2021 to date: 12,644
Cite this page: Lucas DR. Osteoid osteoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/boneosteoidosteoma.html. Accessed October 25th, 2021.
Definition / general
  • Small, benign, bone forming tumor associated with pain and limited growth potential
  • Nidus < 1.5 cm (any larger size arbitrarily considered to be an osteoblastoma)
Epidemiology
  • Children, adolescents and young adults (most patients 5 - 24 years old)
  • Male:female ratio 3:1
Sites
  • Long bones, especially femur and tibia (50%) most common
  • Virtually any bone can be affected
Pathophysiology
Clinical features
  • Intense localized pain, worse at night, relieved by NSAIDs
  • Juxta - articular tumors with arthritis or joint dysfunction
  • Vertebral tumors with scoliosis
Diagnosis
  • Intense pain and classic radiographic features
Radiology description
  • Nidus usually < 1 cm
  • Nidus may be radiolucent or ossified and surrounded by a radiolucent halo
  • Usually surrounded by dense, reactive osteosclerosis
  • Intracortical, subcortical, medullary or bone surface locations
  • Long bone tumors often intracortical
  • Vertebral tumors in neural arch
Prognostic factors
  • Recurrence is rare
  • Incompletely excised tumors can recur
Case reports
Treatment
Radiology images

Contributed by Mark R. Wick, M.D. and AFIP images
Missing Image

Femur

Missing Image

Talus

Missing Image

Phalanx

Missing Image

Femoral neck



Images hosted on other servers:
Missing Image

Femur; coronal CT scan shows a radiolucent nidus

Gross description
  • Small circumscribed nidus with surrounding sclerosis (intact specimen)
  • Most often received as red, gritty fragments post curettage
Gross images

Contributed by Mark R. Wick, M.D., David R. Lucas, M.D. and AFIP images
Missing Image

Various images

Missing Image

Nidus and surrounding sclerosis

Missing Image

Femur

Missing Image

Femur

Microscopic (histologic) description
  • Small, circumscribed
  • Anastomosing, irregular trabeculae or solid, sclerotic nidus of woven bone with variable mineralization
  • Rimmed by single layer of osteoblasts plus frequent osteoclasts
  • Loose, fibrovascular stroma
  • Surrounded by thick sclerotic bone
  • Lymphoplasmacytic synovitis with juxta - articular tumors
Microscopic (histologic) images

Contributed by Mark R. Wick, M.D. and AFIP images
Missing Image

Foot

Missing Image

Various images


Missing Image

Vascular, loosely fibrous stroma

Missing Image

Mature osteoid osteoma

Missing Image

Irregular bony trabeculae

Missing Image

Synovitis

Missing Image

Femur



Images hosted on other servers:
Missing Image

High power

Molecular / cytogenetics description
Differential diagnosis
Back to top
Image 01 Image 02