Abstract
Study Design. Retrospective case series. Objective. (1) To analyze clinical and radiographical characteristics, treatment, and outcome in patients with sacral osteoblastoma, (2) to evaluate progression-free survival and local recurrence rate, and (3) to identify prognostic factors. Summary of Background Data. Osteoblastoma is a rare tumor that has been reported to affect the sacrum from 7% to 17%. Symptoms are various and the diagnosis is often delayed. Methods. From 1980 to 2010, 18 patients with sacral osteoblastoma (16 males and 2 females) were treated at Rizzoli Institute. Lesion involved S1 (2 cases), S1-S2 (3 cases), S2 (1 case), S2-S3 (1 case), S2-S4 (1 case), S3 (2 cases), S3-S4 (5 cases), S4 (1 case), and almost the entire sacrum in 2 cases. According to Enneking classification for benign bone tumors, 13 (72%) were diagnosed at stage 2 and 5 (28%) at stage 3. Mean tumor volume was 64 cm (range, 2-441 cm). Nine patients had preoperative magnetic resonance imaging. Five patients had a previous inadequate intralesional surgery elsewhere. Treatment consisted in intralesional surgery (16 cases), intralesional surgery and radiotherapy (1 case), and wide resection (1 case). Local adjuvants used were phenol (7 patients), cryocoagulation with "iceball" technique (1 case). Embolizations were performed in 7 patients. Results. At a mean of 8.4 years (range, 1-28 yr), 15 patients (83%) remained continuously disease free, whereas 3 patients had local recurrence (17%). Progression-free survival was 87% at 5 years and 74% at 10 years. No statistical difference was found between patients who received or not local adjuvants (P = 1.254), older or younger than 20 years (P = 0.970), at stage 2 or 3 (P = 0.826), evaluated preoperatively with or without magnetic resonance imaging (P = 0.160), primarily treated versus patients with previous intralesional surgery elsewhere (P = 0.131). Conclusion. In our series, curettage was successful in most of the patients. Local adjuvants did not seem to reduce the risk of local recurrence when combined with intralesional surgery.
| Original language | English |
|---|---|
| Journal | Spine |
| Volume | 39 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jan 15 2014 |
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Keywords
- Differential diagnosis
- Local recurrence
- MRI
- osteoblastoma
- Osteoblastomalike osteosarcoma
- Review
- Sacral tumor
- Statistical analysis
- Surgical treatment
- Tumor volume
ASJC Scopus subject areas
- Clinical Neurology
- Orthopedics and Sports Medicine
Cite this
Osteoblastoma of the sacrum : Report of 18 cases and analysis of the literature. / Ruggieri, Pietro; Huch, Klaus; Mavrogenis, Andreas F.; Merlino, Biagio; Angelini, Andrea.
In: Spine, Vol. 39, No. 2, 15.01.2014.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Osteoblastoma of the sacrum
T2 - Report of 18 cases and analysis of the literature
AU - Ruggieri, Pietro
AU - Huch, Klaus
AU - Mavrogenis, Andreas F.
AU - Merlino, Biagio
AU - Angelini, Andrea
PY - 2014/1/15
Y1 - 2014/1/15
N2 - Study Design. Retrospective case series. Objective. (1) To analyze clinical and radiographical characteristics, treatment, and outcome in patients with sacral osteoblastoma, (2) to evaluate progression-free survival and local recurrence rate, and (3) to identify prognostic factors. Summary of Background Data. Osteoblastoma is a rare tumor that has been reported to affect the sacrum from 7% to 17%. Symptoms are various and the diagnosis is often delayed. Methods. From 1980 to 2010, 18 patients with sacral osteoblastoma (16 males and 2 females) were treated at Rizzoli Institute. Lesion involved S1 (2 cases), S1-S2 (3 cases), S2 (1 case), S2-S3 (1 case), S2-S4 (1 case), S3 (2 cases), S3-S4 (5 cases), S4 (1 case), and almost the entire sacrum in 2 cases. According to Enneking classification for benign bone tumors, 13 (72%) were diagnosed at stage 2 and 5 (28%) at stage 3. Mean tumor volume was 64 cm (range, 2-441 cm). Nine patients had preoperative magnetic resonance imaging. Five patients had a previous inadequate intralesional surgery elsewhere. Treatment consisted in intralesional surgery (16 cases), intralesional surgery and radiotherapy (1 case), and wide resection (1 case). Local adjuvants used were phenol (7 patients), cryocoagulation with "iceball" technique (1 case). Embolizations were performed in 7 patients. Results. At a mean of 8.4 years (range, 1-28 yr), 15 patients (83%) remained continuously disease free, whereas 3 patients had local recurrence (17%). Progression-free survival was 87% at 5 years and 74% at 10 years. No statistical difference was found between patients who received or not local adjuvants (P = 1.254), older or younger than 20 years (P = 0.970), at stage 2 or 3 (P = 0.826), evaluated preoperatively with or without magnetic resonance imaging (P = 0.160), primarily treated versus patients with previous intralesional surgery elsewhere (P = 0.131). Conclusion. In our series, curettage was successful in most of the patients. Local adjuvants did not seem to reduce the risk of local recurrence when combined with intralesional surgery.
AB - Study Design. Retrospective case series. Objective. (1) To analyze clinical and radiographical characteristics, treatment, and outcome in patients with sacral osteoblastoma, (2) to evaluate progression-free survival and local recurrence rate, and (3) to identify prognostic factors. Summary of Background Data. Osteoblastoma is a rare tumor that has been reported to affect the sacrum from 7% to 17%. Symptoms are various and the diagnosis is often delayed. Methods. From 1980 to 2010, 18 patients with sacral osteoblastoma (16 males and 2 females) were treated at Rizzoli Institute. Lesion involved S1 (2 cases), S1-S2 (3 cases), S2 (1 case), S2-S3 (1 case), S2-S4 (1 case), S3 (2 cases), S3-S4 (5 cases), S4 (1 case), and almost the entire sacrum in 2 cases. According to Enneking classification for benign bone tumors, 13 (72%) were diagnosed at stage 2 and 5 (28%) at stage 3. Mean tumor volume was 64 cm (range, 2-441 cm). Nine patients had preoperative magnetic resonance imaging. Five patients had a previous inadequate intralesional surgery elsewhere. Treatment consisted in intralesional surgery (16 cases), intralesional surgery and radiotherapy (1 case), and wide resection (1 case). Local adjuvants used were phenol (7 patients), cryocoagulation with "iceball" technique (1 case). Embolizations were performed in 7 patients. Results. At a mean of 8.4 years (range, 1-28 yr), 15 patients (83%) remained continuously disease free, whereas 3 patients had local recurrence (17%). Progression-free survival was 87% at 5 years and 74% at 10 years. No statistical difference was found between patients who received or not local adjuvants (P = 1.254), older or younger than 20 years (P = 0.970), at stage 2 or 3 (P = 0.826), evaluated preoperatively with or without magnetic resonance imaging (P = 0.160), primarily treated versus patients with previous intralesional surgery elsewhere (P = 0.131). Conclusion. In our series, curettage was successful in most of the patients. Local adjuvants did not seem to reduce the risk of local recurrence when combined with intralesional surgery.
KW - Differential diagnosis
KW - Local recurrence
KW - MRI
KW - osteoblastoma
KW - Osteoblastomalike osteosarcoma
KW - Review
KW - Sacral tumor
KW - Statistical analysis
KW - Surgical treatment
KW - Tumor volume
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U2 - 10.1097/BRS.0000000000000061
DO - 10.1097/BRS.0000000000000061
M3 - Article
VL - 39
JO - Spine
JF - Spine
SN - 0362-2436
IS - 2
ER -