Osteoblastoma of the sacrum

Report of 18 cases and analysis of the literature

Pietro Ruggieri, Klaus Huch, Andreas F. Mavrogenis, Biagio Merlino, Andrea Angelini

Research output: Contribution to journalArticle

8 Citations (Scopus)

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 languageEnglish
JournalSpine
Volume39
Issue number2
DOIs
Publication statusPublished - Jan 15 2014

Fingerprint

Osteoblastoma
Sacrum
Recurrence
Disease-Free Survival
Magnetic Resonance Imaging
Curettage
Phenol
Tumor Burden
Neoplasms

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

Ruggieri, P., Huch, K., Mavrogenis, A. F., Merlino, B., & Angelini, A. (2014). Osteoblastoma of the sacrum: Report of 18 cases and analysis of the literature. Spine, 39(2). https://doi.org/10.1097/BRS.0000000000000061

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 journalArticle

Ruggieri, P, Huch, K, Mavrogenis, AF, Merlino, B & Angelini, A 2014, 'Osteoblastoma of the sacrum: Report of 18 cases and analysis of the literature', Spine, vol. 39, no. 2. https://doi.org/10.1097/BRS.0000000000000061
Ruggieri, Pietro ; Huch, Klaus ; Mavrogenis, Andreas F. ; Merlino, Biagio ; Angelini, Andrea. / Osteoblastoma of the sacrum : Report of 18 cases and analysis of the literature. In: Spine. 2014 ; Vol. 39, No. 2.
@article{921578383e8f42a6ac44f6bf805c42e0,
title = "Osteoblastoma of the sacrum: Report of 18 cases and analysis of the literature",
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.",
keywords = "Differential diagnosis, Local recurrence, MRI, osteoblastoma, Osteoblastomalike osteosarcoma, Review, Sacral tumor, Statistical analysis, Surgical treatment, Tumor volume",
author = "Pietro Ruggieri and Klaus Huch and Mavrogenis, {Andreas F.} and Biagio Merlino and Andrea Angelini",
year = "2014",
month = "1",
day = "15",
doi = "10.1097/BRS.0000000000000061",
language = "English",
volume = "39",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

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

UR - http://www.scopus.com/inward/record.url?scp=84895073997&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895073997&partnerID=8YFLogxK

U2 - 10.1097/BRS.0000000000000061

DO - 10.1097/BRS.0000000000000061

M3 - Article

VL - 39

JO - Spine

JF - Spine

SN - 0362-2436

IS - 2

ER -