Abstract
Retrospective case series.(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.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.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 classifi cation
for benign bone tumors, 13 (72%) were diagnosed at stage 2
and 5 (28%) at stage 3. Mean tumor volume was 64 cm 3 (range,
2–441 cm 3 ). 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.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).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.
Lingua originale | English |
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pagine (da-a) | E97-E97-E103 |
Rivista | Spine |
Volume | 39 |
DOI | |
Stato di pubblicazione | Pubblicato - 2014 |
Keywords
- Adolescent
- Adult
- Bone Neoplasms
- Child
- Female
- Follow-Up Studies
- Humans
- Male
- Osteoblastoma
- Sacrum
- Young Adult