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Benign osteoblastic lesion, locally aggressive, with a histological structure similar to osteoid osteoma but without reactive bone sclerosis and larger in size, generally larger than 1.5 cm


Radiographically, it presents large areas of bone rarefaction with few denser foci of ossification.

It presents two clinical forms:

  • Genuine osteoblastoma : the most common, located in the pedicle of the spine and more rarely in the metaphysis of long bones.
  • Aggressive  (“malignant”) osteoblastoma.

It affects the first and second decade of life.

The clinical picture is one of intense pain, which can lead to fractures and functional and neurological deficits, when it occurs in the spine, sometimes with antalgic scoliosis.

Makes differential diagnosis with:

  • Osteoid osteoma,
  • Aneurysmal bone cyst,
  • Osteosarcoma.

Treatment consists of en bloc resection of the lesion and bone grafting when necessary, reserving careful curettage for regions such as the spine, where it is generally not possible to resect en bloc. The use of local adjuvants (phenol, electrothermia) has been increasingly used, seeking to avoid recurrence. 

Author: Prof. Dr. Pedro Péricles Ribeiro Baptista

 Orthopedic Oncosurgery at the Dr. Arnaldo Vieira de Carvalho Cancer Institute

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