Is Biopsy Absolutely Necessary For Osteoid Osteomas Treated with Percutaneous Ablation?

• Published in: Medical journal of Bakirköy Vol. 15; no. 4; pp. 352 - 356
• Main Authors: Gülenç, Barış, Güngören, Zeynep, Erol, Cengiz, Bülbül, Ahmet Murat
• Format: Journal Article
• Language: English; Turkish
• Published: Istanbul Galenos Publishing House 01.12.2019
• Subjects: Biopsy; Bone cancer; Cancer surgery; Tumors
• ISSN: 1305-9319; 1305-9327
• DOI: 10.4274/BTDMJB.galenos.2019.20181010013541

Objective: Osteoid osteoma is a common bone tumor with a benign character. Patients present to orthopedics clinic with irritating nocturnal pain and many of them have a long history of complaints at the time of diagnosis. Its management is mainly conservative although surgical treatment is more effective at alleviating pain and removing tumor. In the last 20 years percutaneous ablation has been safely used with minimum risk, especially for bony regions that are risky for surgical access. Whereas some radiologists perform ablation after taking biopsy from nidus, some others directly proceed with ablation. The aim of the present study was to assess the effect of biopsy result on osteoid osteoma management and its implication on clinical practice. Methods: This study retrospectively involved 10 patients who underwent percutaneous ablation for osteoid osteoma at our clinic between January 2013 and December 2016. All patients were biopsied before the intervention. Those who did not undergo biopsy sampling before the intervention, who were lost to follow-up, and who were diagnosed with conditions other than osteoid osteoma were excluded. Biopsy results and images were obtained retrospectively. The clinical outcomes, recurrence rates, and treatment costs were compared between patients with positive and negative biopsy results. Results: This study involved 10 patients with a mean age of 17.3 (4-35) years. All patients were followed for at least 2 years, and the recurrence and symptom statuses were questioned via telephone interview. A nidus establishing the diagnosis of osteoid osteoma was seen in 7 out of 10 patients. No patient developed lesion recurrence by the end of a 2-year follow-up period, nor any of them suffered persistent pain after the procedure. Patients with and without nidus showed no significant differences with respect to clinical course and recurrence rate. Conclusion: Percutaneous ablation is associated with a high curative potential and can be effectively used for the treatment of osteoid osteoma. The result of pre-procedural biopsy had no effect on patients’ clinical course and recurrence rates.