Soft tissue recurrence of an osteoid osteoma: an exceptional observation
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CASE REPORT
Soft tissue recurrence of an osteoid osteoma: an exceptional observation Emilie Wacheul 1 & Thibaut Leemrijse 2 & Christine Galant 1 & Jacques Malghem 3 & Frédéric E. Lecouvet 3 Received: 26 May 2020 / Revised: 1 September 2020 / Accepted: 10 September 2020 # ISS 2020
Abstract We report the observation of the soft tissue recurrence of an osteoid osteoma (OO) in a 26-year-old man initially complaining of post-traumatic pain and swelling of the right ankle. A first arthroscopic resection was performed after the misdiagnosis of “bone irregularities” observed on computed tomography (CT) and magnetic resonance imaging (MRI). The diagnosis of OO was made by histological analysis of the resection material. The patient became asymptomatic for 5 years until the symptoms progressively recurred. Follow-up MRI and CT studies demonstrated a nodular bony focus within the periarticular soft tissues of the ankle. The lesion was removed, and histological analysis confirmed the diagnosis of a whole viable OO. This observation likely resulted from the displacement of the initial lesion during the initial arthroscopic procedure. This case report highlights the possibility of recurrence of OO in the soft tissues. Keywords Bone . Soft tissue . Tumor, osteoid osteoma . Computed tomography . MRI
Introduction Osteoid osteoma (OO) in the lower limb most often involves the diaphyseal cortices [1]. Although OO of the feet is rare (2– 11%), it represents 19.4% of benign tumors in the foot and ankle, with predominant involvement of the talus and calcaneus, particularly of the talar neck [2–4]. Depending on the location of OO, patients may present with local erythema, swelling, tenderness, bone deformity, gait disturbances, or muscle atrophy [5, 6]. The wide range of symptoms makes clinical diagnosis sometimes challenging, particularly in cases associated with traumatic or surgical history [6]. Intra-articular lesions are not exceptional, explaining particular imaging findings, such as lack of or presence of limited reactive sclerosis and * Frédéric E. Lecouvet [email protected] 1
Department of Pathology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate, 10, 1200 Brussels, Belgium
2
Foot and Ankle Institute, Avenue Ariane, 5, 1200 Brussels, Belgium
3
Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), 10 Avenue Hippocrate, 10/ 2942, 1200 Brussels, Belgium
periosteal reaction on computed tomography (CT) [5, 7] and prominent synovial hypertrophy and joint effusion, which can mimic degenerative, inflammatory, or infectious conditions [8]. Percutaneous CT-guided treatments have replaced surgical en bloc resection and most often consist of radiofrequency thermoablation, microwave ablation, cryoablation, and laser photocoagulation [2, 6, 9, 10]. These less invasive methods achieve results similar to thos
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