Malavia Mira,  Le Viet,  Rivard Douglas,  Reading Brenton

Final Pr. ID: Poster #: EDU-061

Osteoid osteomas (OO) are benign osteoblastic tumors primarily afflicting individuals aged 5 to 30 years, ranking as the third most prevalent among benign bone tumors at around 10%. Patients typically present with persistent nighttime pain that responds positively to NSAIDs, along with potential complications like progressive discomfort, tenderness, swelling, and limited joint mobility with articular involvement. OO usually forms in the cortex of long bones, measuring less than 2 cm, exhibiting a central radiolucent nidus encased by surrounding sclerosis, best visualized using CT scans. The current standard-of-care entails CT-guided radiofrequency ablation (RFA), while surgery becomes an option for complex locations like the spine, extremities, or craniofacial bones. Moreover, advanced thermoprotective techniques have expanded RFA's applicability to previously unsuitable lesions. Cryoablation is a newly indicated for pediatric OO patients and involves controlled tumor freezing, preserving adjacent healthy tissue. It offers reduced pain, shorter recovery, and minimal scarring, enhancing the quality of life for young patients. This exhibit will discuss 3 cases that underscore the diverse management approaches required for osteoid osteomas in young patients. Case 1 featured initial relief with radiofrequency ablation (RFA) but recurrence, ultimately resolved with cryoablation. In Case 2, a CT-guided cryoablation was performed for an S2 osteoid osteoma, with limited follow-up data. Case 3 highlighted the complexity of treating a C1 osteoid osteoma, initially successful with intra-operative cryoablation, but it was followed by new neck muscular pain post-operation. Cryoablation's accuracy and less invasiveness make it a preferred choice in treating OO patients.


Learning Objectives:
Grasp cryoablation principles for pediatric osteoid osteoma.
Recognize indications and contraindications.
Assess benefits and risks in pediatric cases.
Comprehend the pathophysiology of osteoid osteoma and cryoablation's role in treatment for pediatric patients. Read More

Authors:  Malavia Mira , Le Viet , Rivard Douglas , Reading Brenton

Keywords:  cancer, pain management, ablation

Akhter Talal,  Cahill Anne Marie,  Vatsky Seth,  Krishnamurthy Ganesh,  Keller Marc,  Shellikeri Sphoorti,  Srinivasan Abhay

Final Pr. ID: Poster #: EDU-117

Intra-articular osteoid osteomas are uncommon and occur in only 10-13% of cases. Intra-articular osteoid osteomas may not demonstrate typical clinical features and feature subtle radiographic differences when compared to extra-articular osteoid osteomas. Radiofrequency ablation (RFA) has been found to be a safe and reliable method of treating osteoid osteomas. The possible complications of RFA include bleeding, muscle burn, and in cases of intra-articular osteoid osteoma, septhic arthritis. In this study, we evaluated the efficacy of radiofrequency ablation (RFA) of intra-articular osteoid osteomas at a single tertiary pediatric center. Read More

Authors:  Akhter Talal , Cahill Anne Marie , Vatsky Seth , Krishnamurthy Ganesh , Keller Marc , Shellikeri Sphoorti , Srinivasan Abhay

Keywords:  Osteoid osteoma, Radiofrequency ablation, Musculoskeletal

Foo Madeline,  Nicol Kathleen,  Murakami James

Final Pr. ID: Poster #: CR-010

Chondroblastomas (CBs) are rare benign bone tumors that usually present within the first two decades of life, are more common in males, and originate within the epiphysis of long bones. In this same age group, Aneurysmal Bone Cysts (ABCs) commonly occur. ABCs are benign expansile osteolytic lesions which can be primary, occurring in isolation, or they can occur alongside other bone tumors such as CBs. CBs are one of the most common tumors to present with associated ABC-like changes. CBs and ABCs are often difficult to treat because of their locations. To minimize operative morbidity, especially in hard-to-reach lesions, percutaneous approaches for both lesions have been individually described. We present a skull base CB with associated ABC-like changes treated by combining two different previously described percutaneous modalities.

A 17-year-old healthy male presented with neck and shoulder pain. Imaging revealed an expansile lytic bone tumor replacing the clivus and left occipital condyle. The lesion was predominantly cystic with blood-fluid levels on T2W images but also had a 1 cm diameter dark nodular area in the left side of the clivus that was initially felt to be blood products rather than a solid tumor nodule. Pathology later revealed that this nodular area was a CB and the adjacent cystic portions were ABC-like changes. The CB was treated with Radiofrequency Ablation (RFA) and the adjacent ABC areas with doxycycline sclerotherapy. After 3 years of follow-up, there has been no clinical or radiological evidence of recurrence. RFA was complicated by a hypoglossal nerve injury. Otherwise, he had complete resolution of all symptoms and has returned to all activities including collegiate athletics. Read More

Authors:  Foo Madeline , Nicol Kathleen , Murakami James

Keywords:  Chondroblastoma, ABC, Tumor Ablation