• World Neurosurg · Apr 2020

    Review Case Reports

    Can Osteoblastoma evolve to malignancy? A challenge in the decision-making process of a benign spine tumor.

    • Addisu Mesfin, Stefano Boriani, Marco Gambarotti, Stefano Bandiera, and Alessandro Gasbarrini.
    • Department of Orthopaedic Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA; Department of Neurosurgery, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. Electronic address: amesfin@gmail.com.
    • World Neurosurg. 2020 Apr 1; 136: 150-156.

    BackgroundOsteoblastoma is a rare benign aggressive tumor, with one third occurring in the spine. Conversion of osteoblastoma to osteosarcoma is uncommon, and histologically proven conversion has been rarely reported.Case DescriptionCases of 2 patients with rare occurrences of spinal osteoblastomas recurring and transforming into osteosarcomas are presented. Initial presentation, treatment, imaging, and histology findings are described. The outcomes of the patients following surgical intervention for histologically diagnosed osteoblastoma with subsequent transformation to osteosarcoma and relative management are described. A literature review of osteoblastoma converting to osteosarcoma also is provided.ConclusionsThe rare occurrence of osteoblastoma converting to osteosarcoma imparts several lessons, including performing Enneking appropriate surgery for benign aggressive tumors (Enneking stage 3) and always performing a biopsy, particularly at the time of recurrence if imaging is not pathognomonic for a benign primary spine tumor.Copyright © 2019 Elsevier Inc. All rights reserved.

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