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Giant periosteal aggressive epithelioid osteoblastoma: 21-year-old male presents case in the midshaft of his femur

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Abstract

We report a rare case of giant periosteal osteoblastoma in the femur of a 21-year-old male. The patient presented with a painful, firm, non-tender mass in his left thigh. The pain was worse at night and was temporarily relieved with NSAIDS. He had no fevers, night sweats, or weight loss. The patient underwent preoperative radiological studies including plain radiographs, MRI, bone scan, and CT scan. An open biopsy was subsequently performed that was consistent with an aggressive, epithelioid osteoblastoma. Pathology demonstrated a neoplasm characterized by cohesive sheets of epithelioid osteoblasts, mixed with areas of conventional osteoblastoma displaying prominent osteoblastic rimming of woven bone trabeculae in a fibrovascular stroma. The patient subsequently underwent resection, cryosurgery, fixation, and bone grafting with cortical strut allografts. At final follow-up, 32 months postoperatively, there was no evidence of local recurrence. The patient had resumed all his normal activities. He could run without pain and had no restrictions with activities. The goal of this case report is to aid professionals in the diagnosis and treatment of highly uncommon aggressive osteoblastomas.

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Authors and Affiliations

  1. John Theurer Cancer Center, Hackensack University Medical Center, 20 Prospect Avenue, Suite 501, Hackensack, NJ, 07601, USA

    Laura Sonnylal & James C. Wittig

  2. Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Joel R. Peterson & Alexander P. Decilveo

  3. Georgetown University School of Medicine, Washington, D.C., USA

    Ian T. O’Connor

Authors
  1. Laura Sonnylal
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  2. Joel R. Peterson
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  3. Alexander P. Decilveo
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  4. Ian T. O’Connor
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  5. James C. Wittig
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Corresponding author

Correspondence to James C. Wittig.

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The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Additional information

This work was performed at Hackensack University Medical Center, Hackensack, NJ, USA.

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Sonnylal, L., Peterson, J.R., Decilveo, A.P. et al. Giant periosteal aggressive epithelioid osteoblastoma: 21-year-old male presents case in the midshaft of his femur. Skeletal Radiol 47, 1443–1448 (2018). https://doi.org/10.1007/s00256-018-2922-8

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  • DOI: https://doi.org/10.1007/s00256-018-2922-8

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