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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2024; 43(01): e57-e61
DOI: 10.1055/s-0042-1746195
Case Report

Aggressive Osteoblastoma of Temporal Bone Causing Facial Palsy in a 9-year-old Child: A Case Report Based on 2020 WHO Classification of Bone Tumors

Osteoblastoma agressivo do osso temporal causando paralisia facial em uma criança de 9 anos: Um relato de caso baseado na classificação da OMS de 2020 de tumores ósseos
Eduardo Cambruzzi 
1   Department of Histology and Pathology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
2   Pathology Laboratory, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
3   Pathology Laboratory, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil
4   Hemodynamics Service, Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil
,
Roque Domingos Furian
2   Pathology Laboratory, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
,
Luiza Gomes Botega
2   Pathology Laboratory, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
,
Nilo Devigli Júnior
2   Pathology Laboratory, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
,
Eron Rodrigues Cunha Lopes
2   Pathology Laboratory, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
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Abstract

Aggressive osteoblastoma (AO) is an uncommon bone tumor that represents a borderline lesion between osteoblastoma and osteosarcoma. The vertebral column, the sacrum, the pelvis, and jaw/craniofacial bones are primarily affected. Aggressive osteoblastoma does not metastasize and is treated by surgical resection. The authors report a case of AO in a 9-year-old female patient presenting with 5th and 7th cranial nerve palsy. Prior pathological history included resection of an expansile nodule in the left temporal bone. Conventional radiological examination and computed tomography (CT) of the skull revealed an osteoblastic lesion arising in the petrous portion of the left temporal bone, measuring 5.2 cm in the largest dimension. The patient was subjected to partial surgical resection of the process. Microscopy revealed a primary neoplastic bone composed of numerous epithelioid round osteoblasts disposed in solid sheets and with mild atypia, large eosinophilic cytoplasm, and an eccentric, ovoid nucleus. The process exhibited loose stroma, low mitotic index, osteoid formation, and a few osteoclast-like multinucleated giant cells. The diagnosis of AO was thus established. After 5 months of clinical follow-up, the patient is asymptomatic, without evidence of tumoral growth on CT scans.

Resumo

O osteoblastoma agressivo (AO) é um tumor ósseo incomum que representa uma lesão limítrofe entre osteoblastoma e osteossarcoma. A coluna vertebral, o sacro, a pelve e os ossos maxilares/craniofaciais são afetados principalmente. O osteoblastoma agressivo não metastatiza sendo tratado por ressecção cirúrgica. Os autores relatam um caso de OA em paciente do sexo feminino, de 9 anos, com paralisia de V e VII pares cranianos. A história patológica prévia incluiu ressecção de nódulo expansivo no osso temporal esquerdo. O exame radiológico convencional e a tomografia computadorizada (TC) de crânio revelaram lesão osteoblástica surgindo na porção petrosa do osso temporal esquerdo, medindo 5,2 cm em sua maior dimensão. O paciente foi submetido à ressecção cirúrgica parcial do processo. A microscopia revelou osso neoplásico primário composto por numerosos osteoblastos epitelióides redondos dispostos em lâminas sólidas e com leve atipia, grande citoplasma eosinofílico e núcleo ovoide excêntrico. O processo exibiu estroma frouxo, baixo índice mitótico, formação de osteóide e algumas células gigantes multinucleadas semelhantes a osteoclastos. O diagnóstico de OA foi assim estabelecido. Após 5 meses de acompanhamento clínico, o paciente encontra-se assintomático, sem evidência de crescimento tumoral na tomografia computadorizada.

Keywords

aggressive osteoblastoma - osteoblastic tumor - bone tumor - pathology - prognosis

Palavras-chave

osteoblastoma agressivo - tumor osteoblástico - tumor ósseo - patologia - prognóstico


Publication History

Received: 16 March 2021

Accepted: 16 June 2021

Article published online:
10 October 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Dorfman HD. Proceedings: Malignant transformation of benign bone lesions. Proc Natl Cancer Conf 1972; 7: 901-913
    PubMedGoogle Scholar
  • 2 Dorfman HD, Weiss SW. Borderline osteoblastic tumors: problems in the differential diagnosis of aggressive osteoblastoma and low-grade osteosarcoma. Semin Diagn Pathol 1984; 1 (03) 215-234
    PubMedGoogle Scholar
  • 3 Rath A, Mandal S, Goswami S, Khurana N, Dhal A. Aggressive osteoblastoma involving the navicular bone of foot: a rare tumor in a unique location. J Foot Ankle Surg 2020; 59 (06) 1279-1282
    CrossrefPubMedGoogle Scholar
  • 4 Dorfman HD, Weiss SW. Borderline osteoblastic tumors: problems in the differential diagnosis of aggressive osteoblastoma and low-grade osteosarcoma. Semin Diagn Pathol 1984; 1 (03) 215-234
    PubMedGoogle Scholar
  • 5 Morris CD, Hameed MR, Agaram NP, Hwang S. Elevated β-hCG associated with aggressive Osteoblastoma. Skeletal Radiol 2017; 46 (09) 1187-1192
    CrossrefPubMedGoogle Scholar
  • 6 Lu ZH, Cao WH, Qian WX. Aggressive osteoblastoma of the temporal bone: a case report and review of the literature. Clin Imaging 2013; 37 (02) 386-389
    CrossrefPubMedGoogle Scholar
  • 7 Sharma R, Mahajan S, Gupta D. Aggressive cranial Osteoblastoma of the parietotemporooccipital bone: a case report and review of literature with a special emphasis on recurrence/residue. World Neurosurg 2020; 142: 255-267 DOI: 10.1016/j.wneu.2020.06.093.
    CrossrefPubMedGoogle Scholar
  • 8 Salmen FS, Oliveira MR, Navarro CM, Dedivitis RA, Pereira Filho VA, Gabrielli MFR. Aggressive Osteoblastoma in the Maxilla: Unusual Lesion in the Craniofacial Skeleton. J Craniofac Surg 2017; 28 (03) 794-797
    CrossrefPubMedGoogle Scholar
  • 9 Al-Ibraheem A, Yacoub B, Barakat A. et al. Case report of epithelioid osteoblastoma of the mandible: findings on PET/CT and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128 (01) e16-e20
    CrossrefPubMedGoogle Scholar
  • 10 Sharma A, Gogoi P, Arora R, Haq RU, Dhammi IK, Bhatt S. Aggressive osteoblastoma of the acetabulum: A diagnostic dilemma. J Clin Orthop Trauma 2018; 9 (Suppl 2): S21-S25 DOI: 10.1016/j.jcot.2017.09.007.
    CrossrefPubMedGoogle Scholar
  • 11 Sonnylal L, Peterson JR, Decilveo AP, O'Connor IT, Wittig JC. Giant periosteal aggressive epithelioid osteoblastoma: 21-year-old male presents case in the midshaft of his femur. Skeletal Radiol 2018; 47 (10) 1443-1448 DOI: 10.1007/s00256-018-2922-8.
    CrossrefPubMedGoogle Scholar
  • 12 Harrington C, Accurso BT, Kalmar JR. et al. Aggressive osteoblastoma of the maxilla: a case report and review of the literature. Head Neck Pathol 2011; 5 (02) 165-170 DOI: 10.1007/s12105-010-0234-y.
    CrossrefPubMedGoogle Scholar
  • 13 Miyayama H, Sakamoto K, Ide M. et al. Aggressive osteoblastoma of the calcaneus. Cancer 1993; 71 (02) 346-353
    CrossrefPubMedGoogle Scholar
  • 14 Ando K, Imagama S, Kobayashi K, Nishida Y, Ishiguro N. Aggressive osteoblastoma of the cervical spine involving the canal and vertebral artery: a case report. Eur Spine J 2017; 26 (Suppl 1): 111-116 DOI: 10.1007/s00586-016-4904-7.
    CrossrefPubMedGoogle Scholar
  • 15 Dixit R, Gupta S, Chowdhury V, Khurana N. Aggressive osteoblastoma of the temporal bone: an unusual cause of facial palsy. Rev Bras Otorrinolaringol 2018; 84 (01) 119-121
    PubMedGoogle Scholar
  • 16 Kukwa W, Oziębło A, Oecińska A, Czarnecka AM, Włodarski K, Kukwa A. Aggressive osteoblastoma of the sphenoid bone. Oncol Lett 2010; 1 (02) 367-371 DOI: 10.3892/ol_00000065.
    CrossrefPubMedGoogle Scholar
  • 17 Pontual MLA, Pontual AA, Grempel RG, Campos LR, Costa AdeL, Godoy GP. Aggressive multilocular osteoblastoma in the mandible: a rare and difficult case to diagnose. Braz Dent J 2014; 25 (05) 451-456 DOI: 10.1590/0103-6440201300220.
    CrossrefPubMedGoogle Scholar
  • 18 Kashikar S, Steinle M, Reich R, Freedman P. Epithelioid Multinodular Osteoblastoma of the Mandible: A Case Report and Review of Literature. Head Neck Pathol 2016; 10 (02) 182-187 DOI: 10.1007/s12105-015-0665-6.
    CrossrefPubMedGoogle Scholar
  • 19 Cikojević D, Colović Z, Lozić B, Klančnik M. Aggressive middle turbinate osteoblastoma with intracranial extension: a case report. J Med Case Reports 2014; 8 (01) 161 DOI: 10.1186/1752-1947-8-161.
    CrossrefPubMedGoogle Scholar
  • 20 Mohanty S, Rani A, Urs AB, Dabas J. A rare case of an aggressive osteoblastoma of the squamous temporal bone: a unique presentation with literature review. J Craniomaxillofac Surg 2014; 42 (07) 1207-1210
    CrossrefPubMedGoogle Scholar
  • 21 Baker AC, Rezeanu L, Klein MJ. et al. Aggressive osteoblastoma: a case report involving a unique chromosomal aberration. Int J Surg Pathol 2010; 18 (03) 219-224 DOI: 10.1177/1066896908319675.
    CrossrefPubMedGoogle Scholar
  • 22 Chatterjee D, Mukhopadhyay KK, Kumar S, Chakraborty S. The rare aggressive osteoblastoma in a two year old child in an unusual localization. J Bone Oncol 2013; 2 (02) 89-91 DOI: 10.1016/j.jbo.2013.02.001.
    CrossrefPubMedGoogle Scholar
  • 23 Singh DK, Das KK, Mehrotra A. et al. Aggressive osteoblastoma involving the craniovertebral junction: A case report and review of literature. J Craniovertebr Junction Spine 2013; 4 (02) 69-72 DOI: 10.4103/0974-8237.128533.
    CrossrefPubMedGoogle Scholar
  • 24 Castro PHS, Molinari DL, Stateri HQ, Borges AH, Volpato LER. Agressive osteoblastoma in a seven-year-old girl's mandible: Treatment and six-year monitoring. Int J Surg Case Rep 2016; 27: 5-9 DOI: 10.1016/j.ijscr.2016.07.033.
    CrossrefPubMedGoogle Scholar