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Pseudomalignant osteoblastoma of the odontoid process
Pedro Fernandes1, Joaquim Soares do Brito2, Adília Costa3
1Orthopaedics Department, Centro Hospitalar Lisboa Norte, University Hospital of Santa Maria, Avenida Professor Egas Moniz, 1649-035, Lisbon, Portugal.
Pseudomalignant osteoblastomas are rare spinal tumors. This case shows a benign outcome for a pseudomalignant osteoblastoma in a child
Area of Science:
- Orthopedic Surgery
- Pediatric Oncology
- Skeletal Radiology
Background:
- Osteoblastomas are rare bone tumors, with pseudomalignant histology being an infrequent subtype.
- The odontoid process is an exceptionally rare site for osteoblastomas.
- Enneking stage 2 osteoblastomas typically require conservative management, but pseudomalignant features complicate treatment decisions.
Observation:
- A 6-year-old male presented with a type III odontoid fracture, which healed.
- Follow-up CT revealed an expansile lesion at the odontoid process.
- Biopsy confirmed osteoblastoma with pseudomalignant histological features.
Findings:
- The patient underwent intralesional excision for the odontoid osteoblastoma.
- Despite pseudomalignant histological features, no further treatment was administered.
- A 10-year follow-up showed no recurrence, pain, or loss of cervical spine mobility.
Implications:
- Histological pseudomalignant features alone may not predict aggressive behavior in odontoid osteoblastomas.
- Conservative management can be successful for select stage 2 odontoid osteoblastomas with pseudomalignant histology.
- This case highlights the importance of long-term follow-up for spinal tumors.
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