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Osteoid Osteoma Masquerading as Cholelithiasis: A Case Report.
Michael A Fox1, Ryan J Berger2, Katherine A Wright3
1University of Virginia School of Medicine, Charlottesville, Virginia.
JBJS Case Connector
|February 12, 2020
Summary
A rare case highlights osteoid osteoma (OO) mimicking gallbladder issues. This bone tumor caused right upper quadrant pain, leading to unnecessary surgery before correct diagnosis and treatment with radiofrequency ablation.
Area of Science:
- Orthopedic Surgery
- Surgical Oncology
- Diagnostic Imaging
Background:
- Right upper quadrant pain is commonly associated with cholelithiasis.
- Osteoid osteoma (OO) is a benign bone tumor typically affecting long bones, rarely presenting with abdominal pain.
Observation:
- An 18-year-old woman presented with chronic, intermittent right upper quadrant pain, initially suspected as symptomatic cholelithiasis.
- Diagnostic workup and subsequent laparoscopic cholecystectomy were performed.
- Post-operative findings revealed an osteoid osteoma of the right eighth rib as the underlying cause.
Findings:
- Osteoid osteoma of the rib can present with atypical symptoms mimicking intra-abdominal pathology.
- Radiofrequency ablation (RFA) is an effective minimally invasive treatment for osteoid osteoma.
- Complete symptom resolution was achieved 1 month after RFA.
Implications:
- Clinicians should consider osteoid osteoma in the differential diagnosis of persistent right upper quadrant pain, especially in younger patients without typical risk factors for cholelithiasis.
- This case underscores the importance of thorough diagnostic evaluation to avoid misdiagnosis and unnecessary procedures.
- Radiofrequency ablation offers a definitive and minimally invasive treatment option for osteoid osteoma presenting in unusual locations.
