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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
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Summary
This summary is machine-generated.

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.

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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.