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Osteoid Osteoma

  • Overview

    An osteoid osteoma is a benign (non-cancerous), small tumor that usually grows in the long bones of a person’s lower extremities. The thighbone is the most common location, although it can occur in the bones of the hand and it sometimes occurs in the lower part of the spine.

    • The tumor may cause pain, but it doesn’t spread.
    • In young children, it may deform the bone or stimulate the bone to grow larger or longer.
    • It usually appears in teenagers and young adults.
    • Its cause is unknown.
    • The most common treatment uses radio frequencies to heat and kill cancerous cells.
    • Treatments are usually successful, though the tumors can come back.

    How Children’s Hospital Boston approaches osteoid osteoma

    Dana-Farber/Children’s Hospital Cancer Center provides comprehensive medical and surgical care for children and adolescents with bone and soft tissue tumors.

    We understand that you may have a lot of questions when your child is diagnosed with an osteoid osteoma. Is it dangerous? Will it affect my child long-term? What do we do next? We’ve tried to provide some answers to those questions in the following pages, and our experts can explain your child’s condition fully. If you have further questions during your hospital stay, our experts can answer your questions fully.

    Our Bone and Soft Tissue Program’s multidisciplinary approach to care ensures that your child’s case will be given thoughtful discussion by anintegrated care from a team that includes the following specialists:

    • pediatric oncologists, surgical oncologists and radiation oncologists
    • pediatric experts from every medical subspecialty, such as orthopedics, ophthalmology, physical therapy and radiology, among others
    • highly skilled and experienced pediatric oncology nurses.
    • Child Life specialists, psychologists, social workers and resource specialists who provide supportive care before, during and after treatment

    Our team developed a new technique that uses intraoperative bone scan for the surgical removal of spinal osteoid osteoma, which helps our surgeons more accurately removal of the tumor.

    In addition, our cancer center offers the following services:

    • Expert diagnosis by pathologists using advanced molecular diagnostic testing to identify your child’s type of tumor. Knowing the molecular composition of a tumor helps predict which treatments are more likely to work.
    • Access to unique Phase I clinical trials, from our own investigators, and from the Children’s Oncology Group.
    • Expert surgical care from experienced pediatric surgeons and orthopaedic surgeons, several of whom developed approaches used at centers across the country. 
    • Support services to address all of your child and family’s needs.
    • A weekly survivorship clinic, which set the national standard for childhood cancer survivorship care. This weekly clinic offers ongoing care to manage late effects caused by your child’s cancer or the treatment they received.
  • In-Depth

    What is osteoid osteoma?

    An osteoid osteoma is a benign (non-cancerous), small tumor that occurs most often in the long bones of a person’s lower extremities. The thighbone is the most common location it grows, although it can emerge in the bones of the hand and it sometimes occurs in the lower part of the spine.

    The tumor may cause pain, but it doesn’t spread. In young children, it may deform the host bone, or stimulate the bone to grow larger or longer.

    What causes osteoid osteoma?

    An osteoid osteoma occurs when certain cells divide uncontrollably, forming a small mass of bone and other tissue. This growing tumor replaces healthy bone tissue with abnormal, hard bone tissue. No one knows exactly why this occurs.

    Is osteoid osteoma common?

    It usually emerges sometime during the teenage years or early adulthood. The condition seems to occur more often in boys than girls.

    What are the symptoms of osteoid osteoma?

    While symptoms may vary child-to-child, the most common include:

    • dull or sharp pain that worsens at night
    • pain that is usually relieved by aspirin or other anti-inflammatory drugs
    • limping
    • painful scoliosis and muscle spasticity (when tumor is located in the spine)
    • growth disturbance (when tumor is involved with a bone's growth plate)
    • muscle wasting away
    • bowing deformity
    • nerve symptoms (like sciatica) when located in the spine
  • Tests

    How does a doctor know that it’s osteoid osteoma?

    Diagnostic procedures for osteoid osteoma are used to determine the exact type of tumor your child has and whether the tumor has spread. These may include a:

    • physical exam, including neurologic function tests including: reflexes, muscle strength, eye and mouth movement, coordination and alertness
    • x-rays to produce images of internal tissues, bones and organs onto film
    • magnetic resonance imaging (MRI) to produce detailed images of organs and structures within the body and/or spine
    • computerized tomography scan (also called a CT or CAT scan) to capture a detailed view of the body, in some cases
    • biopsy or tissue sample from the tumor to provide definitive information about the type of tumor; this is collected during surgery
    • bone scan to detect bone diseases and tumors as well as to determine the cause of bone pain or inflammation
    • complete blood count (CBC), which measures size, number and maturity of different blood cells in a specific volume of blood
    • blood tests including blood chemistries
  • Dana-Farber/Children's Hospital Cancer Center is home to some of the world's most skilled pediatric oncologists. And while we're known for our science-driven approach to treating conditions like red blood cell disorders, our doctors never forget that your child is a child, and not just a patient.

    We specialize in innovative, family-centered care. From your first visit, you'll work with a team of professionals who are committed to supporting all of your family's physical and psychosocial needs.

    Traditional treatments for osteoid osteoma

    Most of these tumors can be successfully treated. However, they can come back. Prompt medical attention and aggressive therapy are important for the best prognosis. Continuous follow-up care is essential for your child.

    Treatment may include:

    Percutaneous radiofrequency ablation

    A minimally invasive day procedure, percutaneous radiofrequency ablation uses radio frequencies passed beneath the skin through a needle to kill the tumor cells by heating them to a high temperature. The procedure can't be used to treat tumors of the spinal column.

    Curettage and bone grafting

    During this operation, the cyst is scraped out of the bone with a special instrument called a curette that has a scoop, loop or ring at its tip. The remaining cavity is then packed with donor bone tissue (allograft), bone chips taken from another bone (autograft) or other materials.

    En bloc resection

    The surgical removal of bone containing the tumor is necessary if the tumor is located in the pelvis or some other site. Internal fixation, with pins, may be required to restore the structural integrity of the bone. This option is usually rare for osteoid osteoma.

    Treatment for osteoid osteoma at Dana-Farber/Children's Hospital Cancer Center

    Our team developed a new technique that uses intraoperative bone scan for the surgical removal of spinal osteoid osteoma, which facilitates more accurate removal of the tumor.

    What is the recommended long-term care for children treated for osteoid osteoma?

    Children treated for osteoid osteoma should visit a survivorship clinic every year to:

    • manage disease complications
    • screen for early recurrence of cancer
    • manage late effects of treatment

    A typical follow-up visit may include some or all of the following:

    • a physical exam
    • laboratory testing
    • imaging scans

    Through the David B. Perini, Jr. Quality of Life Clinic at Dana-Farber Cancer Institute, childhood cancer survivors receive a comprehensive follow-up evaluation from their cancer care team.

    • Our childhood cancer survivorship clinic is held weekly.
    • In addition to meeting with your pediatric oncologists, your child may see one of our endocrinologists, cardiologists, neurologists, neuro-psychologists or alternative/complementary therapy specialists.
    • We also offer the following services:
      • patient and family education
      • psychosocial assessment
      • genetic counseling
      • reproductive and fertility evaluation and counseling
      • opportunities to speak with other childhood cancer survivors
  • Research & Innovation

    Research and clinical trials

    Dana-Farber/Children's Hospital Cancer Center is the New England Phase I Center of the Children's Oncology Group. If your child has progressive or recurrent tumor, she may be eligible for a number of experimental therapies available through these groups, or from one of our independent clinical investigators.

    Participation in any clinical trial is completely voluntary: We will take care to fully explain all elements of the treatment plan prior to the start of the trial, and you may remove your child from the medical study at any time.

    Find a clinical trial

    To search current and upcoming clinical trials at Children’s, go to:

    To search for a cancer trial at Dana Farber/Children’s Hospital Cancer Center, go to: (under Pediatric).     

    To search the NIH’s list of clinical trials taking place around the world, go to:

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  • International: +1-617-355-5209
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