Osteoid Osteoma

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.

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

While symptoms may vary from 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 the tumor is located in the spine)
• Growth disturbance (when the tumor is involved with a bone's growth plate)
• Muscle wasting
• Bowing deformity
• Nerve symptoms like sciatica (when the tumor is located in the spine)

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.

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:

• Physical exam, including neurologic function tests of reflexes, muscle strength, eye and mouth movement, coordination, and alertness
• X-rays to produce images of internal tissues, bones, and organs
• Magnetic resonance imaging (MRI) to produce detailed images of organs and structures
• Computerized tomography scan (also called a CT or CAT scan) to capture a detailed view of the body biopsy or tissue sample from the tumor to provide definitive information about the type of tumor
• A bone scan to detect bone diseases and tumors as well as to determine the cause of bone pain or inflammation
• A complete blood count (CBC), which measures size, number, and maturity of different blood cells in a specific volume of blood
• Blood tests

The Bone and Soft Tissue Tumor Program is home to some of the world's most skilled pediatric physicians. While we're known for our science-driven approach to treatment, 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. Regular follow-up care is essential for your child.

Treatment may include:

• Percutaneous radio frequency ablation: A minimally invasive day procedure, percutaneous radio frequency ablation uses radio frequencies passed beneath the skin through a needle to kill the tumor cells by heating them to a high temperature.
• Curettage and bone grafting: During this operation, the tumor is scraped out of the bone with a special instrument. 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 rare for patients with osteoid osteoma.

Treatment for osteoid osteoma at the Bone and Soft Tissue Program

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

Although the recurrence rate is less than 10 percent, regular follow-up care is advised until adequate healing has occurred and your child is symptom-free.

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

• Physical exam
• Laboratory testing
• Imaging scans

The Bone and Soft Tissue Tumors Program 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 if 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. If you have further questions during your hospital stay, our experts can answer them fully.

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

• Pediatric experts from relevant medical sub-specialties, such as orthopedics and radiology
• Highly skilled and experienced pediatric nurses
• Physical therapists
• Child life specialists, psychologists, social workers, and resource specialists who provide supportive care before, during, and after treatment

In addition, our center offers:

• 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
• Expert surgical care from experienced pediatric surgeons and orthopedic surgeons, several of whom developed approaches used at centers across the country
• Support services to address all of your child and family’s needs

Boston Children’s is known worldwide for pioneering some of the most effective diagnostic tools, therapies, and preventive approaches in pediatric medicine. A significant part of our success comes from our commitment to research — and to advancing the frontiers of health care by conducting clinical trials.

We coordinate hundreds of clinical trials at any given time. Clinical trials are studies that may involve:

• Evaluating the effectiveness of a new drug therapy
• Testing a new diagnostic procedure or device
• Examining a new treatment method for a particular condition
• Taking a closer look at the causes and progression of specific diseases

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.

• Search current and upcoming clinical trials at Boston Children’s Hospital.
• Search the NIH’s list of clinical trials taking place around the world.