Benign bone tumors

¿Qué es un osteoma osteoide?

It is a very small lesion (the size of a lentil) but can be very annoying, preventing night-time sleep. Most cases are children or adolescents who wake up every day at 3-4 a.m. because of pain.

They need to take anti-inflammatory drugs to be able to sleep. The pain is constant (unlike sarcomas, where it goes "in crescendo"). As it is a very small tumour, it is sometimes not seen on a plain X-ray, and if it is not thought of as a possible cause of nocturnal pain, it may not be diagnosed for years.

A CT scan with spect CT is very useful for diagnosis. Most cases can be treated percutaneously and without hospitalisation, by thermoablation under CT control. The pain usually subsides quickly and the patient is very grateful to be able to go back to sleep without the need to take anti-inflammatory drugs.
 

¿Qué es un osteocondroma?

It is a benign proliferation of normal bone tissue covered by normal cartilage tissue, usually detected in childhood. It is like a "mushroom" growing out of a bone, usually close to the growth plate.

It is usually the parents who detect an abnormal bony prominence in their child. It does not usually hurt. Sometimes it bothers with exercise, or compresses a nerve and is unsightly and the patient or their parents want to remove it If not, it does not require treatment.

Sometimes, in adulthood, they can become malignant, and this is manifested by the fact that they grow or hurt. Sometimes it is multiple (osteochondromatosis or exostoassociated disease, of a genetic nature), and in these cases the risk of malignisation of one of the osteochondromas is greater.

¿Qué es un encondroma?

This is a benign proliferation of cartilage within a bone. The most common locations are the phalanges, proximal humerus and distal femur.

They are usually painless, unless there is a pathological fracture. If they grow, surgical treatment may be indicated. Curettage, cryosurgery or phenolisation and filling are usually performed.

When there are multiple lesions (Ollier's disease) the risk of malignisation of any of the lesions is high and regular check-ups are advisable.

¿Qué es la displasia fibrosa?

It is a benign disease linked to the GNAS gene, usually due to an embryonic mutation during organogenesis.

Depending on the timing of the mutation, it affects one bone (monostotic fibrous dysplasia), several bones (polyostotic fibrous dysplasia) or several bones and the skin, with characteristic "café-au-lait" spots from birth, and sometimes also affects the endocrine system (most often precocious puberty, then called Mc Cune-Albright syndrome).

These are areas of the skeleton where bone is replaced by fibrous tissue. It can lead to severe deformities.

Treatment depends on the severity of the disease: from abstinence to complex surgery to correct deformities.