Osteoblastoma: Non-Cancerous Tumor of the Backbone

This is a non-cancerous tumor, almost like Osteoid Osteoma. Except these tumors are larger.

Introduction

To understand this tumor, first read about Osteoid Osteoma.

Osteoblastoma is a non-cancerous bone forming tumor, similar to osteoid osteoma. It appears as red to purple granular mass that easily crumbles. It has rich blood supply.

Almost 40% of this tumor occurs in the spine. Men get this more often than women.

Complication due to Osteoblastoma

This condition is usually not life-threatening. But it can cause severe pain. When it is spine, the deformations can start compressing the nerves and make things worse.

Symptoms of Osteoblastoma

Symptoms of this disease are similar to an osteoid osteoma, with two exception. (1) These symptoms are much more aggressive and (2) the back pain does not occur at night.

Following are the common symptoms of osteoblastoma:

  • Back pain
  • Muscle pain
  • Muscle weakness
  • Pain, tingling or weakness that travel from the back towards the legs (symptoms of nerve compression)

Diagnosis of Osteoblastoma

Since symptoms are similar for most vertebral tumors, imaging modalities are required to identify the type of tumor.

  • CT Imaging

    CT Scan is the investigation of choice for this tumor.CT image can help to identify the tumor in its early stage as the bone changes can be clearly observed.

  • X-Ray

    X-Ray can miss small tumors in their early stages. So, X-Ray imaging is not recommeneded for initial diagnosis. But once the treatment has started, X-Ray images can be used to monitor the improvement.

Treatment for Osteoblastoma

Following are the standard treatments available for osteoblastoma patients

Medical Treatment

There are no medications available to stop or reverse the tumor. But doctors often prescribe pain relievers to temporarily alleviate the pain.

Surgical Treatment

Complete Surgical Resection: This is the treatment of choice for Osteoblastoma. Successful removal of the complete tumor provides immediate pain relief and good neurological recovery for the patients.

Treatment Window

Patients with symptoms of nerve compression must undergo immediate surgery to relieve the compression and prevent permanent loss of functions.

Oligodendroglioma: Tumors of Glial Cells in Brain (mostly) and Spine

In our brain and spinal cord, there are housekeeping cells called the glial cells. There are 3 types of glial cells. One of them is called oligodendrocytes. Cancer of the oligodendrocytes is called oligodendroglioma.

Introduction to Oligodendroglioma

Glial cells are the housekeeping cells of the brain and the spinal cord. There are three types of glial cells: astrocytes, ependymas and oligodendrocytes. Toxins, radiation exposure, drugs, nutrition imbalance or genetic load can make them grow without control. When oligodendrocytes grow without control, the growth (also called a tumor) is called a oligodendroglima.

Oligodendrocytes (also called oligodendroglia) are somewhat like an octopus. They have a central body and multiple arms shooting from it. Each arm reaches out to the nearest axon, wraps around it, forming a layer of insulation called myelin sheath around the axon. Each oligodendrocyte can have as much as 50 arms.

Oligodendrogliomas always spread into other neighboring tissue. Only when the tumor is very small, surgery can take out these cancers completely. When the tumor has grown to become large, surgery can help in making it smaller so that it doesn’t crush the adjoining structures.

Fortunately, oligodendroglioma responds well to chemotherapy and/or radiation.

Complication due to Oligodendroglioma

There are no known ways to make an oligodendroglioma go away. Provided that the tumor is detected early enough and a rigorous treatment protocol is taken up, many patients successfully outlive this disease.

Symptoms of Oligodendroglioma

The most common symptoms of this disease are

  • Seizure
  • Headache

Other symptoms may include

  • Speech disturbances
  • Vision problems
  • Nausea
  • Vomiting
  • Sudden uncontrolled movemenets
  • Problems with thinking and understanding

Investigations of Oligodendroglioma

In a CT or an MRI image, oligodendroglioma appears like any damaged brain tissue (lesion). Only way to to know if the lesion is an oligodendroglioma is to obtain a small sample of the tissue and investigate it under a microscope.

Treatment of Olidodendroglioma

For this type of cancer, chemotherapy is the first choice of treatment. Chemotherapy is often followed by radiation therapy.

Chemotherapy

This tumor responds well to PCV chemotherapy (Procarbazine, CCNU and Vincristine). It also responds reasonably well to a chemotherapy drug called Temozolomide. However, this tumor must be treated aggressively and monitored closely.

Surgical Treatment

Because this type of growth diffuses into neighboring tissue, surgery usually cannot remove it completely. Only when the tumor is very small, surgical removal is worth trying.

On the other hand, when the tumor has grown up to be very large and it starts crushing the adjoining tissue, a surgeon will try to remove as much of the tumor tissue as possible. This process is called debulking.

Treatment Window

This tumor responds well to aggressive chemotherapy with close monitoring. If the tumor is detected at an advanced stage, so much better. Patients who have been treated this way have lived for several decades.

Osteochondroma: Non-Cancerous Tumor of the Backbone

This is a non-cancerous tumor, growing from the cartilaginous part of growing bones.

Introduction

Osteo = bone. Chondro = Soft bone or Cartilage.

This tumor develops from the soft part of growing bone. It shoots out like a branch from a tree. It has a broad base, a stalk and a cartilage cap at the tip.

Since the tumor occurs in growing bones, it is usually seen in patients younger than 20. The tumor stops increasing in size once the bone reaches maturity.

Men are more affected by this condition than women. This tumor can develop in any part of the body, including the spine.

Complication due to Osteochondroma

 

Symptoms of Osteochondroma

Most patients with this condition do not have any symptom.

When a large tumor is seen in the spine and it starts compressing the surrounding structures, the following symptoms can occur:

  • Back pain
  • Muscle aches
  • Muscle weakness

As mentioned above, an osteochondroma stops growing once the bone reaches maturity. In case of persistent increase in size, other cancerous conditions may be suspected.

Diagnosing Osteochondroma

Here are the standard tools of diagnosis:

  • MRI Imaging

    An MRI imaging study is preferred over CT or X-Ray as the former helps to clearly visualize the soft tissue margins surrounding the tumor

Treatment for Osteochondroma

There are no known ways to medically stop or reverse this growth.

Medical Treatment

Pain killers are often prescribed to relieve the pain symptoms of this condition.

Surgical Treatment

Complete Surgical Excision: This is the treatment of choice for this condition. The tumor is completely cut off below the stalk and removed. Further follow up is required to watch for recurrence.

Treatment Window

Surgery is recommended for patients in whom the growth seem to continue unabated.

Osteosacroma: Tumor of the Backbone

Osteosarcoma is the second most common form of bone cancer.

Introduction

Osteo = bone. Sarcoma = Cancerous tumor.

These are large tumors made up of immature bone cells, provided with a rich blood supply. The tumor has disorganized masses on the surface, making it gritty. The bone in which the tumor grows may even be fractured by the tumor.

The tumor is highly aggressive. If it is not treated early, it can rapidly invade the whole bone and other areas. Since the tumor invades blood vessels, bleeding or tissue death may be seen in the area surrounding the tumor.

Even though they are a common form of cancer, they seldom affects the vertebra. The disease strikes both men and women equally.

Complication due to Osteosarcoma

If untreated or treated inadequately, this can lead to several complications, including death.

Symptoms of Osteoblastoma

Symptoms of this tumor vary depending on the location and severity. Common symptoms of this tumor appearing in the spine include:

  • Back Pain
  • Joint pains
  • Weakness
  • Numbness
  • Gait problems
  • Loss of bowel and bladder control (in severe cases)
  • Paralysis (In severe cases)

Since the tumor is cancerous, patients may experience:

  • Rapid loss of weight
  • Loss of desire to eat food
  • Excessive tiredness

Diagnosis of Osteoblastoma

Here are the standard tools used to diagnose this disease:

  • X-Ray

    An X ray shows damaged areas of bone, and some areas of abnormal new bone formation. Fractures of the bone caused by the tumor can also be appreciated on X Ray.

  • CT Imaging

    A CT scan helps to visualize the bone structure as a whole. Any lesion missed out on X ray can be seen on a CT scan.

  • MRI Imaging

    An MR image helps to identify the whole extent of the tumor, along with soft tissue involvement. Nerve compression can also be seen with help of an MRI.

  • Bone Scan

    If multiple lesions are suspected, a bone scan is helpful to view all the lesions, by injecting a dye into the bone. The defective areas pick up the dye and when a picture of the bone is taken, these are seen as patches.

  • Needle Biopsy

    In order to identify the exact type of the tumor tissue, a needle is inserted into the tissue and a tiny bit of the tumor is sucked out and examined under a microscope.

Treatment of the Osteosarcoma

Here are the standard treatments available:

Medical Treatment

Prior to a surgery to be carried out to remove the cancer, two or three cycles of chemotherapy is administered. This reduces the size of the tumor. Chemotherapy will be continued even after the surgery.

Other than this, these patients are always on pain relievers.

Surgical Treatment

Radical Tumor Excision: After 10 to 15 weeks of medical treatment with chemotherapy drugs, the tumor shrinks. At this time, the mass can be easily cut and taken out without damaging the surrounding nerves and blood vessels.

Radiation Therapy

Following surgery, radiation therapy may be given as determined by the doctor.

Treatment Window

Since the tumor is cancerous, if left untreated, it can invade and destroy the whole spinal cord, sometimes leading to paralysis. The tumor can also spread to other parts of the body.

Hence immediate treatment is recommended.

Osteoid Osteoma: Non-Cancerous Tumor of the Backbone

Non-cancerous bone growth, formation of new bone from immature bone cells depositing on existing bone is called Osteoid Osteoma.

Introduction

Osteoid = Immature bone. Osteoma = Formation of new bone upon existing tissue (usually existing bone tissue).

An osteoid osteoma is a non-cancerous bone tumor that arises from immature bone cells, and results in the formation of new bone over the existing bones.

This tumor is soft, dark red or yellowish white mass surrounded by thickened areas of new bone formation.

It can arise in the backbone or any of the long bones of the body. In backbone, the lumbar (lower back) area is most commonly affected. Men are more commonly affected  by this than women.

Complication due to Osteoid Osteoma

Except when this occurs in bone joints, difficulties due to this is limited to constant or periodic pain. In spine, this can cause spinal deformation, which must be treated before they become irreversible.

Symptoms of Osteoid Osteoma

Due to the formation of new bone over the existing bone, the affected vertebral bone starts to thicken. This thickening causes deformity of the backbone and compresses the nerves in that area, resulting in the following:

  • Back pain, much severe at night
  • Deformity of the spinal cord (scoliosis)
  • Pain, tingling or weakness that travel from the back towards the legs

Diagnosing Ostoid Osteoma

Following are the standard tools for diagnosing an incidence of Osteoid Osteoma:

  • X-Ray Imaging

    A normal bone is translucent under X-Ray. In an X-Ray image, normal bones appear grey in color. Because this disease increases the thickness of the bone in patches, the tumor is seen as whiter patches.

  • CT Imaging

    A CT Scan is the investigation of choice for osteoid osteoma. In a CT image, the tumor is seen as a well defined oval shaped area of abnormal tissue, surrounded by whitish patches of newly formed bone tissue.

  • Bone Scan

    A dye injected into the body gets collected over the area of abnormal bone formation like ink blots. This helps in identifying areas affected by osteoid osteoma.

Treatment for Osteoid Osteoma

Following treatments are available for an Osteoid Osteoma patient

Medical Treatment

At this point in time, no medications are available to stop or reverse this disease. However, patients with this disease may suffer from severe pain and they are prescribed pain medication.

Surgical Treatment

Complete Surgical Excision: This is the treatment of choice for Osteoid Osteoma. Successful removal of the complete tumor provides immediate pain relief for the patients.

Treatment Window

When this disease is seen in the spine, early surgery reduces the chances of permanent bone damage. This is because once the tumor erodes the spinal pillars, it is difficult to reverse the damage.

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