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Case Reports
. 2024 Jan;14(1):17-21.
doi: 10.13107/jocr.2024.v14.i01.4130.

A Foot in the Right Direction: Metatarsal Osteoblastoma-A Rare Case and its Management

Raghul Siddharth  1 , Raghavendran Balasubramanian  1 , Thiyagarajan Umasankar  1
Affiliations
Case Reports

A Foot in the Right Direction: Metatarsal Osteoblastoma-A Rare Case and its Management

Raghul Siddharth et al. J Orthop Case Rep. 2024 Jan.

Abstract

Introduction: Osteoblastoma is a rare, benign, bone-forming tumor accounting for <1% of all primary bone tumors. It has a predilection for the posterior elements of the spine and metaphysis and diaphysis of long bones. The occurrence of this tumor in the metatarsal region is rare. We report such the case of a metatarsal osteoblastoma which was treated with wide excision and non-vascularized fibular autograft: a reliable method of reconstruction.

Case report: A 25-year-old woman presented with progressive pain and swelling over the right foot for 4 years. On examination, there was a gross swelling over the fourth metatarsal region over the dorsum of the foot. Radiographs revealed a osteoblastic lesion of the fourth metatarsal bone expanding into the intermetatarsal region. Magnetic resonance imaging (MRI) revealed an expansile altered signal intensity lesion which was hypointense on both T1 and T2 - weighted images with no soft-tissue component. With a working diagnosis of locally aggressive bone-forming tumor, she underwent wide excision of the tumor with reconstruction using a non-vascularized fibular autograft. Intraoperative samples sent for histopathological examination confirmed the diagnosis of osteoblastoma. After 2 years of follow-up, the patient is able to weight bear with no pain and imaging shows graft incorporation with no signs of recurrence.

Conclusion: Osteoblastoma of the metatarsal region can present a diagnostic conundrum to the treating clinician due to its rare nature. Proper evaluation and reconstruction at an early stage with wide excision and reconstruction with non-vascularized fibular autograft are a reliable treatment option.

Keywords: Osteoblastoma; fibular autograft; metatarsal.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
AP and oblique radiographs of the right foot showing a well-defined eccentric lesion over the fourth metatarsal region.
Figure 2
Figure 2
(a-c) Computed tomography 3D reconstruction showing a well-defined, exophytic, and dense sclerotic lesion with osteoid matrix arising from the fourth metatarsal.
Figure 3
Figure 3
(a-c) Coronal, axial, and sagittal sections of magnetic resonance imaging of the left foot showing expansile hypointense lesion in T1 and T2 weighted imaging.
Figure 4
Figure 4
Gross appearance of the excised tumor.
Figure 5
Figure 5
H and E stained section of the excised specimen.
Figure 6
Figure 6
2-year follow-up radiograph of the right foot.
See this image and copyright information in PMC

References

    1. Jaffe HL. Benign osteoblastoma. Bull Hosp Joint Dis. 1956;17:141–51. - PubMed
    1. McLeod RA, Dahlin DC, Beabout JW. The spectrum of osteoblastoma. Am J Roentgenol. 1976;126:321–5. - PubMed
    1. Kroon H, Schurmans J. Osteoblastoma:Clinical and radiologic findings in 98 new cases. Radiology. 1990;175:783–90. - PubMed
    1. Jaffe HL, Mayer L. An osteoblastic osteoid tissue-forming tumor of a metacarpal bone. Arch Surg. 1932;24:550–64.
    1. Lichtenstein L. Benign osteoblastoma;A category of osteoid-and bone-forming tumors other than classical osteoid osteoma, which may be mistaken for giant-cell tumor or osteogenic sarcoma. Cancer. 1956;9:1044–52. - PubMed

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