title: Enhanced localization of osteoid osteoma with radiolabeling and intraoperative gamma counter guidance: a case report.
abstract: Osteoid osteoma is a benign bone tumor that can be removed by marginal excision. Excessive removal of reactive bone may result in significant morbidity. We made use of the highly specific radioactive technetium uptake characteristic of osteoid osteoma for its localization. Radioactive technetium (25 mCi) was injected intravenously 2 hours before surgery to a 21-year-old male patient with an osteoid osteoma over the left distal radius. Tumor tissue was localized intraoperatively by a portable hand-held radioactive gamma counter to detect a focal high intensity of radioactivity. Complete tumor removal was shown by reduction of radioactivity to background level. This was confirmed by bone scintigraphy of the specimen and the forearm immediately after surgery. The defect was packed with cancellous bone graft taken from the ipsilateral distal radius through the same wound. Postoperative recovery was very satisfactory. We found this approach useful in limiting resection margin and surgical site morbidity in resection of osteoid osteoma.
authors.affiliation: Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: W L
authors.initials: WL
authors.lastname: Tse
authors.forename: L K
authors.initials: LK
authors.lastname: Hung
authors.forename: Bonita
authors.initials: B
authors.lastname: Law
authors.forename: P C
authors.initials: PC
authors.lastname: Ho
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging* / Q000601:surgery; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery; D012588:Scintillation Counting / Q000379:methods*; D013669:Technetium Tc 99m Medronate
chemical_list: D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate