title: Osteoid osteoma transformation into osteoblastoma: fact or fiction?
abstract: BACKGROUND
  Osteoid osteoma and osteoblastoma are rare, benign, bone-forming tumours. The clinical presentation, imaging study findings, and course indicate clearly that these two tumours are distinct entities.
  
  
  METHODS
  We report two cases suggesting transformation of osteoid osteoma into osteoblastoma and therefore inviting a discussion of the links between these two tumours. An 11-year-old girl with a small metaphyseal lesion of the proximal tibia was given a diagnosis of osteoid osteoma. Over the next few weeks, worsening pain and marked tumour growth prompted a biopsy, which was consistent with an aggressive osteoblastoma. A review of the case suggested primary osteoblastoma at the earliest stage of development. In a 14-year-old boy, en-bloc excision was performed to remove a 1cm defect located within the femoral shaft cortex and typical for osteoid osteoma. An asymptomatic recurrence measuring 20mm along the long axis was removed 18 months later. Reassessment of the histological slides indicated recurrence of an incompletely excised osteoid osteoma.
  
  
  CONCLUSIONS
  The histological similarities between osteoid osteoma and osteoblastoma, together with the lesion size criterion, may result in confusion. Collaboration between the clinician and pathologist is crucial and should take the tempo of evolution into account.
  
  
  CONCLUSIONS
  The histopathological differences between these two tumour types deserve to be emphasized. The data reported here challenge the concept that osteoid osteoma can transform into osteoblastoma. These two tumours are distinct entities that should no longer be differentiated based on size, as was long done in the past.
authors.affiliation: Paediatric Orthopaedic Department, Lyon Mother and Child Teaching Hospital, Eastern Hospital Group/Lyon Civilian Hospitals, Claude Bernard Lyon I University, 59, boulevard Pinel, 69677 Bron, France. franck.chotel@yahoo.co.uk
authors.forename: F
authors.initials: F
authors.lastname: Chotel
authors.forename: F
authors.initials: F
authors.lastname: Franck
authors.forename: F
authors.initials: F
authors.lastname: Solla
authors.forename: F
authors.initials: F
authors.lastname: Dijoud
authors.forename: R
authors.initials: R
authors.lastname: Kohler
authors.forename: J
authors.initials: J
authors.lastname: Berard
authors.forename: K
authors.initials: K
authors.lastname: Abelin Genevois
mesh_terms: D000293:Adolescent; D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005269:Femur / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D018215:Osteoblastoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D010017:Osteoma, Osteoid / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D011230:Precancerous Conditions / Q000473:pathology; D035583:Rare Diseases; D018570:Risk Assessment; D013977:Tibia / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome