Abstract
Camurati–Engelmann disease (CED) is a rare, progressive diaphyseal dysplasia characterized as diaphyseal hyperostosis and sclerosis of the long bones. Corticosteroids, bisphosphonates, and losartan have been reported to be effective systemic medications used to reduce CED symptoms. There are no reports of osteoblastoma in patients with CED, and osteoblastoma in the distal radius is rare. We present a patient diagnosed with CED, based on radiological and histological examinations, at 11 years old. At 22 years old, she experienced severe pain in her right forearm and was treated with bisphosphonate, losartan, and prednisolone; however, the pain continued. An expansive and sclerotic lesion at the distal radius was observed on radiography. A follow-up plain radiograph indicated that the lesion was growing. Fluorodeoxyglucose positron emission tomography revealed solitary, intense radiotracer uptake, and a biopsy and surgical resection were performed due to suspected malignancy. Pathologic analysis showed anastomosing bony trabeculae rimmed by osteoblasts observed in a loose fibrovascular stroma. The lesion was diagnosed as an osteoblastoma. Following bone excision and artificial bone grafting, the patient’s severe pain almost completely disappeared. At final follow-up, no evidence of osteoblastoma recurrence was noted. To our knowledge, this is the first case report of osteoblastoma arising in a patient with CED. Bone excision and artificial bone grafting may be a treatment option for local symptomatic osteoblastoma in patients with CED.
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Data are available from the corresponding author upon reasonable request.
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Acknowledgements
We thank Issei Nomura, MD, PhD (Department of Orthopaedic Surgery, Kanazawa Disabled Children’s Hospital), for preparation of medical record. We also thank Editage (www.editage.com) for English language editing and publication support.
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HY, KH, NY, AT, KT, SM, KI, HK, YA, SM, YA, YA, KS, HI, TN, and HT were involved in the diagnosis and clinical management of the patient. All authors revised the paper critically for intellectual content and approved the final version. All authors agree to be accountable for this work.
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Hirotaka Yonezawa, Katsuhiro Hayashi, Norio Yamamoto, Akihiko Takeuchi, Kaoru Tada, Shinji Miwa, Kentaro Igarashi, Hiroaki Kimura, Yu Aoki, Sei Morinaga, Yoshihiro Araki, Yohei Asano, Keisuke Sakurakichi, Hiroko Ikeda, Takayuki Nojima, and Hiroyuki Tsuchiya declare that they have no conflict of interest.
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Yonezawa, H., Hayashi, K., Yamamoto, N. et al. Significant Improvement After Surgery for a Symptomatic Osteoblastoma in a Patient with Camurati–Engelmann Disease: Case Report and Literature Review. Calcif Tissue Int 108, 819–824 (2021). https://doi.org/10.1007/s00223-021-00813-8
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DOI: https://doi.org/10.1007/s00223-021-00813-8