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  • Title: Large sacral osteoblastoma: a case report and review of multi-disciplinary management strategies.
    Author: Khan IS, Thakur JD, Chittiboina P, Nanda A.
    Journal: J La State Med Soc; 2012; 164(5):251-5. PubMed ID: 23362588.
    Abstract:
    INTRODUCTION: Osteoblastomas are uncommon primary benign bone tumors. The sacrum is an uncommon site of involvement. We present a case of a large, technically challenging sacral osteoblastoma in a pediatric patient that was managed with en-bloc resection and lumbo-sacral reconstruction showing long-term remission. CASE REPORT: A 15-year-old Hispanic male presented to our clinic in May 2006 with low back pain. Imaging revealed a large expansile and erosive mass at the S2 vertebral body. Definitive treatment of the lesion with en-bloc surgical resection was planned after a biopsy that confirmed osteoblastoma. The patient underwent pre-operative embolization and a same-day, two-stage resection of the tumor with lumbosacral instrumentation for pelvic reconstruction. The S1 nerve roots were sacrificed during en-bloc resection of the mass. Post-operatively, the patient developed an areflexic bladder without major motor or sensory impairment. Subsequently, insertion of an artificial urinary sphincter and a colostomy were performed. At the five-year follow up, the patient remains symptom free with no detectable recurrence. CONCLUSION: The sacrum is a known, but rare, location for an osteoblastoma. We present a technically challenging case of a pediatric patient with a large sacral osteoblastoma. We highlight the importance of a multidisciplinary approach to ensure a long-term, disease-free outcome.
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