A Rare Tumor of the Trapezoid Bone in a Patient with Chronic Wrist Pain

Abstract

Background: Osteoid osteoma (OO) is a benign tumor that rarely occurs in carpal bones. Occurrence of OO in trapezoid is extremely rare. We present a patient with OO of the trapezoid as 7th reported case around the world.

Case Presentation: A 25-year-old man was referred to our clinic with a 12-month history of pain of his left wrist. He mentioned that he had wrist pain during manual activity and the pain was increasing over time. He did not have history of trauma. He was treated with nonsteroidal anti-inflammatory drugs (NSAIDs) before being referred to our clinic; however, it did not work. Examination showed tenderness over the dorsoradial side of the left wrist. Conventional radiographs of the wrist were normal. Computed tomography (CT) demonstrated a halo radiolucent osteoid tissue surrounded by a sclerotic tissue in left trapezoid. Magnetic resonance imaging (MRI) showed a focal hypointense lesion (nidus) in the trapezoid with 10 mm diameter. A focal increased uptake of 99mTc in his trapezoid was shown by bone scintigraphy. According to the clinical and imaging findings, we considered excisional biopsy with the diagnosis of OO of trapezoid bone. Surgery was performed through a dorsal incision. We performed en bloc excision. Histopathological findings confirmed the diagnosis of OO. The patient got pain-free on postoperative day 3.

Conclusions: Carpal bones tumor such as OO should be considered in differential diagnosis of patients with chronic wrist pain.