ABSTRACT
CASE: A 22-year-old man presented with long-standing, progressive neck pain of unknown etiology. Investigation revealed a cervical spine osteoid osteoma affecting the right C4-5 facet joint. He underwent minimally invasive en bloc resection with O-arm-assisted 3-dimensional navigation without introducing iatrogenic spinal instability. Symptoms resolved after surgery, without recurrence or instability at the 2-year follow-up. CONCLUSION: Cervical spine osteoid osteoma is a tumor that presents diagnostic and therapeutic challenges. Achieving precise, complete resection of the tumor with a minimally invasive approach while avoiding spinal instrumentation and arthrodesis is paramount to excellent surgical outcomes.
Subject(s)
Osteoma, Osteoid , Spinal Neoplasms , Surgery, Computer-Assisted , Adult , Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/surgery , Humans , Imaging, Three-Dimensional , Male , Osteoma, Osteoid/diagnostic imaging , Osteoma, Osteoid/pathology , Osteoma, Osteoid/surgery , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/surgery , Surgery, Computer-Assisted/methods , Tomography, X-Ray Computed , Young AdultABSTRACT
Patients with many types of malignancy commonly harbor quiescent disseminated tumor cells in bone marrow. These cells frequently resist chemotherapy and may persist for years before proliferating as recurrent metastases. To test for compounds that eliminate quiescent cancer cells, we established a new 384-well 3D spheroid model in which small numbers of cancer cells reversibly arrest in G1/G0 phase of the cell cycle when cultured with bone marrow stromal cells. Using dual-color bioluminescence imaging to selectively quantify viability of cancer and stromal cells in the same spheroid, we identified single compounds and combination treatments that preferentially eliminated quiescent breast cancer cells but not stromal cells. A treatment combination effective against malignant cells in spheroids also eliminated breast cancer cells from bone marrow in a mouse xenograft model. This research establishes a novel screening platform for therapies that selectively target quiescent tumor cells, facilitating identification of new drugs to prevent recurrent cancer.
