Unusual Osteoblastoma of the First Metatarsal Bone Treated by Total Resection and Fibular Autograft: A Case Report.

CASE: A 25-year-old man presented with progressive pain and swelling of the left foot for 4 years. The images showed a contrast-enhanced mixed lesion (osteolytic and blastic) of the first metatarsal bone with surrounding soft-tissue edema. The differential diagnoses favored chronic osteomyelitis or neoplasia, most likely benign. Histopathology confirmed the diagnosis of osteoblastoma as immature bone trabeculae rimmed by osteoblasts appeared. Then, the patient was successfully treated with wide surgical excision of the first metatarsal bone and reconstruction using a nonvascularized fibular autograft. After 3 years of follow-up, the graft was well incorporated and no recurrence was encountered.

CONCLUSION

Osteoblastoma is rare in metatarsals; only 12 cases have been reported. It may have similar clinical and radiological picture to osteomyelitis. Wide surgical excision followed by fibular autograft reconstruction is an effective treatment option.