A Rare Case of Osteoblastoma of the Sacrum

Osteoblastoma (OB) is a rare bone tumor. It is classified as benign and represents about 1% of all bone neoplasms. While it typically occurs in the axial skeleton, sacral involvement is extremely rare. Despite its non-malignant nature, OB can be locally aggressive and may lead to considerable morbidity if not addressed in a timely manner. This report discusses a unique case of sacral, focusing on the clinical, radiological, and surgical features.A 14-year-old male patient reported experiencing increasing pain in his left lower limb and lumbosacral region for two years. A magnetic resonance imaging (MRI) of the lumbosacral area identified a mass measuring 50x43 mm on the left side of the sacrum in T2-weighted images. Further evaluation with a positron emission tomography/computerized tomography (PET/CT) scan indicated a destructive bone lesion in the left sacrum, measuring 43x40 mm, with a soft tissue component and increased fluorodeoxyglucose (FDG) uptake (standardized uptake value maximum: 11). The patient underwent surgical excision by a neurosurgery team, and histopathological analysis confirmed the diagnosis of OB.Although OB is a benign tumor, its location can cause significant symptoms, particularly in rare areas like the sacrum. Diagnostic imaging modalities such as MRI and PET/CT are crucial for identifying the tumor and planning surgical intervention. The elevated FDG uptake observed on PET/CT indicated a metabolically active lesion, reinforcing the need for surgical treatment.Sacral OB is an exceptionally rare entity. This case underscores the need to include OB in the differential diagnosis of sacral lesions and illustrates the value of imaging in facilitating accurate diagnosis and management. Surgical resection remains the cornerstone of treatment, offering good clinical outcomes.