Ortho team removes girl’s painful bone tumor

Patient Stories |

03/21/2024

Brooklyn Andrews foot tumor ortho surgery

The tumor in her ankle was benign, but it interfered with Brooklyn Andrews’ ability to play and sleep.

By Maureen Gilmer, IU Health senior writer, mgilmer1@iuhealth.org

When a doctor tells you there’s a tumor in your little girl’s foot, your brain can go to a dark place. Even if he says it’s a benign tumor.

That’s what Brandi and Tim Andrews were faced with last year when their then-7-year-old daughter, Brooklyn, was diagnosed with an osteoid osteoma in her left ankle.

“They said the word tumor but said it wasn’t serious. Still, you worry,” Brandi said this week during a visit to Riley Hospital for Children.

It was an MRI ordered by orthopedics physician assistant Todd Osterbur that finally got to the root of Brooklyn’s pain, which had been interfering with her play and her sleep for several months.

Brooklyn and Brandi Andrews foot tumor ortho surgery

At first, Brandi said, she and her husband thought their middle daughter was being dramatic or had tweaked her foot somehow when she often complained of pain. When it persisted, they took her to her pediatrician, who suggested it might be growing pains, which can cause soreness in the legs of a child, or flat feet.

But when it began interrupting her sleep and getting worse, they were sent to a podiatrist, who took X-rays that showed something was going on in the ankle bone. That’s when they were referred to orthopedics at Riley.

“That’s when we met Todd,” Brandi said. “He very quickly knew something was wrong and ordered an MRI.”

Osterbur, who first met Brooklyn in February of 2023, said there’s always a concern with a story like hers that this could be a real cancer, but the MRI showed she had a benign tumor in the talus bone of the ankle, where it bends in the front.

Osteoid osteomas account for about 10% of all benign bone tumors and are relatively common in children and young adults.

“It’s classically described as a tumor that causes a lot of night pain,” Osterbur said. “It releases prostaglandins, which create an inflammatory response, which explains the pain, swelling and limping. She couldn’t run and play and do the things she likes to do.”

Treatment starts with over-the-counter anti-inflammatories like ibuprofen or naproxen at bedtime, he said. In time, the condition often resolves on its own.

Not so with Brooklyn.

“This had been going on for many months, and they were pretty frustrated,” Osterbur said.

That’s when he introduced them to Dr. Sean Pfaff, an interventional radiologist at Riley Downtown, who would go on to try radiofrequency ablation, a minimally invasive procedure, to kill the tumor.

While it’s effective 80% to 90% of the time and Brooklyn found some relief, it didn’t last.

“At that point, we discussed trying RFA (ablation) again or getting with one of our orthopedic surgeons to have it removed,” Osterbur said.

The family chose surgery.

On Nov. 28, Dr. Daniel Drake and Osterbur took Brooklyn into the operating room at IU Health North Hospital, where they successfully removed the tumor. She went home the same day.

It would be a few months before Brooklyn would be given the all-clear to resume running, riding her bike and jumping on her trampoline, but the third-grader is back in full play mode now, her mom said.

“She struggled last summer riding her bike because that motion would cause pain. As soon as they told her she could get back on her bike, that’s the first thing she did. It was like 40 degrees outside.”

Other than a slight limp that she is working through in physical therapy, she is back to normal, a blessing for the busy Indianapolis family.

“The Riley team was so amazing,” Brandi said. “I don’t think it would have been found as quickly if it weren’t for Todd. They were amazing at making us feel better.”

That team approach is what Osterbur is most proud of in Brooklyn’s story.

“It was multidisciplinary,” he said, “involving orthopedics, interventional radiology, surgery, recovery and physical therapy. It took a year, but she’s back doing what she loves.”

Osterbur said he sees a couple osteoid osteoma cases a year, including tumors in the hip and spine. There is a chance they can grow back, but he believes the likelihood in Brooklyn’s case is small.

Now, Brooklyn can look forward to her 9th birthday next month, which happens to fall on the day of the solar eclipse, April 8, so party planning is in full gear. She gets the day off school, some cool eclipse glasses and maybe an eclipse-themed cake.

Photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org

Related Doctor

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Todd A. Osterbur, PA-C

Pediatric Orthopedic Surgery

Daniel F. Drake, MD

Daniel F. Drake, MD

Pediatric Orthopedic Surgery

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Sean J. Pfaff, MD

Radiology