Osteoblastoma of the Hamate: A Case Report.

Introduction: Osteoblastomas are rare, benign, osteoid-producing primary bone tumors that typically occur in adolescents and young adults. They constitute only 1% of all bone tumors and are exceptionally rare in the hand and wrist. Carpal bone involvement is exceedingly uncommon, with only 9 cases reported in the literature involving the hamate. This case is important to report because the occurrence of this neoplasm in the fifth decade of life is extremely rare, making it one of the very few reports of hamate osteoblastoma in late adulthood. Case Report: A 51-year-old male presented with a 2½ year history of persistent pain and progressive swelling over the dorsal aspect of the ulnar side of the left wrist. The pain was unrelieved by painkillers and worsened after minor trauma. Clinical examination revealed a firm, tender swelling accompanied by joint stiffness. Radiographs showed a well-defined lytic lesion with a sclerotic rim in the hamate, whereas further imaging demonstrated blood-fluid levels. Histopathology confirmed the diagnosis of osteoblastoma. He underwent extended curettage followed by filling the defect with an autologous cancellous bone graft. The patient experienced rapid symptomatic relief, returned to routine activities with full range of motion, and showed no signs of recurrence at the 18-month follow-up. Conclusion: This case report demonstrates that despite its rarity, osteoblastoma should be considered in the differential diagnosis of persistent, non-traumatic wrist pain, even in older adults. This original case is of particular interest to the orthopedic specialty, as it advances our clinical knowledge by proving that joint-preserving methods can ensure structural stability and resolve symptoms. Early recognition and meticulous surgical management with extended curettage and bone grafting provide excellent long-term outcomes while minimizing recurrence risk and avoiding radical resections that significantly impair wrist mobility.