Giant ossifying fibroma of the skull. Case report

✓ A case of giant ossifying fibroma of the cranial vault is reported. The rapid extensive growth of this large parietal bone tumor inaccurately suggested malignancy. The literature relative to this benign bone tumor as well as its surgical management and follow-up findings are presented.

Morphogenetic potential of rat growth cartilages as isogeneic transplants in the interparietal suture area

The proximal end of the tibia or the spheno-occipital synchondrosis with some adjoining bone were isogeneically transplanted across the interparietal suture of 10-day-old rats. As a sham procedure, a piece of calvarium traversed by a part of the interparietal suture was interchanged between pairs of animals. Untreated rats served as controls. The animals, injected with Alizarin red S, were killed 25-75 days after the operation, 10 in each group. The transverse dimensions of the neurocranium were larger in the rats with the cartilage transplants than in the controls, particularly at 25 days after the operation; the differences persisted longer in the animals with the synchondroseal transplant. The orientation of the bone interdigitation at the anterior lambdoidal suture changed temporarily in response to the excessive lateral displacement of the parietal bones. The observations indicate that basicranial synchondroses, like epiphyseal cartilage, are endowed with a tissue-separating property that may persist for a prolonged period under transplant conditions. As such cartilaginous structures may also be affected by environmental influences, there must be a two-way interaction between the synchondroses and their immediate environment.

Ethnic considerations in ultrasonic scanning of fetal biparietal diameters

Biparietal diameters (BPD) were determined by ultrasonography on 86 Caucasians and 107 Polynesians at different gestations. Analysis of variance showed a highly significant (p less than 0.01) difference between groups. At any gestational age, Polynesian fetuses had BPDs 1.89 mm greater than Caucasian fetuses and this fact must be taken into consideration when a single measured value of BPD is being used in the estimation of gestational age. In areas where the obstetrical population comprises different ethnic groups, there is a need for establishing local reference tables by race.

Areal growth in the human fetal parietal bone

The areal growth of the human fetal parietal bone is described using 51 dissected right parietal bones of Japanese fetuses ranging from the fifth month to term. Their shadows were taken on printing paper and analyzed by a sonic digitizer. The absolute growth of the projected area of the fetal parietal bones progresses at a fairly constant rate during the latter half of the fetal period, despite some deceleration in the 9-10th month. By allometric analysis, the allometric coefficients against crown-rump length are 2.201 for males, 2.202 for females, and 2.204 for both sexes, respectively. The allometry is essentially monophasic, showing no inflection point, indicating a change in the slope of the regression line; that is, the growth of the human fetal parietal bone is continuous with a constant specific growth rate. These results are discussed in connection with growth in thickness of the bone.

On the likelihood that Mallin and Rathbun mistook an enlarged parietal foramen for a trephination

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The migration of osteoblasts

The endocranial matrix surfaces of parietal bones of 2-week old Albino Wistar rats were partly denuded of osteoblasts and then cultured for various periods up to 24 h, in control or PTE-enriched medium. They were examined by scanning electron microscopy and evidence for cell locomotion was found. Osteoblasts traversed the denuded bone surface and cut edges of bone in either medium, and cells also migrated out from vascular channels. Glass spicules were placed on the otherwise undisturbed osteoblast layer in similar organ cultures for 2, 3 or 5 days. Osteoblasts migrated from the bone to populate the glass, negotiating any angle. The cells in PTE-enriched media were always aligned parallel to one another and elongated, tended to align with the edges of the glass and, in time, formed a substrate of aligned fibrils whose axes were parallel to those of the cells. Osteoblasts in control medium on glass showed variable degrees of alignment and elongation and were less influenced by edges of the glass. Non-locomotory, nearly equidiametrical cells on glass in 5d control cultures had formed a substrate of randomly oriented fibrils. Migrating osteoblasts on bone matrix did not have leading edge ruffles; isolated, migrating ones on glass did.

[Extracalvarial meningioma--report of a case (author's transl)]

A case of extracalvarial meningioma was reported. 75-year-old man was admitted to our department on November 11, 1974 because of a slowly growing tumor in the right frontoparietal area. The tumor was ovoid and 15x13 cm in size, protruding 5 cm above the skin level, and covered by the normal scalp. Neurological and electroencephalographic examination were negative. Spinal tap showed an opening pressure of 90 mm of water and clear CSF with 62 mg/dl of protein content. Plain roentgenogram and laminagram of the skull revealed both osteolytic and osteoblastic change in the outer and inner table of the skull just beneath the tumor. A right external carotid angiography disclosed a homogeneous extracalvarial tumor stain supplied by the superficial temporal artery and draining into the superficial temporal vein. A right carotid angiogram showed a 1 cm thick avacular area. The segmentally occluded superior sagittal sinus was displaced inward together with bridging collateral channels. Radiologically these picture corresponded to "intracranial non-globoid shape or avascular meningioma" discussed by Huckman et al. The tumor was well-circumscribed, encapsulated and loosely adherent to the periosteum and the skull except for a small portion through which the tumor was communicated with its intracranial part. Histological examination revealed that it was a typical endotheliomatous meningioma. This case should be allocated to the transitional or intermediate type between Lopez II and III type. In the schematical presentation (Fig. 6) we tried to readjust the rather confusing concept and classification of the extracalvarial meningioma.

Transillumination of the skull in premature infants

Transillumination of the skull in infants is a simple technique which can be used to detect several major abnormalities of the central nervous system. The usefulness of transillumination has been limited, however, by the lack of standard techniques for its performance and by the absence of normal values, especially in premature infants. In healthy premature infants, there is a progressive increase in transillumination with increasing gestational age over three sites--the anterior fontanelle, the frontotemporal fossa, and the parieto-occipital eminence.

Hydatid cyst of the skull: report of four cases

Four new cases of cranial echinococcosis are presented and the literature is reviewed. Young males are most commonly affected. Early cases present as an expansile osteolytic lesion in the diploe. The more advanced forms manifest as multilocular or unilocular destructive lesions with adjacent soft-tissue masses. Two patients with unilocular hydatid cysts recovered completely after surgery. One youth with the multilocular form died four months after operation. The other patient is well two years after surgery. The location, anatomical forms of the lesion, and the importance of early diagnosis are stressed.