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Lee DY, Lim S, Yoon JS, Eo S. Recurred forehead osteoma disseminated after previous osteoma excision: A case report. World J Clin Cases 2023; 11:7684-7689. [DOI: 10.12998/wjcc.v11.i31.7684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/14/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Forehead osteoma is a commonly encountered benign facial bone tumor. Endoscopic excision of benign forehead masses is widely performed. Here, we report a rare case of recurrent forehead osteoma that disseminated after a previous osteoma excision.
CASE SUMMARY A 54-year-old female patient had previously undergone endoscopic removal of a single forehead osteoma at 30 years of age. However, she had a recurrent osteoma around the same site and underwent another endoscopic resection at 40 years of age. During her first visit to our outpatient clinic, she presented with a cobblestone-like irregular surface on the forehead and a 3D facial bone computed tomography scan revealed a widely ragged surface of the inoculated osteoma on the outer table of the frontal bone. Under general anesthesia, we performed a radical complete excision of the disseminated osteoma through a bicoronal incision using an osteotome, chisel, mallet, and rasping. We hypothesized that the recurrence may have been caused by the inoculation of residual osteoma remnants from the previous procedure. Craniofacial surgeons should be cautious when removing osteoma particles, particularly when using an endoscopic approach.
CONCLUSION To prevent recurrence, it is essential to conduct additional meticulous burring and a thorough inspection of the surface after copious irrigation.
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Affiliation(s)
- Dong Yun Lee
- Plastic and Reconstructive Surgery, DongGuk University Medical Center, GoYang 10326, South Korea
| | - SooA Lim
- Plastic and Reconstructive Surgery, DongGuk University Medical Center, GoYang 10326, South Korea
| | - Jung Soo Yoon
- Plastic and Reconstructive Surgery, DongGuk University Medical Center, GoYang 10326, South Korea
| | - SuRak Eo
- Plastic and Reconstructive Surgery, DongGuk University Medical Center, GoYang 10326, South Korea
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Ren Y, Liu Y, Wu H, Meng Q, Zhang J, Li H, Dong S, Lian H, Du C, Zhang H. Subdural osteoma in an adolescent patient with epilepsy: an unusual case report and literature review. Childs Nerv Syst 2023; 39:3281-3288. [PMID: 37318613 DOI: 10.1007/s00381-023-06015-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/31/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Subdural osteoma (SO) is a rarely reported benign tumor, and there is no report of SO manifested with epileptic seizures. We aim to further the understanding of SO-related epilepsy. METHODS Here, we report a meaningful case of epilepsy secondary to SO. A systematic review of the literature about SO using the electronic database PubMed and Web of science up to December 2022 was conducted. RESULTS A 15-year-old girl presented with epileptic seizures for 8 years. Magnetic resonance imaging revealed an irregular lesion with heterogeneous signal in the right frontal convexity. Right frontal craniotomy was performed to remove the lesion. The pathological diagnosis was SO. Histological analysis revealed that the mechanosensitive ion channels Piezo 1/2 were upregulated in the brain tissue compressed by the osteoma, compared with the levels in the osteoma-free region. Seizure freedom was obtained during the 6-month follow-up after the surgery. We identified 24 cases of SO in 23 articles. With our case, a total of 25 cases with 32 SOs was included. Of 25 cases, 24 are adults, and 1 is a child. Seizure has been reported only in our case. Frontal osteoma was found in 76% of the patients. Symptoms were cured in 56% of the patients after surgery. CONCLUSION Surgery is a safe and effective approach to the treatment of symptomatic osteoma. Mechanical compression on cerebral cortex may be a predisposing factor of the epileptogenesis caused by the SO.
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Affiliation(s)
- Yutao Ren
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
- Center of Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yong Liu
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Hao Wu
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
- Center of Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qiang Meng
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Jiale Zhang
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
- Center of Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Huanfa Li
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Shan Dong
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Haiping Lian
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Changwang Du
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Hua Zhang
- Department of Neurosurgery and Clinical Research Center for Refractory Epilepsy of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China.
- Center of Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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Yang X, Liu Y, Zhang Y. Relapse of skull osteoma after hydroxyapatite cement cranioplasty: Case Report. Front Oncol 2023; 13:1174128. [PMID: 37274241 PMCID: PMC10235521 DOI: 10.3389/fonc.2023.1174128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/08/2023] [Indexed: 06/06/2023] Open
Abstract
In this case report, we present an extremely rare and previously unreported case of skull osteoma relapse without any attachment to the skull after hydroxyapatite cement (HAC) cranioplasty. The 49-year-old male patient was admitted with recurrence of the left frontal skull lesion; he underwent craniectomy and HAC cranioplasty for a left frontal osteoma 14 years before. Intraoperative findings disclosed multiple irregular lesions located on the HAC flap without any attachment to the bony structure and the roots of the lesions originating from the outer layer of the dura through several reserved holes. Pathological diagnosis was osteoma. The purpose of this report is to document this rare occurrence and provide the most probable pathogenesis for this rare event.
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Colamaria A, Sacco M, Iodice S, Settembrini G, Ciavarella G, Fochi NP, Carbone F, Leone A. Solitary subdural osteomas: Systematic review of the literature with an illustrative case. Surg Neurol Int 2022; 13:203. [PMID: 35673651 PMCID: PMC9168329 DOI: 10.25259/sni_245_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022] Open
Abstract
Background Subdural osteomas represent an extremely rare entity with only 20 cases described to date. Despite the typical benign behavior, these tumors can grow to compress the brain and occasionally detach from the dura mater. Methods A systematic search of the literature was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After screening for duplicates, 179 publications met the eligibility criteria. Finally, 18 manuscripts were included in this review. Moreover, a detailed description of an illustrative case is provided. Results The median age at diagnosis was 43.2 years, showing a female prevalence. The inner table of the frontal bone was reported as the most frequent location, and in six cases, the lesions did not show any relation with the dura, which appeared intact. Surgical resection appears to be an effective and safe management option. In the present work, the case of a 60-year-old female who presented with persistent, diffuse headaches which had first occurred 6 months earlier is described. On admission, the physical and neurological examinations were unremarkable, and her medical history disclosed no systemic disease, meningitis, or head injury. Computed tomography showed a homogeneous, high-density nodule attached to the inner table of the left middle cranial fossa. Conclusion In addition to an in-depth case description, the first systematic and qualitative review of the literature on intracranial subdural osteomas using the PRISMA is provided.
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Affiliation(s)
| | | | | | | | | | | | | | - Augusto Leone
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
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Li L, Ying GY, Tang YJ, Wu H. Intradural osteomas: Report of two cases. World J Clin Cases 2021; 9:1863-1870. [PMID: 33748235 PMCID: PMC7953386 DOI: 10.12998/wjcc.v9.i8.1863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/03/2021] [Accepted: 01/21/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Intradural osteoma is very rarely located in the subdural or subarachnoid space. Unfortunately, intradural osteoma lacks specificity in clinical manifestations and imaging features and there is currently no consensus on its diagnosis method or treatment strategy. Moreover, the pathogenesis of osteoma without skull structure involvement remains unclear.
CASE SUMMARY We describe two cases of intradural osteomas located in the subdural and subarachnoid spaces, respectively. The first case involved a 47-year-old woman who presented with a 3-year history of intermittent headache and dizziness. Intraoperatively, a bony hard mass was found in the left frontal area, attached to the inner surface of the dura mater and compressing the underlying arachnoid membrane and brain. The second case involved a 56-year-old woman who had an intracranial high-density lesion isolated under the right greater wing of the sphenoid. Intraoperatively, an arachnoid-covered bony tumor was found in the sylvian fissure. The pathological diagnosis for both patients was osteoma.
CONCLUSION Surgery and pathological examination are required for diagnosis of intradural osteomas, and craniotomy is a safe and effective treatment.
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Affiliation(s)
- Li Li
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Guang-Yu Ying
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Ya-Juan Tang
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Hemmings Wu
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
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Laghari FJ, Eakin S, El-Zuway S. Bilateral intracranial subdural osteomas of varying sizes imaged 7 years apart: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2021; 1:CASE20141. [PMID: 36046769 PMCID: PMC9394223 DOI: 10.3171/case20141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 12/16/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUNDPreviously, solitary and unilateral aggregates of intracranial subdural osteomas have been described. These tumors are thought to be slow growing and at times inconsequential on the basis of characteristics of subjacent brain. Unilateral location and history of traumas have led to the thought that the head trauma may play a role in pathogenesis.OBSERVATIONSThe authors describe a unique case of a patient who was found to have bilateral intracranial subdural osteomas of unequal size on the basis of computed tomography and magnetic resonance imaging. The presenting symptom was headache. Initially small and thought to be irrelevant, these tumors grew over the course of 7 years to cause mass effect and effacement of the sulci and gyri. The larger 15-cm-long tumor was excised and was sent for pathology, which showed classic histology for subdural osteoma.LESSONSThe described case uniquely demonstrates evidence of the slow growth of intracranial subdural osteomas over the course of years. It is crucial not to disregard the tumor because it can grow over time to cause mass effect. Patient follow-up is strongly recommended. Bilateral tumor occurrence at a similar location in this case supports an etiology other than trauma. Further research is necessary.
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Affiliation(s)
| | | | - Salem El-Zuway
- Neurosurgery, University of Pittsburgh Medical Center Hamot, Erie, Pennsylvania
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Cao X, Wang Y, Jin Y. Subarachnoid Osteoma of the Right Frontal Lobe. World Neurosurg 2020; 143:415-418. [PMID: 32805469 DOI: 10.1016/j.wneu.2020.08.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Intracranial osteoma arising from nonosseous tissue and surrounded by brain parenchyma is extremely rare. We report an intracranial osteoma surgical case with no heterotopic ossification. CASE DESCRIPTION A 32-year-old woman presented with headache, vertigo, and weakness. Preoperative neuroimaging revealed a spherelike, calcified intracranial lesion in the right frontal region. The bone-hard mass was completely removed by right frontal craniotomy; adhesion and invasion of the skull inner plate and dura were not found. The subarachnoid lesion was surrounded by right middle frontal gyrus, and the blood supply was from branches of pia mater. Postoperative histologic examination suggested an extensive intracranial ossification. At 6-month follow-up, the patient demonstrated a good recovery without any neurological deficits and no recurrence. CONCLUSIONS In this rare surgical case of subarachnoid osteoma, comprehensive preoperative neuroradiologic examinations, accurate surgical management of adjacent brain tissue, and vessel protection were the cornerstones of successful resection.
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Affiliation(s)
- Xiangyuan Cao
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yida Wang
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi Jin
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
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Takeuchi S, Tanikawa R, Tsuboi T, Noda K, Miyata S, Ota N, Hamada F, Kamiyama H. Surgical case of intracranial osteoma arising from the falx. Oncol Lett 2016; 12:1949-1952. [PMID: 27588144 DOI: 10.3892/ol.2016.4833] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 06/02/2016] [Indexed: 12/29/2022] Open
Abstract
Intracranial osteomas completely unrelated to osseous tissues are extremely rare. In the present study, the case of a 40-year-old female who presented with persistent headache is reported. Computed tomography (CT) and bone window CT revealed an ossified lesion in the frontal area. Fast imaging employing steady-state acquisition (FIESTA)/CT venography fusion imaging demonstrated that the mass was located just below the superior sagittal sinus and cortical veins, and had adhered partially to these veins. Surgery achieved complete tumor removal with preservation of the cortical veins and superior sagittal sinus. The histological examination findings were compatible with osteoma. The present postoperative course was uneventful. The present rare case of intracranial osteoma originating from the falx was successfully treated surgically. Preoperative FIESTA/CT venography fusion imaging was very useful to demonstrate adhesion between the tumor mass and the superior sagittal sinus and cortical veins.
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Affiliation(s)
- Satoru Takeuchi
- Department of Neurosurgery, National Defense Medical College, Saitama 359-8513, Japan; Department of Neurosurgery, Teishinkai Hospital, Hokkaido 065-0033, Japan
| | - Rokuya Tanikawa
- Department of Neurosurgery, Teishinkai Hospital, Hokkaido 065-0033, Japan
| | - Toshiyuki Tsuboi
- Department of Neurosurgery, Teishinkai Hospital, Hokkaido 065-0033, Japan
| | - Kosumo Noda
- Department of Neurosurgery, Teishinkai Hospital, Hokkaido 065-0033, Japan
| | - Shiro Miyata
- Department of Neurosurgery, Teishinkai Hospital, Hokkaido 065-0033, Japan
| | - Nakao Ota
- Department of Neurosurgery, Teishinkai Hospital, Hokkaido 065-0033, Japan
| | - Fumihiro Hamada
- Department of Neurosurgery, Teishinkai Hospital, Hokkaido 065-0033, Japan
| | - Hiroyasu Kamiyama
- Department of Neurosurgery, Teishinkai Hospital, Hokkaido 065-0033, Japan
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Kim EY, Shim YS, Hyun DK, Park H, Oh SY, Yoon SH. Clinical, Radiologic, and Pathologic Findings of Subdural Osteoma: A Case Report. Brain Tumor Res Treat 2016; 4:40-3. [PMID: 27195262 PMCID: PMC4868817 DOI: 10.14791/btrt.2016.4.1.40] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 01/27/2016] [Accepted: 04/04/2016] [Indexed: 12/20/2022] Open
Abstract
We present a case of a subdural osteoma. A 29-year-old female presented with a 3-year history of headaches. Computed tomography scan revealed a homogeneous high-density lesion isolated from the inner table of the frontal bone (a lucent dural line) in the right frontal convexity. Magnetic resonance imaging revealed an extra-axial lesion with a broad base without dural tail sign and punctate enhancement pattern characteristic of abundant adipose tissue. Upon surgical excision, we found a hard bony mass clearly demarcated from the dura. The mass displayed characteristics of an osteoma upon histological examination. The symptom was relieved after operation.
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Affiliation(s)
- Eun Young Kim
- Department of Neurosurgery, Inha University Hospital, Incheon, Korea
| | - Yu Shik Shim
- Department of Neurosurgery, Inha University Hospital, Incheon, Korea
| | - Dong Keun Hyun
- Department of Neurosurgery, Inha University Hospital, Incheon, Korea
| | - Hyeonseon Park
- Department of Neurosurgery, Inha University Hospital, Incheon, Korea
| | - Se Yang Oh
- Department of Neurosurgery, Inha University Hospital, Incheon, Korea
| | - Seung Hwan Yoon
- Department of Neurosurgery, Inha University Hospital, Incheon, Korea
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Krisht KM, Palmer CA, Couldwell WT. Multiple osteomas of the falx cerebri and anterior skull base: case report. J Neurosurg 2015; 124:1339-42. [PMID: 26587651 DOI: 10.3171/2015.6.jns15865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors describe a rare case of intracranial extraaxial parafalcine and anterior skull base osteomas in a 22-year-old woman presenting with bifrontal headaches. This case highlights the possible occurrence of such lesions along the anterior skull base and parafalcine region that, as such, should be considered as part of the differential diagnosis for extraaxial calcific lesions involving the anterior skull base. To the authors' knowledge, this is the first reported case of a patient who underwent complete successful resection of multiple extraaxial osteomas of the anterior skull base and parafalcine region.
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Affiliation(s)
- Khaled M Krisht
- Department of Neurosurgery, Clinical Neurosciences Center, and
| | - Cheryl A Palmer
- Department of Pathology, University of Utah, Salt Lake City, Utah
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Chen SM, Chuang CC, Toh CH, Jung SM, Lui TN. Solitary intracranial osteoma with attachment to the falx: a case report. World J Surg Oncol 2013; 11:221. [PMID: 24010982 PMCID: PMC3846101 DOI: 10.1186/1477-7819-11-221] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 08/28/2013] [Indexed: 01/26/2023] Open
Abstract
Background Intracranial osteomas are uncommon lesions that usually arise from the inner table of the cranium. There are few reports in the literature of intracranial osteomas with meninges attachment and without direct relation with the skull bone; these osteomas were mostly attached with dura. We report a rare osteoma with falx attachment. Case A 64-year-old woman presented with a 3-month history of intermittent tinnitus and dizziness. The scout film of petrous bone computed tomography scan revealed a high-density lesion in the frontal area. Magnetic resonance imaging showed a 2.5-cm mass attached to the surface of the falx in the right frontal parasagittal area. The patient underwent right frontal craniotomy, and a bony hard mass was found located in the right frontal parasagittal region extra-axially, with its medial surface attached to the falx. It could not be broken down by the cavitron ultrasonic surgical aspirator or even the cutting loop and was detached from the falx and removed in one piece. Histopathological examination showed a nodule with bony trabeculae and bone marrow tissue, compatible with osteoma. The postoperative course was uneventful, and the patient was discharged from the hospital with no neurological deficits one week after operation. Conclusions This is the first case report in the English literature of an intracranial osteoma arising from the falx. Because of their slow growth and their locations in silent brain areas, intracranial osteomas are usually diagnosed incidentally. Surgical resection is the primary treatment choice.
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Affiliation(s)
- Shu-Mei Chen
- Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
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