Mastoid osteoma: A rare incidental finding in an orthodontic patient

Differential diagnosis of an osseous cranial tumor from Hellenistic Muğla, Turkey

OBJECTIVE

This project evaluates a cranial lesion from a Hellenistic-era individual excavated by the Muğla Archaeological Museum in Gülağzı, Turkey.

MATERIALS

An osseous tumor measuring 3.02 × 3.54 × 2.98 cm originating from the occipital bone of a probable young adult male.

METHODS

The tumor was examined using gross morphological inspection, plain radiography (x-ray), and computed tomography (CT) imaging to identify potential differential diagnoses for the osseous cranial tumor.

RESULTS

The lesion in question displays features highly consistent with both osteoid osteoma and osteoblastoma. The tumor had a non-sclerotic, sharply demarcated border, a radiolucent nidus measuring less than 2 centimeters in diameter, and homogeneous sclerotic bone surrounding the nidus.

CONCLUSIONS

Differential diagnosis determined the osseous tumor to be a benign neoplasm, and in this case the features of the tumor are highly consistent with a diagnosis of either osteoblastoma or osteoid osteoma.

SIGNIFICANCE

The identification of novel neoplastic cases in paleopathology represents an important contribution to ongoing discussions regarding the temporality and regional variability of neoplastic conditions in the past. Additionally, a rigorous diagnostic study augmented by x-ray, CT scans, and 3D modeling provides data that can be utilized in future paleopathological studies.

LIMITATIONS

Diagnostic interpretation would be aided by histological examination of the tumor, which was impossible in this case. Histological examination would provide a definitive diagnosis.

SUGGESTIONS FOR FURTHER RESEARCH

Given the high incidence of benign tumors in the clinical literature but a paucity of reports in the paleopathological record, further research is indicated to better understand the implications of benign neoplasms in antiquity.

Long-Term Surgical Results of Cortical Mastoid Bone Osteomas

Background: Though osteomas can commonly arise in the cranial bones, an extra canalicular mastoid bone location is a rare entity with less than 200 cases described to date. We present three cases of cortical mastoid bone osteomas and compare them with cases presented in the literature. Methods: In this study, we used a retrospective chart analysis. Results: All three patients presented after years of progressively increasing postauricular swelling without symptoms. Temporal bone non-contrast CT allowed accurate preoperative diagnosis. Surgical treatment was performed for cosmetic issues with minimal postoperative morbidity. Complete excision was achieved in all cases, and to date, there is no evidence of recurrence. Conclusions: Mastoid osteomas are rare benign slow-growing tumors. They usually present as a painless cosmetic disfigurement and are otherwise asymptomatic. Surgical excision is the treatment of choice when they cause esthetic discomfort or are symptomatic. Recurrences are infrequently reported.

Craniofacial Osteomas: From Diagnosis to Therapy

An osteoma is a benign bone lesion with no clear pathogenesis, almost exclusive to the craniofacial area. Osteomas show very slow continuous growth, even in adulthood, unlike other bony lesions. Since these lesions are frequently asymptomatic, the diagnosis is usually made by plain radiography or by a computed tomography (CT) scan performed for other reasons. Rarely, the extensive growth could determine aesthetic or functional problems that vary according to different locations. Radiographically, osteomas appear as radiopaque lesions similar to bone cortex, and may determine bone expansion. Cone beam CT is the optimal imaging modality for assessing the relationship between osteomas and adjacent structures, and for surgical planning. The differential diagnosis includes several inflammatory and tumoral pathologies, but the typical craniofacial location may aid in the diagnosis. Due to the benign nature of osteomas, surgical treatment is limited to symptomatic lesions. Radical surgical resection is the gold standard therapy; it is based on a minimally invasive surgical approach with the aim of achieving an optimal cosmetic result. Reconstructive surgery for an osteoma is quite infrequent and reserved for patients with large central osteomas, such as big mandibular or maxillary lesions. In this regard, computer-assisted surgery guarantees better outcomes, providing the possibility of preoperative simulation of demolitive and reconstructive surgery.