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Osteoma

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• Added by Chris Estes, last edited by Christian Veillette on Sep 29, 2009  (view change)

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Tumor biology and incidence Osteomas are slow growing lesions of compact bone almost exclusively found in the craniofacial bones, projecting into the oral cavity and sinuses. These lesions are observed in 3% of patients requiring sinus radographs. Primary extracranial osteomas are extremely rare and referred to as a "parosteal osteomas." When present with cutaneous cysts, fibromatoses and colonic polyps the diagnosis of Gardner's Syndrome is present 1 . Age Adults in their 30's and 40's Gender Unknown Presentation Prolonged history of swelling and dull aching pain. Physical findings Palpable mass Plain films AP Tibia Lateral Tibia Smoothly contoured, radiodense lesions attached to the cortical surface. Density is uniform and similar to that of cortical bone. Site Almost exclusively affects the craniofacial bones. Extracranial lesions most commonly affect the long bones (most commonly the middle 1/3 of the tibia). Also observed in the femur, ulna, clavicle, fourth metacarpal, and pelvis. Size Extracranial lesions are typically larger than cranial lesions and usually 1-4 centimeters in size. Tumor effect on bone Enter text Bone response to tumor Enter text Matrix Lamellar bone. Cortex Enter text Soft tissue mass Enter text Bone scan Enter text CT Scan Axial CT Tibia Coronal CT Tibia Enter text MRI Axial T1 MRI Tibia Coronal T1 and T2 MRI Tibia Enter text PET CT Differential Diagnosis Parosteal osteosarcoma Osteoid osteoma Osteochondroma Natural history Enter text Pathology Enter text Diagnosis and treatment Diagnosis: Treatment: Controversial. Observation vs. En bloc excision Complications Enter text Related Orthopaedia Resources Related Resources Osteoma (PORTNotes) References Fri Mar 12 12:34:44 PST 2010 Footnotes Ref Notes 1 Peyser AB, Makley JT, Callewart CC, Brackett B, Carter JR, Abdul-Karim FW, 1996. "Osteoma of the long bones and the spine. A study of eleven patients and a review of the literature." J Bone Joint Surg Am 78 (8): 1172-80 [PubMed] Abstract: The clinical features, radiographic and histopathological findings, treatment, and results are described for eleven patients who were managed for an extracranial osteoma at our medical center between 1980 and 1993. Ten of the patients were initially seen because of dull, aching bone pain that had been present for two weeks to thirty years. Radiographs demonstrated single or multiple homogeneous, well defined, radiodense foci with smooth round or lobulated margins. The histopathological features consistently included uniformly dense, compact, cortical-like, mature lamellar bone. The preoperative diagnosis was unclear for all patients, and osteoma was rarely considered in the differential diagnosis. For four patients, a tentative diagnosis of osteosarcoma was made, and a wide excision was carried out in two of these patients. Marginal excision with less than three millimeters of normal tissue around the lesion was performed in most patients. None of the osteomas recurred, and ten patients had relief of the pain. Awareness of the clinical, radiographic, and histopathological features of osteoma, as described, is valuable for making a differential diagnosis and for distinguishing osteomas from other lesions. Recommended Reading Click on citation to view abstract Fri Mar 12 12:34:45 PST 2010 Peyser AB, Makley JT, Callewart CC, Brackett B, Carter JR, Abdul-Karim FW, 1996. "Osteoma of the long bones and the spine. A study of eleven patients and a review of the literature." J Bone Joint Surg Am 78 (8): 1172-80 [PubMed] Abstract: The clinical features, radiographic and histopathological findings, treatment, and results are described for eleven patients who were managed for an extracranial osteoma at our medical center between 1980 and 1993. Ten of the patients were initially seen because of dull, aching bone pain that had been present for two weeks to thirty years. Radiographs demonstrated single or multiple homogeneous, well defined, radiodense foci with smooth round or lobulated margins. The histopathological features consistently included uniformly dense, compact, cortical-like, mature lamellar bone. The preoperative diagnosis was unclear for all patients, and osteoma was rarely considered in the differential diagnosis. For four patients, a tentative diagnosis of osteosarcoma was made, and a wide excision was carried out in two of these patients. Marginal excision with less than three millimeters of normal tissue around the lesion was performed in most patients. None of the osteomas recurred, and ten patients had relief of the pain. Awareness of the clinical, radiographic, and histopathological features of osteoma, as described, is valuable for making a differential diagnosis and for distinguishing osteomas from other lesions.

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. Orthopaedia - Osteoma. In: Orthopaedia - Collaborative Orthopaedic Knowledgebase. Created Aug 26, 2009 01:21 by Chris Estes , Last modified Sep 29, 2009 16:45 ver.17. Retrieved 2010-03-12, from http://www.orthopaedia.com/x/NAJqAQ.

Contributions

The following individuals have contributed to this page:

User	Edits	Comments	Labels	Label List	Last Update
Chris Estes	11	0	0		197 days ago
Christian Veillette	5	0	0		163 days ago
Christopher Beauchamp	1	0	0		165 days ago
Rose Olea	0	0	0

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