Peripheral Solitary Osteoma of the Zygomatic Arch: A Case Report and Literature Review.

Thomas Starch-Jensen

doi:10.2174/1874210601711010120

Abstract

Osteoma is a benign slow-growing osteogenic neoplasm commonly occurring in the craniofacial skeleton, characterized by the proliferation of compact and/or cancellous bone. Osteomas may be peripheral, central, or extraskeletal. Peripheral osteomas arise from the periosteum and are quite uncommon in the jaw bones. The exact aetiology and pathogenesis of peripheral osteoma are unknown. Clinically, peripheral osteomas are usually asymptomatic, but depending on the location and size of the lesion, it may cause swelling, pain, esthetic disfigurement and functional impairment. On radiological imaging, a peripheral osteoma appears often as well-circumscribed, round to oval, pedunculated radiopaque mass attached to the cortex by a broad base or a pedicle. Asymptomatic osteomas are treated conservatively, while surgical excision is indicated when the lesion is symptomatic, actively growing, or for cosmetic reasons. Histologically, osteomas are composed of a normal-appearing, dense mass of lamellar bone. Recurrence of peripheral osteoma after surgical removal is extremely rare and there are no reports of malignant transformation. A review of the literature disclosed only 7 well-documented cases of peripheral osteoma located at the zygomatic bone. The purpose of this article is to present the clinical, radiographic, surgical and histological features of a solitary peripheral osteoma of the left zygomatic arch in a 55-year-old woman and to review the literature about this uncommon pathologic entity.

Highlights

Osteoma is a benign slow growing neoplasm characterized by the proliferation of compact or cancellous bone, and one of the most common tumors of the nose and paranasal sinuses [1]
Multiple osteomas are mainly associated with Gardner's syndrome while solitary osteomas can be further classified based on the location as: (1) the central osteoma arising from the endosteum; (2) the peripheral osteoma deriving from the periosteum and (3) the extraskeletal soft tissue osteoma, which usually develops within the muscles [2]
The slow growth of an osteomas justified a conservative approach toward an asymptomatic lesion, whereas surgical removal of osteomas is indicated when the lesion is symptomatic, actively growing, or causing esthetic disfigurement and functional impairment

Summary

INTRODUCTION

Osteoma is a benign slow growing neoplasm characterized by the proliferation of compact or cancellous bone, and one of the most common tumors of the nose and paranasal sinuses [1]. It was first recognized as a tumor by Jaffe in 1935 [2]. A panoramic radiographic exam showed the presence of a pedicled osseous lesion originating from the left zygomatic arch (Fig. 1). Surgical closing osseous lesion lateral resection by to the zygomatic extraoral arch approach. Surgical swelling osseous radiopaque resection by mass on the zygoma extraoral approach. Firm bony swelling Surgical above the zygomatic resection by arch extraoral approach.

DISCUSSION

CONCLUSION