Benign Osteogenic Neoplasm Research Articles

Case Paper: Combination of the Skeletal and Extra-Skeletal Craniofacial Osteomas: A Case Report

Osteoma is a slow-growing benign osteogenic tumor. Osteomas can be central, peripheral, and extra-skeletal. The prevalence of extra-skeletal osteoma often found in muscles is very low. Osteomas unrelated to the syndrome often occur as solitary tumors, but sometimes multiple osteomas are unrelated to the syndrome. Here, we report a rare non-syndromic craniofacial osteoma, a combination of skeletal and extra-skeletal types. During mastication, the patient complained of dull pain in the right maxillary molar area. Panoramic and CBCT showed multiple homogenous opacities on the right mandibular body and condylar neck, as well as in the right infratemporal fossa and masticator space, having a pressure effect on the base of the skull. A biopsy of the mass on the mandibular body confirmed osteoma. The absence of the other manifestations of Gardner syndrome made the patient a rare case of multiple non-syndromic osteomas.

An unusual case of peripheral osteoma in a young patient

Osteoma is a benign osteogenic neoplasm characterized by gradual growth. Commonly, it manifests in the craniofacial region, marked by the proliferation of compact and/or cancellous bone. Despite its frequent occurrence, peripheral osteoma’s precise etiology and pathogenesis remain unknown. Post-surgical excision recurrence is rare, and malignant transformation has yet to be documented. This study aims to detail an unusual case of an 11-year-old male patient presenting with a solitary peripheral osteoma in the right retromolar trigone region, a previously unreported site. The patient was initially asymptomatic, but after one month, the lesion induced facial asymmetry and discomfort while chewing. Successful surgical intervention resulted in the lesion's removal, and after 1 year of monitoring, no signs of recurrence were observed. This paper also highlights the peripheral osteoma’s clinical, radiographic, surgical, and histopathological features, as well as its differential diagnoses.

A Rare Case of Ethmoido-Maxillary Osteoblastoma: Case Report and Systematic Review

Osteoblastoma (OB) is a rare benign osteogenic tumor, primarily found in the axial skeleton and long tubular bones. It accounts for <1% of all primary bone tumors, mainly affecting young adults. Maxillofacial involvement is rare, often manifesting in the mandible. Osteoblastoma's pathogenesis is unclear, with slow growth and varied clinical presentations. Radiologically, it appears as a well-defined, osteolytic lesion with sclerotic rims. The definitive diagnosis relies on histopathology, with immunohistochemistry aiding in challenging cases. Differential diagnoses include fibrous dysplasia, osteoid osteoma, osteomas, cemento-ossifying fibroma, and low-grade osteosarcoma. Surgical excision with safety margins is the standard treatment, while radiotherapy may be considered for certain cases. Prognosis is generally good, but long-term follow-up is essential due to recurrence risks, particularly in aggressive forms. Malignant transformation can occur, emphasizing the importance of careful diagnosis and management.

Recurrent Solitary Clavicular Parosteal Osteoma 25 Years after Surgical Resection

Osteoma is a slowly growing, asymptomatic, benign osteogenic tumor. An extremely rare case of clavicular parosteal osteoma (PO) is reported. A 46-year-old female patient was treated with marginal resection after an open biopsy for a large, firm symptomatic mass originating from the middle part of the left clavicle, which recurred 25 years after surgery. In the fifth year postoperatively, the patient was followed up with a full range of motion of the left shoulder without any problem in her daily life. In this case report, the clinical course, imaging findings, diagnosis, and long-term results of a rare case of parosteal osteoma recurrence of the clavicle are described for the first time in the literature.

Osteoid Osteoma

Çoğunlukla başka bir nedenle yapılan radyolojik incelemelerde rastlantısal olarak saptananan benign osteojenik tümörlerden olan osteoid osteoma aktiviteden bağımsız, geceleri daha şiddetli ağrıya neden olur. Standart radyografiler lezyonu gösterebilir ancak nidusun gösterilmesi ve lezyonun yerinin kesin tespiti için bilgisayarlı tomografi (BT) gerekmektedir. Nidus adı verilen radyolusen bir alana sahip olan bu benign tümörde ağrı nidus içi prostoglandin E2 seviyesinin yüksek oluşu ile ilişkilendirilmiştir. Ayırıcı tanıda stres kırığı, kortikal kemik absesi ve intra-kortikal osteosarkom düşünülmelidir. Tedavisinde nidusun tümü ile uzaklaştırılması gerekmektedir. Marjinal rezeksiyon, intralezyonel küretaj ve radyofrekans ablasyon tedavi seçenekleri arasındadır. Marjinal rezeksiyon yapıldıysa alınan piyesin radyolojisi ile nidusu ihtiva edip etmediği gösterilmelidir.

A Case Report and Review on Mandibular Compact and Cancellous Osteomas

Osteomas are benign osteogenic tumors that are characterized by the proliferation of either cancellous, compact or a combination of both. Central and peripheral are two types of osteomas. In this article, we report two cases of osteomas that were clinically diagnosed as mandibular tori. The radiographic, computed tomography, three-dimensional computed tomography (3DCT) and histopathological investigations were employed in achieving final diagnosis. Both cases were managed by surgical excision. This article aims to discuss the cases presented with literature review on diagnosis and management.

Unilateral Mandibular Coronoid Osteoma-An Unusual Cause for Pseudoankylosis

An osteoma is a benign osteogenic tumor characterized by compact or cancellous bone proliferation with unknown etiology, but it may arise from cartilage or embryonal periosteum. Osteomas are rare, slow growing, usually asymptomatic until their size and position interferes with functioning. This is a report of a 53-year-old male patient who complained of difficulty in opening his mouth, which was diagnosed as an osteoma of mandibular coronoid producing pseudo ankylosis, a very unusual condition. Surgical excision of the tumor was performed, followed by physiotherapy and no recurrence was observed. This case report highlights the rare causes of pseudo ankylosis with significance to early diagnosis and intervention which can prevent further complications to the patient.

Minimally Invasive Technique for Treatment of Osteoid Osteoma: A Case of Anatomically Critical Lesion in an Adolescent Patient

Background: Osteoid osteoma is a benign osteogenic tumor affecting adolescents and young adults. It is managed using different treatment options. The lesions located around the lesser trochanter is rare and the management of these lesions is troublesome. Here, we report a case of an osteoid osteoma in the lesser trochanteric region, managed with a minimally invasive surgical excision of the lesion. Case Report: In a 14-year-old girl patient with nocturnal left thigh pain from 2 years before, conservative treatment with administration of non-steroidal anti-inflammatory drugs (NSAIDs) was not effective, and symptoms were refractory to medication. The day after surgery the patient was pain-free. Conclusion: The surgical management of osteoid osteoma in the region of the lesser trochanter is troublesome. The minimally invasive surgical excision of the lesion using CT-guided percutaneous drilling and resection of the osteoid osteoma is a safe, simple, cost-benefit, and effective technique.

Surgical treatment of extensive peripheral osteoma in the mandibular ramus: Case report

Osteomas are benign osteogenic tumors, which clinically manifest as well-defined and asymptomatic lesions. This article aims to report a case of extensive osteoma in the mandibular branch, addressing the main tools used for diagnosis and treatment modalities. Patient L.M.S, 55 years old, male, sought the service of Maxillofacial Surgery, reporting the appearance of a nodule on the face with evolution of 2 years. On physical examination, a significant volumetric increase was observed in the pre-auricular region on the left side, asymptomatic on palpation and non-bleeding. Computed tomography was requested, which showed a hyperdense bone lesion in the mandibular ramus region. The planned surgical proposal was for extra-oral access in the pre-auricular region on the left side, excision of the lesion by osteotomy followed by osteoplasty for the regularization of the remaining bone tissue and suture by planes. Subsequently, the piece was sent for histopathological analysis that identified the lesion as a compact osteoma. The patient was followed up for 1 and a half years, through clinical and radiographic evaluation, through which an excellent bone repair was observed, with no signs of recurrence. Carrying out the clink exam is essential for the diagnosis of osteoma, as it is an asymptomatic pathology. Due to the fact that it has a low probability of recurrence and does not present malignancy, a conservative approach can be performed with the appropriate postoperative follow-up. Therefore, it is concluded that the performance of a thorough clinical examination associated with the imaging and microscopic information are essential for a good clinical management of this pathology.

DIAGNOSIS AND SURGICAL TREATMENT OF PERIPHERAL MANDIBULAR OSTEOMA: CASE REPORT

Osteomas are benign osteogenic tumors composed of compact or spongy bone, and may present on the periphery, intraosseous, or within the soft tissues. Peripherals are uncommon, usually present as pedicled bony masses and are more common in young adults. The present study aims to report a case of peripheral osteoma located in the mandibular body of a 32-year-old male, asymptomatic, presenting an aesthetic complaint. A surgical procedure was performed under general anesthesia where intraoral access, osteotomy, and tumor excision were done with about 2 cm in diameter. At the anatomopathological examination, the diagnosis was confirmed and the patient presented no signs of relapse after 1 year and 6 months of postoperative control. The treatment and diagnosis of this pathology should be judicious, since small lesions can be treated conservatively, with periodic observation, in contrast to the large symptomatic tumors or that cause deformities that require surgical treatment.

Fibroma desmoplásico em arco zigomático: relato de caso raro

O fibroma desmoplásico é um tumor osteogênico benigno muito raro, composto por fibroblastos difusos e abundantes fibras de colágeno. É localmente agressivo e apresenta alta taxa de recorrência, sendo assim, seu tratamento pode ser um desafio e diversas estratégias têm sido descritas como forma de evitar sua recidiva. Desse modo, o objetivo deste relato foi apresentar o curso clínico e tratamento de um paciente com diagnóstico de fibroma desmoplásico em região de arco zigomático esquerdo. Foi descrito um caso de um paciente de 37 anos de idade, cuja queixa era de aumento de volume indolor em face com aproximadamente seis meses de evolução. O exame físico evidenciou-se uma massa firme, sólida e bem delimitada em região temporal do arco zigomático esquerdo, que foi submetida a excisão cirúrgica. Os achados histológicos da lesão incluíram células fusiformes envolvidas por deposição de colágeno intersticial difusa com ausência de revestimento mucoso superficial, compatível com fibroma desmoplásico. O paciente segue com 2 anos e 6 meses de pós-operatório, não apresentando sinais de recidiva da lesão.

Juvenile trabecular ossifying fibroma of the mandible

Fibro-osseous lesions are bony lesions where the bone is replaced by fibrous connective tissue and include fibrous dysplasia (FD), cemento-osseous dysplasia, and ossifying fibroma (OF). OF is a benign osteogenic mesenchymal tumor and clinicopathologically divided into juvenile and conventional subtypes. Juvenile OF (JOF) is a rare rapidly growing tumor of the craniofacial bones having aggressive clinical behavior with high recurrence rate. Pathologically, JOF is classified into juvenile trabecular OF (JTOF) and juvenile psammomatoid OF. JTOF microscopically shows proliferation of fibrocellular connective tissue stroma along with immature and woven bony trabeculae with varied histologic features. We report a case of JTOF of the mandible in a 12-year-old male with the initial presentation of painless swelling on the right side lower jaw. Clinicoradiologically, the case was suspected as central giant cell granuloma and odontogenic tumors. He was successfully treated with wide local excision and reconstruction and was on follow-up for 8 months without any recurrence of the disease.

Peripheral Osteoma of Mandibular Angulus: Analysis of the Literature and Report of a New Case

Osteoma is a benign osteogenic neoplasm originating from the continuous proliferation of compact and/or cancellous mature bone. The tumor can be classified as peripheral, central or extra-skeletal regarding location and it commonly seen in the cranio-facial region especially at the skull and paranasal sinuses. The exact etiology of the tumor is still controversial; however, it is considered that infection, trauma, muscle activity contributes the occurrence of the tumor. Due to the slow growing nature of osteoma, it is coincidentally detected on radiographs or when the tumor reaches a large size enough to trigger symptoms and cause facial disfigurement. Although mainly detected in the craniofacial bones, osteomas are rarely located in the jaw bones. The purpose of this review, is to present the diagnosis and treatment plan of a peripheral osteoma in the mandibular angulus region of an 8-year-old boy together with a review of published cases of peripheral osteomas of mandibular angulus.

Surgical Treatment of Osteoma in the Basilar Region of the Mandible.

Osteoma is an uncommon benign osteogenic tumor characterized by the proliferation of compact and cancellous bone. The objective of this study was to report a case of osteoma in the basilar region of the mandible. The patient reported no pain, but the affected area was tender to touch and there was esthetic concern because of the apparent swelling. The mass measured approximately 5 cm in diameter and extended to the lingual area of the mandible. A vestibular approach was used for surgical treatment. After infiltration of a local anesthetic and vasoconstrictor, to expose the mandibular ramus, an incision was made with an electric scalpel along the external oblique ridge through the mucosa, submucosa and muscle, fascia and periosteum until the lower second molar, 3 to 5 mm inferior to the mucogingival junction. A mucoperiosteal flap was raised until the base of the mandible to access the tumor. Osteotomy was performed and the tumor was removed. The patient shows no recurrence of the tumor after 1 year and 6 months of follow-up. Periodical clinical and radiographic follow-up are satisfactory since recurrence is rare.

Solitary peripheral osteoma of the body of the mandible

Osteomas are benign osteogenic tumors that are often slow growing and frequently arising in the craniofacial bones and rarely originating from the mandible. Central, peripheral, and extraskeletal are the three varieties of osteomas of which the central and the peripheral types are commonly seen in the facial bones. Peripheral osteomas most commonly were seen in the frontal, ethmoidal, and maxillary sinus and very rarely seen in the jaws. Typically asymptomatic in nature, osteoma presents itself as a welldefined radiopaque mass. Herein, we report a rare case of peripheral osteoma of the body of the mandible of a 45-year-old female patient.

Mastoid osteoma: Report of a case and literature review

Mastoid osteoma is a benign osteogenic tumor with few reported cases in the literature. The exact cause is unknown; however, developmental anomaly, trauma, and infection have been implicated. Majority are asymptomatic, and diagnosis can be made with computed tomography scan. Surgical excision is curative and offers acceptable cosmetic results. We aimed to report a case of mastoid osteoma coexisting with subgaleal lipoma and outline its management. A 35-year-old woman presented with left mastoid and frontal swellings because of unacceptable disfigurement. Clinical and radiological evaluation was suggestive of mastoid osteoma and sublingual lipoma. The diagnosis was confirmed by histology, after total surgical excision. The patient made uneventful recovery and had acceptable curative and esthetic results. Mastoid osteoma can occur alone or in association with other lesions such as lipoma, especially in syndromic type. In general, asymptomatic and cranial computed tomography scan remained an imaging of choice and surgical resection confers good outcome.

Le Fort I Disassembly for the Management of Juvenile Ossifying Fibroma Extending To the Skull Base.

Ossifying fibroma is a rare benign osteogenic neoplasm arising from undifferentiated cells of the periodontal ligament. Ossifying fibroma have a well-defined border that differentiates it from fibrous dysplasia clinically; these tumors manifest as a round or ovoid, expansile, painless, slow-growing mass may displace the roots of adjacent teeth and also cause root resorption. A variety of approaches for resection of the maxilla have been described. Most involve the use of facial and lip-splitting incisions to gain wide access. Surgical approach specifically to the ossifying fibroma located in the midface includes the Le Fort I approach, Caldwell-Luc access, lateral rhinotomy with medial or total maxillectomy, external ethmoidectomy, and endoscopic surgery. The access through Le Fort I disassembly is a versatile approach not only because of the aesthetic potential in using intraoral incision but also due to its minimal invasiveness, lesser complications and gives the possibility of reconstruction in a single operation. Le Fort I disassembly followed by an excision appears to be a versatile, secure, and satisfactory option.

RARE-05BIFRONTAL OSTEOMA IN CONJUNCTION WITH CALVARIUM HEMANGIOMA: FIRST REPORTED CASE

INTRODUCTION: Osteomas are benign osteogenic neoplasms of cancellous bone that typically occur in the head and neck as a single lesion. They may be central, peripheral or extra-skeletal and typically involve the frontal sinus. Hemangiomas are exceedingly rare benign tumors that arise from intra-skeletal vasculature. They are typically located in the vertebral body with calvarium involvement occurring less commonly. To our knowledge, no prior cases have been reported in the literature of bifrontal bone osteoma that co-occurs with frontal bone hemangioma. CASE: A 65-year-old female presented with a 4-month history of a painless mass developing over her right eyebrow. On physical exam patient had a nonpainful immobile growth. Magnetic Resonance Imaging (MRI) revealed a peripheral enhancing mass of the right frontal calvarium without breach apparent to the inner or outer table or sinus involvement. Computed Topographic (CT) imaging showed a mixed density, expansile lesion consistent with a hemangioma inside the right frontal calvarium. The patient underwent a bifrontal craniectomy where the hemangioma was resected in conjunction with the second bony lesion. Pathology results confirmed a frontal osteoma in conjunction with a hemangioma of the calvarium. The patient underwent an uncomplicated clinical course with no adjuvant therapy. The patient is presently 4 months post-operation with no evidence of recurrence. CONCLUSION: Osteomas rarely occur as multiple lesions, especially in the absence of sinus involvement. In similar tone, hemangiomas themselves are rare lesions, with calvarium origin reported as a less common location. Both osteoma and hemangioma are benign lesions and treatment for each alone is surgical excision without the need of adjuvant therapies. As such, this coincidence of lesions is unprecedented, making it difficult to determine the clinical or prognostic significance of this patient's presentation and treatment outcomes.

Osteoid osteoma of the proximal femur: Treatment by percutaneous bone resection and drilling (PBRD). A report of 44 cases

IntroductionOsteoid osteoma is a benign osteogenic tumor that is mainly located in the lower limbs. According to Campanacci the proximal femur is involved in 25% of cases. We present a series of 44 cases of osteoid osteoma located in the neck of the femur or the lesser trochanter treated by the minimally invasive method, CT-guided percutaneous bone resection and drilling (PBRD). Materials and methodsThis series included 44 patients, 20 girls and 24 boys, treated between 1987 and 2012. The average age at surgery was 12.7 years old (range 4–34). The diagnosis was based on the “association” of scintigraphy (hyperfixation) – CT scan (nidus located on the femoral neck or near the lesser trochanter). These patients underwent CT-guided PBRD under general anesthesia. Specific ancillary material was used to reach and remove the nidus and a cylinder of bone was sent to the pathologist for assessment. A lateral or anterior approach was used in all cases except one in which a posterior incision was made. Histological confirmation was obtained in 23 cases (the bone fragment was damaged in 21 cases). ResultsForty-two patients were reviewed after a minimum follow-up of one year (12–56 months). Two patients were lost to follow-up. Results were evaluated clinically and on CT scan 1 year after surgery: there were 35 cures with complete and permanent pain relief. There were 5 failures and 1 case of recurrence requiring a second CT-guided PBRD procedure as well 2 complications involving femoral fracture (one associated with failure). DiscussionThe proximal femur is a common location of osteoid osteoma. Treatment requires careful preoperative planning to determine the surgical approach for safe removal. PBRD is a minimally invasive technique, allowing complete resection with suitable ancillary equipment. This method should be compared with thermoablation, which is a similar technique. ConclusionCT-guided PBRD is a therapeutic option in case of osteoid osteoma of the proximal femur. Level of evidenceLevel IV.

Solitary osteoma of body of the mandible

Osteomas are relatively rare benign osteogenic neoplasm's characterized by the proliferation of compact or cancellous bone. Osteomas can develop as peripheral (periosteal) masses attached to the cortical plates or as central lesions arising from endosteal bone surfaces. Although multiple osteomas of the jaws are a hallmark of Gardner's syndrome (familial adenomatous polyposis), non-syndromic cases are typically solitary. The purpose of this paper is to present a large peripheral osteoma originating from the buccal surface of the mandible and causing asymmetry in a 35-year-old woman.