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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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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: 1.0] [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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Abstract
Subdural osteomas are extremely rare benign neoplasms. Here, we report the case of a 35-year-old female patient with a right frontal and parietal subdural osteoma. The patient presented with a 2-year history of intermittent headache and fatigue. Computerized tomography (CT) scan showed a high-density lesion attached to the inner surface of the right frontal and parietal skull. Magnetic resonance imaging (MRI) demonstrated T1 hyperintensity and T2 hypointensity of the lesion. Intraoperatively, the hard mass was located in subdural space and attached to the dura mater. Histopathological examination revealed lamellated bony trabeculae lined by osteoblasts and the intertrabecular marrow spaces occupied by adipose tissue. The patient underwent neurosurgical resection and recovered without complication. Surgical excision is recommended to extract the symptomatic lesions with overlying dura mater.
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Affiliation(s)
- Yunna Yang
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Zheng Gu
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yinglun Song
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Yang H, Niu L, Zhang Y, Jia J, Li Q, Dai J, Duan L, Pan Y. Solitary subdural osteoma: A case report and literature review. Clin Neurol Neurosurg 2018; 172:87-89. [PMID: 29986201 DOI: 10.1016/j.clineuro.2018.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/27/2018] [Accepted: 07/01/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Subdural osteomas are benign neoplasms that are rarely encountered. We report the case of a 64‑year‑old female patient with a left temporal subdural osteoma. CASE DESCRIPTION The patient presented with intermittent dizziness that first began two years earlier. Non-contrast computed tomography revealed a densely calcified left temporal extra-axial mass. Magnetic resonance imaging of the lesion revealed signal loss on T1-weighted and T2-weighted images and non-enhancement on Gadolinium enhanced T1-weighted images, and diffusion-weighted and ADC images demonstrated reduced values attributed to calcium-induced signal loss. Histologically, the lesion predominantly consisted of lamellar bone without bone marrow elements. The patient underwent stereotactic magnetic resonance imaging-guided neurosurgical resection and recovered without complication. CONCLUSIONS Subdural osteomas may not be enhanced on magnetic resonance imaging. Surgical tumourectomy can be considered for symptomatic patients with subdural osteomas.
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Affiliation(s)
- Hu Yang
- Department of Neurosurgery, Lanzhou University Second Hospital, China
| | - Liang Niu
- Department of Neurosurgery, Lanzhou University Second Hospital, China
| | - Yinian Zhang
- Department of Neurosurgery, Lanzhou University Second Hospital, China
| | - Juan Jia
- Department of Anesthesiology, Lanzhou University Second Hospital, China
| | - Qiao Li
- Department of Neurosurgery, Lanzhou University Second Hospital, China
| | - Junqiang Dai
- Department of Neurosurgery, Lanzhou University Second Hospital, China
| | - Lei Duan
- Department of Neurosurgery, Lanzhou University Second Hospital, China
| | - Yawen Pan
- Department of Neurosurgery, Lanzhou University Second Hospital, China; Institute of Neurology, Lanzhou University Second Hospital, China.
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Pau A, Chiaramonte G, Ghio G, Pisani R. Solitary Intracranial Subdural Osteoma: Case Report and Review of the Literature. TUMORI JOURNAL 2018; 89:96-8. [PMID: 12729372 DOI: 10.1177/030089160308900121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Intracranial subdural osteomas without any relation to osseous or meningeal tissues are rare, with only five cases including the present one having been reported so far. In most patients headache, which was always localized at the site of the lesion, was the most frequent complaint and subsided after complete resection of the neoplasm. The mechanism of origin of such lesions remains unknown.
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Affiliation(s)
- Antonio Pau
- Department of Neurosurgery, University of Genoa, Italy
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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: 0.8] [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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9
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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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Celzo FG, Venstermans C, De Belder F, Van Goethem J, van den Hauwe L, van der Zijden T, Voormolen M, Menovsky T, Maas A, Parizel PM. Brain stones revisited-between a rock and a hard place. Insights Imaging 2013; 4:625-635. [PMID: 24022617 PMCID: PMC3781244 DOI: 10.1007/s13244-013-0279-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 07/31/2013] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES AND METHODS Large intracranial calcifications are occasionally encountered in routine computed tomography (CT) scans of the brain. These calcifications, also known as "brain stones", can be classified according to location and aetiology. Combining imaging findings with relevant clinical history and physical examination can help narrow down the differential diagnosis and may allow confident diagnosis in certain situations. RESULTS This article provides a pictorial review illustrating various clinical entities resulting in brain stones. DISCUSSION Based on location, brain stones can be classified as extra- or intra-axial. Extra-axial brain stones comprise tumours and exaggerated physiological calcifications. Intra-axial brain stones can further be classified according to aetiology, namely neoplastic, vascular, infectious, congenital and endocrine/metabolic. Imaging findings combined with essential clinical information can help in narrowing the differential diagnosis, determining disease state and evaluating effect of therapy. TEACHING POINTS • Based on location, brain stones can be either extra- or intra-axial. • Extra-axial brain stones comprise tumours and exaggerated physiological calcifications. • Intra-axial aetiologies include neoplastic, vascular, infectious, congenital and endocrine/metabolic. • CT scan is the mainstay in identifying and characterising brain stones. • Certain MRI sequences (gradient echo T2* and susceptibility-weighted imaging) are considered adjunctive.
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Affiliation(s)
- Froilan G Celzo
- Department of Radiology, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium,
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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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Abstract
Osteomas are benign, slow growing tumors of bone that occur almost exclusively in the craniofacial region. They are uncommon in the temporal bone. Surgical excision is indicated in symptomatic cases. An osteoma arising from the lateral semicircular canal growing into the mastoid cavity is extremely rare and usually discovered on routine radiography. We present a case of osteoma arising from the lateral semicircular canal growing into the mastoid cavity, followed by a discussion of the etiology, presentation, and management of osteomas.
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13
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Layadi F, Aniba K, Lmejjati M, Aït Elqadi A, Aït Benali S. [Giant osteoid osteoma of the posterior skull base. A case report and literature review]. Neurochirurgie 2006; 52:128-32. [PMID: 16840973 DOI: 10.1016/s0028-3770(06)71208-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Osteoid osteoma is a benign bone neoplasm which is seen in the long bones. It is rarely described in the cranium. Posterior skull base osteoma is extremely rare and has been anecdotally reported. OBSERVATION We report a rare case of a large osteoid osteoma of the petro-occipital area in a 26-year-old man. He presented with clinical sign of raised intracranial pressure, cerebellar symptoms and large left retro-auricular swelling. Cerebral MRI shows a giant lesion of the posterior cerebral fossa with destruction of the left petrous bone and the left side of the occipital bone. Large excision was performed through a retro-sigmoid approach. In our knowledge, there is no similar case reported in the literature to date. CONCLUSION Although benign and rare, osteoid osteoma can present with neurological deficit due to mass effect and involvement of nervous structures especially in the posterior skull base.
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Affiliation(s)
- F Layadi
- Département de Neurochirurgie (Pr. Aït Benali), CHU Mohammed-VI, Marrakech, Maroc.
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Akiyama M, Tanaka T, Hasegawa Y, Chiba S, Abe T. Multiple intracranial subarachnoid osteomas. Acta Neurochir (Wien) 2005; 147:1085-9; discussion 1089. [PMID: 16047105 DOI: 10.1007/s00701-005-0588-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2004] [Accepted: 06/01/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE AND IMPORTANCE Intracranial osteomas, which have no connections with the dura or the skull, are very rare. Here we report one case of multiple intracranial subarachnoid osteomas. CLINICAL DESCRIPTION A 24-year-old gentleman, who had no previous history of systemic disease, meningitis or head injury, presented with a 6-month history of non-specific intermittent headache over the whole head. Neuro-imaging showed multiple ossified lesions in the right frontal area, which were found to compress the underlying cerebral hemisphere. The patient underwent a right frontal craniotomy. The masses were dissected from the depressed brain along the intact pial planes, however, all of the white bone-hard masses tightly adhered to the superficial cortical veins. The masses were removed and the cortical veins were sacrificed. The patient had headaches and was nauseous for three days after the surgery due to venous congestion; however, the patient was neurologically intact on discharge. Pathological diagnosis was osteoma. CONCLUSION To our knowledge, this is the first report of multiple intracranial subarachnoid osteomas. Surgical findings strongly support the hypothesis of the origin of the tumour that the primitive mesenchymal cells from the connective tissue might have migrated into the subarachnoid space accompanying the intracerebral blood vessels.
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Affiliation(s)
- M Akiyama
- Department of Neurological Surgery, Atsugi City Hospital, Kanagawa, Japan.
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Cakirer S, Karaarslan E, Arslan A. Spontaneously T1-hyperintense lesions of the brain on MRI: a pictorial review. Curr Probl Diagn Radiol 2003; 32:194-217. [PMID: 12963867 DOI: 10.1016/s0363-0188(03)00026-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In this work, the brain lesions that cause spontaneously hyperintense T1 signal on MRI were studied under seven categories. The first category includes lesions with hemorrhagic components, such as infarct, encephalitis, intraparenchymal hematoma, cortical contusion, diffuse axonal injury, subarachnoid hemorrhage, subdural and epidural hematoma, intraventricular hemorrhage, vascular malformation and aneurysm, and hemorrhagic neoplasm. The second category includes protein-containing lesions, such as colloid cyst, craniopharyngioma, Rathke's cleft cyst, and atypical epidermoid. The third category includes lesions with fatty components, such as lipoma, dermoid, and lipomatous meningioma. Lesions with calcification or ossification, such as endocrine-metabolic disorder, calcified neoplasm, infection, and dural osteoma, constitute the fourth category, whereas the fifth category includes lesions with other mineral accumulation, such as acquired hepatocerebral degeneration and Wilson disease. The sixth category includes melanin-containing lesions, such as metastasis from melanoma and leptomeningeal melanosis. The last category is the miscellaneous group, which includes ectopic neurohypophysis, chronic stages of multiple sclerosis, and neurofibromatosis type I. The above-mentioned lesions are presented with their typical T1-hyperintense images, and the underlying reasons for those appearances in magnetic resonance imaging are discussed.
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Affiliation(s)
- Sinan Cakirer
- Department of Radiobiology, Istanbul Sisli Etfal Hospital, Turkey.
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Abstract
A 43-year-old female presented with persistent headache and dizziness which had first occurred two years earlier. The physical and neurological findings at admission were unremarkable, though plain radiography revealed the presence of a dense calcified mass in the left frontal area, and CT showed that a homogeneous high-density nodule was attached to the inner surface of the left frontal skull. The hard bony mass found and excised during surgery was shown at histopathologic examination to be a subdural osteoma. We describe the clinicopathologic findings of this entity and discuss the radiological features which suggest its subdural location.
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Affiliation(s)
- Jung-Eun Cheon
- Department of Radiology, Seoul Municipal Boramae Hospital, Seoul, Korea
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Affiliation(s)
- S S Badr
- Departments of Diagnostic Radiology and Imaging and Pathology, Al-Sabah Hospital, Kuwait
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