Cases reported "Osteoma"

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1/387. pneumocephalus associated with ethmoidal sinus osteoma--case report.

    A 35-year-old female suffered sudden onset of severe headache upon blowing her nose. No rhinorrhea or signs of meningeal irritation were noted. Computed tomography (CT) with bone windows clearly delineated a bony mass in the right ethmoid sinus, extending into the orbit and intracranially. Conventional CT demonstrated multiple air bubbles in the cisterns and around the mass in the right frontal skull base, suggesting that the mass was associated with entry of the air bubbles into the cranial cavity. T1- and T2-weighted magnetic resonance (MR) imaging showed a low-signal lesion that appeared to be an osteoma but did not show any air bubbles. Through a wide bilateral frontal craniotomy, the cauliflower-like osteoma was found to be protruding intracranially through the skull base and the overlying dura mater. The osteoma was removed, and the dural defect was covered with a fascia graft. Histological examination confirmed that the lesion was an osteoma. The operative procedure resolved the problem of air entry. CT is superior to MR imaging for diagnosing pneumocephalus, by providing a better assessment of bony destruction and better detection of small amounts of intracranial air. ( info)

2/387. Fibro-osseous lesions of the external auditory canal.

    OBJECTIVES: To differentiate a novel type of benign circumscribed bone lesion of the external auditory canal from those described previously, such as exostoses and osteomas. STUDY DESIGN: Information was obtained from computed tomography (CT) images, surgical findings, and pathologic study. methods: Five patients (26 to 82 years old) who presented a hard, round, unilateral, skin-covered mass occluding the external auditory canal to varying degrees were studied. A CT study carried out before resection of the lesions by curettage disclosed the absence of a bony connection to the underlying structures. All the tissue specimens underwent pathologic study. RESULTS: CT and surgical findings demonstrated the absence of a connective pedicle. The pathologic findings showed lesions consisting of an osteoma-like bone formation with sparse osteoblastic areas; mature lamellar bone was observed in three cases, bone marrow containing adipose tissue and hematopoietic remnants in two, and a dense, collagenous stroma in another. They all showed irregular trabeculae, bordered by osteoid osteoblasts. In no case was there evidence of a relationship to the cartilaginous tissue or to the bony structures of the external auditory canal. CONCLUSIONS: The data obtained from the clinical, CT, surgical, and pathologic findings suggest the existence of a lesion unlike those previously known, possibly related to ossifying reactions in other parts of the organism. ( info)

3/387. Management of multiple miliary osteoma cutis.

    BACKGROUND: Multiple miliary osteoma cutis of the face is a variant of osteoma cutis that usually occurs in women with a previous history of acne vulgaris. OBJECTIVE: To effectively treat cosmetically objectionable lesions of multiple miliary facial osteomas. methods: We report a patient with multiple miliary osteoma cutis, without a previous history of acne vulgaris, and the results of treatment of these lesions with curettage and the carbon dioxide continuous-wave laser. RESULTS: The patient had an excellent cosmetic outcome with minimal scarring and faint hypopigmentation after 3 treatment sessions. CONCLUSION: Surgical ablative therapy remains the treatment of choice for patients with this condition, and the use of curettage and carbon dioxide laser ablation provided excellent results for our patient. To our knowledge, this approach to treatment has not been previously described. ( info)

4/387. ethmoid sinus osteoma presenting as epiphora and orbital cellulitis: case report and literature review.

    Paranasal sinus osteoma is a slow-growing, benign, encapsulated bony tumor that may be commonly asymptomatic, being detected incidentally in 1% of plain sinus radiographs or in 3% of sinus computerized tomographic scans. In a patient presenting with orbital cellulitis and epiphora, computed tomography disclosed a large osteoma of the ethmoid sinus. Excision of the osteoma allowed recovery of vision, return of extraocular muscle function, and resolution of choroidal folds. Proptosis, diplopia, and visual loss are other frequent presenting signs of paranasal osteomas. epidemiology, diagnosis, treatment, and pathologic findings in paranasal sinus osteoma are reviewed. ( info)

5/387. Presence of bilateral limbal dermoids and choroidal osteomas in a family with inherited limbal dermoids.

    We report a case of bilateral limbal dermoids and bilateral choroidal osteomas in a 14-year-old girl with no extraocular anomalies. Histopathological examination of a limbal lesion confirmed the clinical diagnosis of dermoid. Computerized tomography and ultrasonography were compatible with a diagnosis of choroidal osteoma. Limbal dermoids were present in the patient's mother, in a brother with down syndrome, and in an aunt with no choroidal osteoma. The present pedigree is compatible with autosomal dominant inheritance of bilateral limbal dermoids. The same gene may be involved in the pathogenesis of ocular choristomas in same patients. ( info)

6/387. Detection of choroidal calcium by computed tomography scan quantitative computerized tomography: a clinically useful diagnostic tool.

    OBJECTIVE: Quantitative computerized tomography (QCT), a scanning method routinely used to classify tissues based on their radio density, was used to detect choroidal calcification. DESIGN: case reports. PARTICIPANTS: Two patients with known or suspected choroidal calcium-choroidal osteoma (CO) and pseudoxanthoma elasticum (PXE) and five normal control subjects were assessed. INTERVENTION: The CT scan of choroid, B-scan ultrasound, fluorescein angiography. MAIN OUTCOME MEASURES: The QCT scan used to detect the presence of calcium based on a readout greater than 90. RESULTS: calcium was detected bilaterally, as predicted, in PXE, and in both eyes of CO, although only one eye had a clinically noted lesion. No control eye gave a scale readout consistent with calcium. No findings suggestive of calcium were noted with B-scan ultrasound or fluorescein angiography in PXE or CO. CONCLUSION: The QCT can detect calcium in the choroid when B-scan ultrasonography and CT scan fine sectioning fail to identify calcium despite high clinical suspicion. ( info)

7/387. Abdominal desmoid masses in Gardner's syndrome.

    Abdominal masses, "desmoid tumors," occur in approximately 4% of patients with Gardner's Syndrome, usually 1--3 years after total colectomy. Histologic sections usually resemble those of an infiltrating fibrous tumour, a desmoid lesion. The radiographic pattern may be similar to any diffuse abdominal retroperitoneal tumor, metastatic disease, lymphoma, or possibly retractile mesenteritis. The clinical setting usually differentiates these entities. ( info)

8/387. Cochleo-vestibular manifestations of jugular foramen pathologies.

    patients presenting pathologies of the jugular foramen are presented, for whom the main symptoms are of cochleo-vestibular nature. A classification of the various pathologies is attempted, the anatomy reviewed and hypotheses capable of producing the symptom elaborated. ( info)

9/387. Unusual radiological appearance of a skull osteoma.

    A 24-year-old woman presented with a 7-week history of headache and left frontal scalp swelling. A plain radiograph and CT demonstrated a 2-cm lytic lesion in the frontal bone which was excised via craniotomy. histology showed this to be an osteoma. Osteomas very rarely, if ever, appear as lytic lesions. The differential and radiological diagnoses are discussed. ( info)

10/387. A giant intracranial mucocele associated with an orbitoethmoidal osteoma. Case report.

    The authors present a rare case of a giant intracranial mucocele associated with an orbitoethmoidal osteoma in a patient suffering from a generalized convulsive disorder. The broad pedicle of the osteoma had penetrated the cribriform plate and extended intracranially to form a nodular mass in the olfactory groove. The intracranial portion of the osteoma was surrounded by a mucocele. Both the cyst wall and multilayered intracystic septations of the mucocele were indented by layers of the osteoma. Although the extracranial portion adhered to the mucosa of the ethmoidal sinus, there were no signs of sinus obstruction. No direct communication other than the osteoma was identified between the mucocele and the ethmoidal mucosa. The large cerebral defect, which the mucocele occupied, communicated directly with the lateral ventricle without any intervening membranous structures. A frontal craniotomy is recommended for exposure of the lesion and plastic repair of the dural defect. ( info)
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