Ossifying fibroma of the temporal bone

A case of ossifying fibroma of the cranial vault is described. Several reports emphasized the rare existence of this lesion limiting in the cranial vault. The patient was a 76-year-old woman who suffered mild headache in the parietal region after a trivial head trauma. Physical and neurological examination were normal. Plain skull X-P revealed irregularly bordered, 4 X 4 cm sized radiolucent area in the left temporal bone. The bone scintigraphy using 99mTc-MDP showed an abnormal uptake like a doughnut. Levels of serum P, Ca and alkaline phosphatase were within normal range. A tumor was softer than normal skull, and undertaken piecemeal removal. The dura was normal. After the total removal of the tumor, cranioplasty using Resin plate was performed. Microscopically the lesion was composed immature, irregular spicules of bone and fibrous tissue. Abundant fibroblasts were arranged in a random fashion in the stroma. Characteristically, the spicules of bone surrounded by rimming of osteoblasts. Ossifying fibroma is a benign fibroosseous tumor. Although this tumor is typically found in the maxillary sinus and mandible, it has also been reported in the paranasal sinuses, frontal, ethmoid, sphenoid bone and orbital roof of the young adult. But previously reported cases involving the cranial vault alone were only 7 cases. Etiology of ossifying fibroma is almost unknown.     

Ossifying fibroma of the frontoethmoid sinus

We report the case of a woman with ossifying fibroma of the right frontoethmoid sinus. Computed tomography and hypocycloidal tomography were useful in identifying the lesion and its extension into the intracranial and intraorbital cavity.     

Ossifying fibroma in the cranial vault. Case report]

Ossifying fibroma is relatively common in the maxilla, but rare in the cranial vault. A 10-year-old girl was referred for painful swelling of the left temporal region. On admission, she presented no abnormal physical and neurological findings except for the painful swelling. Plain skull X-ray films showed a radiolucent lesion of the left temporal bone about 4 cm in diameter, with a hyperostotic area of the parietal side. Computed tomography scan using bone window level also showed an abnormal density lesion in the same site. Curettage of this tumor was performed from a cosmetic point of view and at the family's petition. Histological examination showed vascular fibrous tissue in which lamellar bone was surrounded by osteoblasts.     

Ossifying fibroma in the sylvian fissure: case report

A rare case of an ossifying fibroma that developed in the sylvian fissure is reported here. During surgery, branches of the middle cerebral artery were encased in osseous tumor. The encased branches were divided and reanastomosed after the mass was removed. Postoperative angiograms demonstrated patency of the anastomosed arteries and a postoperative magnetic resonance imaging scan revealed no infarction distal to the arterial anastomoses. The authors recommend division and anastomosis of the encased arteries rather than partial removal of tumor from around the encased arteries, resulting in residual tumor being left behind.     

Ossifying fibroma of the thoracolumbar spine: a case report and review of the literature.

A 43-year-old woman with ossifying fibroma of the thoracolumbar vertebrae was presented with a 6-month history of progressive radiculomyelopathy. The symptoms were successfully treated by laminectomy and partial resection of the lesion. This is the first reported case of ossifying fibroma involving the thoracolumbar spine. The clinical significance and management of this rare lesion are discussed with a review of the literature.     

Ossifying fibroma of the mid-face and paranasal sinuses: diagnostic and therapeutic considerations

Ossifying fibroma is benign, usually slow-growing tumor that may behave in an unpredictably aggressive fashion. Most of these unusual tumors affect the mandible. Their behavior in the mid-face and paranasal sinuses is not well documented. In our review of the subject, and of the cases presented, it appears that these lesions behave more aggressively than their mandibular counterparts. A more aggressive approach may be more beneficial than expectant observation or curettage in the initial management of this neoplasm.     

Aneurysmal bone cysts of the occipital bone

Two cases of aneurysmal bone cysts are reported. Each patient presented with a palpable mass in the occipital region and signs of compression of structures in the posterior fossa. One of the cases is unique, in that the aneurysmal bone cyst was associated with an epidural hematoma in the posterior fossa. The pertinent literature is reviewed.     

Aneurysmal bone cyst of the occipital bone

A 13 years boy presented with a painless hard and fixed swelling in occipital region for the last three months. Plain X-ray, CT scan and MRI showed an expansile multi loculated cystic lesion in occipital bone. Histopathological examination revealed it to be an aneurysmal bone cyst. Treatment of choice is surgery. However, radiotherapy may be helpful in incompletely excised lesions.     

Ossifying fibroma of long bones in adults: a case report

Ossifying fibroma (osteofibrous dysplasia) is a rare fibro-osseous lesion made up of fibrous tissue with woven bone formation. It is most commonly found in the tibia and fibula of children ten years of age or younger. The most important differential diagnosis is monostotic fibrous dysplasia, which is radiologically similar but without woven bone rimmed by active osteoblasts like ossifying fibroma on histological examination. No epitheloid cells are found as in adamantinoma. We report the case of a 45-year-old woman who had a 12-month history of pain and slight swelling. Radiographs showed a multilocular radiolucent lesion with sclerotic rim in the proximal tibia. The lesion was curetted and the defect was packed with bone graft and acrylic cement. Microscopic examination showed active osteoblasts rimming the irregulary woven bone. One-year follow-up showed good functional recovery without recurrence of the lesion.     

Morphologic and radiologic anatomy of the occipital bone.

Several diseases may cause craniovertebral instability warranting occiput-cervical fusion. As occipital screw and rod constructs are becoming more popular, requiring that screws be placed either medially or laterally in the occipital bone, the need for clearer anatomical and computed tomography (CT)-confirmed data regarding the relative thickness of the occiput in its various localities has become more critical. In 18 cadaveric specimens, the occipital bone was divided into 35 measurable segments. Transversely, the occipital bone was divided into five lines starting at the level of the inion; horizontal lines then proceeded inferiorly in 1-cm segments, 1, 2, 3, and 4 cm below the level of inion. In a comparable fashion, the occipital bone was divided vertically, starting at the midline, and proceeding laterally also in 1-, 2-, and 3-cm segments. Anatomical measurements of thickness were directly performed using a Vernier caliper. Results were directly correlated with axial CT measurements of bony thickness. Anatomical and CT measurements closely correlated within the same specimen, but there was significant interspecimen variability. The marked differences in the occipital bone anatomy noted between specimens indicates that patients undergoing occipital screw placement for cranial-cervical instability would benefit from preoperative occipital CT evaluations.     

Chondromyxoid fibroma in the metacarpal bone of the thumb.

We present a case of a chondromyxoid fibroma in the exceptionally rare location of the first metacarpal bone in a 12-year-old boy. The tumor had evolved asymptomatically over a period of 8 years destroying all diaphyseal trabecular bone. No recurrence was evident 50 months following aggressive curettage of the metacarpal lesion, which presented a predominantly myxoid appearance.     

Chondromyxoid fibroma of bone

Chondromyxoid fibroma is a benign, although potentially aggressive tumor, with a cartilage-like matrix, accounting for approximately 1% of all bone tumors. It usually affects the metaphyseal region of long bones of patients in their first or second decade of life. An additional peak of incidence has been observed between 50 and 70 years of age. Three cases are presented here: 10-, 13-, and 52-year-old patients, with lesions in the proximal tibia, the proximal humerus, and the proximal femur, respectively. The literature is reviewed in terms of clinical behavior, diagnostic procedures, prognostic factors, treatment, and outcome. Preferred treatment is complete local excision with tumor-free margins. Intralesional curettage with or without local adjuvants shows a local recurrence rate of approximately 25%. Radiation therapy may be useful in nonresectable cases but bears the well documented risk of radiation-induced malignancies.     

Epidermoid tumor of the occipital bone

Intradiploic epidermoid-tumor of the occipital bone was presented. There were neither intracranial extensions nor neurologic deficits. The lesion started as a painless mass under the scalp.The total removal of the tumor was associated with a good prognosis.     

Benign chondroblastoma of the occipital bone

We report the case of a 14-year-old boy with benign chondroblastoma in the occipital bone associated with a cerebellar hemorrhage. The clinical features, radiologic and histologic appearances, and histogenesis in this case are described. Other reports of benign chondroblastomas of the cranial bones are also discussed.