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Canadian Journal of Surgery. Journal... Dec 1997To document the epidemiologic and clinical features of benign skull lesions.
OBJECTIVE
To document the epidemiologic and clinical features of benign skull lesions.
DESIGN
A case series.
SETTING
St. Michael's Hospital, a tertiary care facility affiliated with the University of Toronto.
PATIENTS
Thirty-one patients who had a neurosurgical consultation and were discharged from hospital after excision of a benign skull lesion during a 10-year period.
MAIN OUTCOME MEASURES
Patient demographics, clinical signs and symptoms, radiographic and pathological tumour characteristics, surgical procedure, length of hospital stay, outcome and follow-up.
RESULTS
The 31 patients (6 men, 25 women) had 32 lesions excised. The mean age of the patients was 41.9 years. Osteomas accounted for 63% of the tumours. The most frequent location was the parietal bone. Neurologic symptoms were absent in the majority of calvarial tumours. Useful diagnostic studies included plain skull radiography and computed tomography. Nuclear bone scanning was done in 7 patients. All patients underwent craniectomy, with cranioplasty in most cases. Three patients had new neurologic symptoms postoperatively and 1 patient had incomplete resolution of symptoms.
CONCLUSIONS
Benign skull lesions are infrequent, but they require neurosurgical intervention. When necessary, surgical excision can serve to confirm the diagnosis, improve cosmesis and retard the progression of neurologic dysfunction. Of primary importance is the recognition of such lesions by primary care physicians and referral to the surgeon so that an appropriate treatment plan can be made.
Topics: Adult; Bone Diseases; Diagnosis, Differential; Female; Humans; Male; Osteoma; Retrospective Studies; Skull Neoplasms; Tomography, X-Ray Computed
PubMed: 9416255
DOI: No ID Found -
Virchows Archiv : An International... Jan 2020According to the WHO, mesenchymal tumours of the maxillofacial bones are subdivided in benign and malignant maxillofacial bone and cartilage tumours, fibro-osseous and... (Review)
Review
According to the WHO, mesenchymal tumours of the maxillofacial bones are subdivided in benign and malignant maxillofacial bone and cartilage tumours, fibro-osseous and osteochondromatous lesions as well as giant cell lesions and bone cysts. The histology always needs to be evaluated considering also the clinical and radiological context which remains an important cornerstone in the classification of these lesions. Nevertheless, the diagnosis of maxillofacial bone tumours is often challenging for radiologists as well as pathologists, while an accurate diagnosis is essential for adequate clinical decision-making. The integration of new molecular markers in a multidisciplinary diagnostic approach may not only increase the diagnostic accuracy but potentially also identify new druggable targets for precision medicine. The current review provides an overview of the clinicopathological and molecular findings in maxillofacial bone tumours and discusses the diagnostic value of these genetic aberrations.
Topics: Chondrosarcoma; Facial Bones; Fibrous Dysplasia of Bone; Granuloma, Giant Cell; Humans; Maxillary Neoplasms; Skull Neoplasms
PubMed: 31838586
DOI: 10.1007/s00428-019-02726-2 -
European Annals of Otorhinolaryngology,... Dec 2016
Topics: Aged; Bell Palsy; Breast Neoplasms; Female; Humans; Petrous Bone; Skull Neoplasms
PubMed: 27344096
DOI: 10.1016/j.anorl.2016.06.002 -
Neurologia Medico-chirurgica Nov 1999A 12-year-old boy presented with right visual disturbance. Skull radiography and computed tomography (CT) showed an irregular deformity of the sella turcica,...
A 12-year-old boy presented with right visual disturbance. Skull radiography and computed tomography (CT) showed an irregular deformity of the sella turcica, hypertrophic change of the dorsum sellae, and an inhomogeneously calcified mass in the sella turcica. Magnetic resonance (MR) imaging demonstrated the mass lesion filled the hypophyseal fossa, and extended to the dorsum sellae, right cavernous sinus, and right suprasellar region. The Dolenc pterional combined epidural and subdural approach was carried out. The histological diagnosis was chondroma. Sellar chondroma requires relief of the compression to the chiasm or optic nerve as soon as possible, so partial resection can still be beneficial. However, follow-up MR imaging or CT, visual examination, and control of pituitary dysfunction are required after the operation.
Topics: Child; Chondroma; Humans; Magnetic Resonance Imaging; Male; Neoplasm Invasiveness; Sella Turcica; Skull Neoplasms; Tomography, X-Ray Computed
PubMed: 10639816
DOI: 10.2176/nmc.39.870 -
Medicine Dec 2017Primary splenic angiosarcoma (PSA) is a rare, fatal neoplasm originating from sinusoidal vascular endothelial cells, and usually metastasizes and almost always has a... (Review)
Review
RATIONALE
Primary splenic angiosarcoma (PSA) is a rare, fatal neoplasm originating from sinusoidal vascular endothelial cells, and usually metastasizes and almost always has a poor prognosis. Surgical excision is the main treatment of this highly malignant disease.
PATIENT CONCERNS
We reported a special case of a 68-year-old female who had a 6-month history of scalp masses.
DIAGNOSIS
The patient was found to have 2 skull masses on computed tomography (CT). Laboratory findings revealed erythropenia and thrombocytopenia. Enhanced abdomen magnetic resonance imaging (MRI) showed multiple masses in liver and spleen. The pathological result of the skull masses was revealed to be metastatic angiosarcoma.
INTERVENTIONS
The patient underwent surgical excision of skull masses, and no subsequent radiotherapy or chemotherapy was done.
OUTCOMES
The patient died due to dyscrasia at August 12, 2015, with a survival of nearly 1 month.
LESSONS
We highlight the importance for clinicians to be aware of this rare neoplasm, and to consider it in the differential diagnosis when encountering a skull mass. Early confirmation and treatment may improve the prognosis.
Topics: Aged; Anemia; Erythrocyte Count; Erythrocytes; Fatal Outcome; Female; Hemangiosarcoma; Humans; Liver Neoplasms; Skull Neoplasms; Splenic Neoplasms; Thrombocytopenia
PubMed: 29245237
DOI: 10.1097/MD.0000000000008787 -
Medicine Mar 2020Chondromyxoid fibroma (CMF) is a rare form of benign bone tumor and easily misdiagnosed as fibrosarcoma. Hence, to explore the clinical manifestations, diagnostic tests,... (Review)
Review
RATIONALE
Chondromyxoid fibroma (CMF) is a rare form of benign bone tumor and easily misdiagnosed as fibrosarcoma. Hence, to explore the clinical manifestations, diagnostic tests, and therapeutic procedures for temporal bone cartilage myxoid fibroma, it is important to optimize patient treatment and avoid overtreatment. Previous research has discussed cases of CMF, but this paper presents a systematic, complete, and comprehensive introduction of this disease based on this case and related literature.
PATIENT CONCERNS
A 52-year-old male patient presented with pain in his right ear for 2 years and hearing loss in his right ear with tinnitus for 1 year. The patient had a history of hypertension for 9 years and it was well-controlled.
DIAGNOSIS
A computed tomography (CT) scan of the temporal bone showed an expansive growth on the right temporal bone plate and tympanic plate, presenting as a cloud-like ground glass opaque shadow involving the temporom and ibular joint, middle skull base, and small auditory bones. A magnetic resonance imaging (MRI) of the temporal bone showed a large and irregular soft tissue mass shadow on the right temporal bone plate. The right temporal bone plate was occupied by the lesion, consistent with a bone origin. From the results of the imaging examination of the patient, a lesion occupying the temporal bone in the right ear and mastoiditis in the right middle ear was initially diagnosed.
INTERVENTIONS
Right ear temporal bone tumor resection and abdominal fat extraction were conducted.
OUTCOMES
Postoperative pathological results demonstrated myxoid fibroma of the temporal bone cartilage. No recurrence or severe complications were observed in 8 months of follow-up.
LESSONS
A finding of myxoid fibroma of the temporal bone cartilage is rare in the clinic. The growth of such tumors is slow. The temporal bone CT and inner ear MRI were helpful in diagnosis. Surgery was the principal treatment.
Topics: Chondroma; Diagnosis, Differential; Hearing Loss; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Skull Neoplasms; Temporal Bone; Tinnitus; Tomography, X-Ray Computed
PubMed: 32176085
DOI: 10.1097/MD.0000000000019487 -
Eye (London, England) Nov 2013Primary intraosseous haemangioma (IOH) is a rare benign neoplasm presenting in the fourth and fifth decades of life. The spine and skull are the most commonly involved,...
PURPOSE
Primary intraosseous haemangioma (IOH) is a rare benign neoplasm presenting in the fourth and fifth decades of life. The spine and skull are the most commonly involved, orbital involvement is extremely rare. We describe six patients with cranio-orbital IOH, the largest case series to date.
PATIENTS AND METHODS
Retrospective review of six patients with histologically confirmed primary IOH involving the orbit. Clinical characteristics, imaging features, approach to management, and histopathological findings are described.
RESULTS
Five patients were male with a median age of 56. Pain and diplopia were the most common presenting features. A characteristic 'honeycomb' pattern on CT imaging was demonstrated in three of the cases. Complete surgical excision was performed in all cases with presurgical embolisation carried out in one case. In all the cases, histological studies identified cavernous vascular spaces within the bony tissue. These channels were lined by single layer of cytologically normal endothelial cells.
DISCUSSION
IOCH of the cranio-orbital region is rare; in the absence of typical imaging features, the differential diagnosis includes chondroma, chondrosarcoma, bony metastasis, and lymphoma. Surgical excision may be necessary to exclude more sinister pathology. Intraoperative haemorrhage can be severe and may be reduced by preoperative embolisation.
Topics: Adult; Female; Hemangioma, Cavernous; Humans; Male; Middle Aged; Orbital Neoplasms; Retrospective Studies; Skull; Skull Neoplasms; Spine; Vascular Malformations
PubMed: 23989119
DOI: 10.1038/eye.2013.162 -
Medicine Dec 2017Primary osteosarcomas of the skull and skull base are rare, comprising <2% of all skull tumors. Primary osteosarcomas of the skull are aggressive neoplasms composed of... (Review)
Review
RATIONALE
Primary osteosarcomas of the skull and skull base are rare, comprising <2% of all skull tumors. Primary osteosarcomas of the skull are aggressive neoplasms composed of spindle cells producing osteoid which have poor outcome.
PATIENT CONCERNS
A 33-year-old woman was admitted to our hospital with a major complaint of a growing mass on her left frontal region of the skull for 10 months. Prior to the accurate diagnosis, the mass on her skull was considered to be eosinophilic granuloma.
DIAGNOSES
Computerized tomogram (CT) scan of skull revealed a lytic lesion causing destruction of left frontal bone with surrounding soft tissue mass. The histological examination of the lesion showed typical features of osteosarcoma.
INTERVENTIONS
The patient received 3 surgeries and adjuvant chemotherapy and radiotherapy for the frontal bone lesion.
OUTCOMES
At the last follow-up, after 4 years, the patient was free of disease both clinically and on imaging by magnetic resonance imaging (MRI) scan after 4 years.
LESSONS
Because osteosarcoma of skull is a rare disease, the early recognition and correct diagnosis are very important for a better prognosis. It is therefore imperative that clinicians recognize osteosarcoma early to make an accurate diagnosis and complete surgical resection followed by combined chemo-radiation is proved to be one of the most optimal treatment regimens.
Topics: Adult; Female; Frontal Bone; Humans; Osteosarcoma; Skull Neoplasms; Tomography, X-Ray Computed
PubMed: 29390546
DOI: 10.1097/MD.0000000000009392 -
Annals of the Academy of Medicine,... May 2005Facial nerve palsy results in the loss of facial expression and is most commonly caused by a benign self-limiting inflammatory condition, known as Bell's palsy. However,... (Review)
Review
INTRODUCTION
Facial nerve palsy results in the loss of facial expression and is most commonly caused by a benign self-limiting inflammatory condition, known as Bell's palsy. However, there are other conditions which may result in injury of the seventh cranial nerve and the radiologist should be familiar with their imaging appearances.
MATERIALS AND METHODS
The relevant anatomy of the facial nerve and pathology which may affect the intratemporal portion of the nerve is described. The role of imaging and choice of imaging modality is also reviewed.
RESULTS
High-resolution computer tomography(HRCT) images of the temporal bone and magnetic resonance(MR) images of the facial nerve from 11 patients who presented with facial nerve palsy were used to illustrate how intratemporal facial nerve injury of other aetiologies can mimic Bell's palsy. The typical imaging appearance of Bell's palsy was also presented.
CONCLUSIONS
Most patients with suspected Bell's palsy do not require radiologic imaging. However, when symptoms progress, persist or when there is multiple cranial nerve involvement, recurrent symptoms or subacute onset of facial nerve palsy, causes other than Bell's palsy should be considered.
Topics: Cranial Nerve Neoplasms; Facial Nerve Diseases; Facial Paralysis; Humans; Skull Neoplasms; Temporal Bone
PubMed: 15937573
DOI: No ID Found -
Child's Nervous System : ChNS :... Mar 2018Ewing sarcoma typically arises in bone and is unrelated to intraparenchymal small blue cell embryonal central nervous system (CNS) tumors previously designated primitive...
BACKGROUND
Ewing sarcoma typically arises in bone and is unrelated to intraparenchymal small blue cell embryonal central nervous system (CNS) tumors previously designated primitive neuroectodermal tumors (PNETs). When the CNS is impacted, it is usually secondary to local extension from either the epidural space, skull, or intracranial or spinal metastases. Primary examples within the cranial vault are rare, usually dural-based, and are largely case reports in the literature. We detail four pediatric patients with solitary, primary intracranial Ewing sarcoma, all manifesting the archetypal EWRS1 gene rearrangement that confirms diagnosis.
PROCEDURE
Neurosurgical Department records, spanning 21 years (1995-2016), were reviewed to identify patients. Demographics, clinical history, pathological/genetic features, and clinical course were retrieved from the medical record and personal files of the authors.
RESULTS
Four patients, one male and three females, age 5 to 16 years, were identified. One presented in extremis from a large lesion, two with soft tissue masses, and the fourth as an incidental finding after being involved in a motor vehicle collision. Three had clear bony involvement: a 10-year-old girl with a large left temporal lesion had clear origin in the skull, with spiculated calcified striations throughout the mass; a 9-year-old girl presented with a bony left petrous apex mass; and a 16-year-old girl presented with a left temporal mass with extension to the dura and underlying bone erosion. Only the 5-year-old boy had a large left frontoparietal mass traversing the falx with no bony contact. All four tumors manifested the diagnostic EWSR1 mutation and were treated with an Ewing sarcoma regimen. Outcomes were variable, with one patient showing progressive metastatic disease and death 3 years after presentation, one patient with disease-free survival 10.5 years after completion of therapy, and one alive and well at the completion of therapy 1 year after diagnosis. One patient completed therapy recently with post-therapy scans showing no evidence of disease.
CONCLUSION
Testing for the EWSR1 mutation confirms the diagnosis of Ewing sarcoma and excludes other types of embryonal CNS tumors. Long-term disease-free survival is possible with adherence to the appropriate therapeutic regimen after gross surgical resection.
Topics: Adolescent; Brain Neoplasms; Child; Child, Preschool; Female; Humans; Male; Sarcoma, Ewing; Skull Neoplasms
PubMed: 29285586
DOI: 10.1007/s00381-017-3684-7