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Leontiasis ossea is largely a historical term used to describe a number of conditions that result in the affected patient's face resembling that of a lion. Although it is most frequently associated with craniofacial fibrous dysplasia, it has a broader meaning encompassing other lesions that have similar appearance 1,4.
The distinction is made between true leontiasis ossea (craniofacial fibrous dysplasia) and other conditions having similar external appearance (mimics); however it would be safe to say that as a term it is no longer of clinical use, primarily due to its negative connotations, and should be avoided.
In addition to craniofacial fibrous dysplasia the following conditions may mimic leontiasis ossea:
- Paget disease
- tumors of the paranasal sinuses
- syphilitic osteoperiostitis
- uremia with secondary hyperparathyroidism 2
When one of these differentials is the cause of this distinctive craniofacial phenotype, the name of the underlying condition is sometimes used in combination with leontiasis ossea, e.g. "Pagetic leontiasis ossea" or "uremic leontiasis ossea".
History and etymology
The famed Rudolf Ludwig Carl Virchow (1821-1902), a German pathologist and statesman, first coined the term leontiasis ossea in 1864 3,5.
- 1. Evans J. Leontiasis ossea; a critical review, with reports of four original cases. J Bone Joint Surg Br. 2003;35-B (2): 229-43. Pubmed citation
- 2. Maramattom BV. Leontiasis ossea and post traumatic cervical cord contusion in polyostotic fibrous dysplasia. Head Face Med. 2009;2 (1): 24. doi:10.1186/1746-160X-2-24 - Free text at pubmed - Pubmed citation
- 3. Capon NB. A Case of Leontiasis Ossea (Diffuse Osteitic Form). Arch. Dis. Child. 2011;3 (18): 285-91. Free text at pubmed - Pubmed citation
- 4. Mulligan M. Classic Radiologic Signs. CRC Press. ISBN:1850706646. Read it at Google Books - Find it at Amazon
- 5. Brown TM, Fee E. Rudolf Carl Virchow: medical scientist, social reformer, role model. (2006) American journal of public health. 96 (12): 2104-5. doi:10.2105/AJPH.2005.078436 - Pubmed