Citation, DOI, disclosures and article data
At the time the article was created Frank Gaillard had no recorded disclosures.View Frank Gaillard's current disclosures
Osteomas are benign bone tumors that most commonly occur in the head. When occurring in the medullary cavity osteomas are called bone islands 5.
Osteomas are common with an equal male/female distribution 5.
Diagnostic criteria according to the WHO classification of soft tissue and bone tumors (5th edition) 5:
essential: bone tumor with compatible imaging; tumor arises on the bone source or within the medullary cavity; composed of lamellar/cortical-type bone
These lesions are benign, slow growing, and usually asymptomatic. They may be incidentally identified as a mass in the skull or jaw, or as the underlying cause of sinusitis or paranasal sinus mucocele 5.
Osteomas are benign osteogenic tumors composed of lamellar/cortical-type bone. The etiology is unknown 5.
Osteomas most commonly occur in bones formed in membrane, almost exclusively occurring in the head 5, with the most common locations including:
These are well-cirumscribed tumors broadly attached to the bone surface 5.
Two histological subtypes are recognized: compact and spongious. In cancellous bone, the bone marrow is filled with a well-vascularized and moderately cellular and fibrous stroma with inconspicuous osteoblasts and osteocytes and absent inflammatory infiltrate 5.
when multiple, Gardner syndrome should be considered 5
Plain radiograph / CT
Osteomas appearing ivory-like as round, very radiodense lesions, similar to the normal cortex 5. Mature osteomas may demonstrate central marrow ref.
T1: low signal
T2: low signal 5
Mild uptake may be seen on bone scintigraphy 5.
Treatment and prognosis
Osteomas are benign and only require excision if they cause adjacent complications (e.g. mucocele formation) or mass-effect (functional or cosmetic impairment). They can slowly grow 5.
History and etymology
Osteomas have been documented as far back as 664-332 BCE in ancient Egypt 5.
Considerations include many cranial and facial bone lesions 6:
- 1. Roberto Maroldi, Piero Nicolai. Imaging in Treatment Planning for Sinonasal Diseases. (2004) ISBN: 9783540423836 - Google Books
- 2. Erdogan N, Demir U, Songu M, Ozenler N, Uluç E, Dirim B. A Prospective Study of Paranasal Sinus Osteomas in 1,889 Cases: Changing Patterns of Localization. Laryngoscope. 2009;119(12):2355-9. doi:10.1002/lary.20646
- 3. Bruce M. Wenig. Atlas of Head and Neck Pathology. (2008) ISBN: 9780721697888 - Google Books
- 4. Wolfgang Dähnert. Radiology Review Manual. (2011) ISBN: 9781609139438 - Google Books
- 5. Nielsen G, Baumhoer D, Bredella M, Sumathi V. Osteoma. In: WHO Classification of Tumours Editorial Board. Soft tissue and bone tumours. Lyon (France): International Agency for Research on Cancer; 2020. (WHO classification of tumours series, 5th ed.; vol. 3). https://publications.iarc.fr
- 6. Tarsitano A, Ricotta F, Spinnato P et al. Craniofacial Osteomas: From Diagnosis to Therapy. J Clin Med. 2021;10(23):5584. doi:10.3390/jcm10235584 - Pubmed