Skull vault osteomas are benign primary bone tumors that are commonly incidentally discovered. They are less common than paranasal sinus or mandibular osteomas.
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Clinical presentation
Skull vault osteomas are typically asymptomatic but may present as painless, slow-growing masses or with compressive symptoms 2,4.
Pathology
Skull vault osteomas are juxtacortical in location and can be sessile or pedunculated and arise from the outer table (most commonly), intradiploic space, or inner table 1. They can extend into the paranasal sinuses but do not cross cranial sutures 1. Most commonly, they occur in the frontal and parietal bones 4.
Associations
Gardner syndrome if multiple skull vault osteomas are present 1,3
Radiographic features
See main osteoma article for further details.
Differential diagnosis
calcified meningiomas can mimic pedunculated inner table osteomas 3
Treatment and prognosis
No treatment is required if asymptomatic. Symptomatic osteomas are typically surgically excised 4.
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