Clinical features and therapeutic management of choroidal osteoma: A systematic review.

Choroidal osteoma is a benign ossifying tumor within the choroid. Complications associated with choroidal osteoma, including disruption of retinal pigment epithelium, atrophy of photoreceptors, subretinal fluid, and choroidal neovascularization, present challenges for clinicians, and management remain controversial. We performed a comprehensive search in the PubMed, EMBASE, and Ovid databases for published studies and case reports relating to the management of choroidal osteoma. Since it was first described in 1978, various case reports of ocular complications associated with choroidal osteoma have been documented, and various therapies have yielded different outcomes. We systematically evaluate the literature published on this rare entity.

Calcaneal Bone Tumors.

Bone tumors of the foot are an uncommon finding. Most tumors are found incidentally on imaging and are benign. Care must be taken although due to the aggressive nature of malignant bone tumors that can occur in the calcaneus. Malignant lesions will more commonly present with symptoms of pain and swelling. Often misdiagnosed as soft tissue injuries, it is critical to be able to diagnose and treat these lesions early. Imaging plays an important role with plain films and advanced imaging. Surgical treatments can range from curettage with grafting to amputation for more aggressive lesions.

Pápulas faciales induradas / Indurated Papules on the Face

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Frontal Sinus Osteoma Presenting with Meningitis and Epilepsy.

BACKGROUND: Osteomas are benign lesions of bone, most frequently seen in the paranasal sinuses; however, they are typically asymptomatic and without complication. We report a rare case of large frontal sinus osteoma with intracranial extension, associated with meningitis and the development of seizures. CASE DESCRIPTION: The patient is a 38-year-old man with a prolonged history of headache and seizures, who was seen by multiple specialists previously, all of whom deferred treatment. After years of worsening seizure activity, he finally underwent surgical resection of the lesion at our institution in a joint operation with neurosurgery and otolaryngology. We examine his course, presentation, and management, and examine the literature for cases of complicated sinus osteomas. CONCLUSIONS: This represents the fourth reported case of frontal sinus osteoma associated with meningitis. We believe this case demonstrates the value of a robust differential and a multidisciplinary approach.

Clinical implications, diagnosis, and treatment of a giant frontoethmoid osteoma.

Osteomas are benign, asymptomatic fibro-osseous tumors that are most commonly observed in the paranasal sinuses and sometimes are found in imaging examinations that were taken for other reasons. Giant osteomas are rarely found in the frontal and ethmoid sinuses but, when they are, they may cause intracranial and orbital complications. The aims of this case report are to describe a frontoethmoid osteoma in a 40-year-old woman, discuss the characteristics of this lesion through cone beam computed tomography (CBCT) imaging, and review the options for treatment. A CBCT examination performed for the purpose of orthodontic diagnosis revealed the presence of a large, well-defined, lobular, hyperdense mass that occupied a sizeable area of the frontal sinus and extended to the ethmoid sinus. The patient did not report any pain. Based on the physical and imaging characteristics of the mass, the location and size of the lesion, and the patient's age, the diagnosis was a giant frontoethmoid osteoma. Due to its enhanced field of view, CBCT may enable earlier diagnosis of lesions that affect the maxillofacial region.

Propuesta de estadificación de las lesiones inflamatorias de la región frontal / Proposal for staging of inflammatory lesions in the frontal region

El aumento de volumen en la región frontal puede deberse a múltiples etiologías, dentro de las cuales deben considerarse: mucocele, tumor de Pott-Puffy, lesiones fibro-óseas, tumores de nariz y senos paranasales, lesiones intracraneales y metástasis. El objetivo del estudio fue describir el protocolo clínico empleado en los pacientes que se presentaron con aumento de volumen frontal y una propuesta de estadificación de las lesiones inflamatorias. Se realizó un estudio retrospectivo observacional. Se encontraron 7 casos con aumento de volumen en la región frontal: 4 casos secundarios a enfermedad inflamatoria (3 casos tumor de Pott-Puffy, un mucocele frontal) y 3 por neoplasia (un caso benigno y 2 malignos). Es muy importante considerar, entre los diagnósticos diferenciales de aumento de volumen en la región frontal, enfermedades inflamatorias que pueden representar una complicación grave de infecciones nasosinusales o neoplasias malignas avanzadas. Se propone un sistema de estadificación de las lesiones inflamatorias frontales (AU)

Frontal swelling can be due to multiple etiologies, including: mucocele, Pott's puffy tumor, fibro osseous lesions, benign and malignant neoplasms of the nose and paranasal sinuses, intracranial lesions, and metastasis. The objective of this study was to describe the clinical protocol used for the diagnosis of patients presented with frontal swelling and the proposal for staging of inflammatory lesions. We performed an observational retrospective analysis. We found 7 cases of patients with frontal swelling: 4 cases secondary to inflammatory pathology (3 Potts puffy tumors and one frontal mucocele), and 3 cases secondary to neoplasms (one benign and 2 malignant neoplasms). It's very important to consider the wide differential diagnosis that can present as frontal swelling, from inflammatory pathologies secondary to possible advanced infections of the paranasal sinuses to invasive malignant neoplasms. We propose a system of staging of frontal inflammatory lesions (AU)

Paranasal sinus osteomas: Diagnosis and treatment.

INTRODUCTION: Osteoma is the most common benign tumor of the nose and paranasal sinuses. It is a slow-growing bony tumor, often asymptomatic, occurring mainly in frontal and ethmoid sinuses. Theories regarding the origin of osteomas are still discussed. The aims of the study were to describe diagnosis circumstances in our series and to set out our respective indications for open and endoscopic approaches in the treatment of nasosinusal osteomas. PATIENTS AND METHODS: A retrospective study was conducted on the files of all the patients treated for a paranasal sinus osteoma in our department between 1990 and 2013. Diagnosis circumstances and kind of treatment were collected and analyzed. RESULTS: The files of 45 patients (mean age: 49.2; sex-ratio: 1.19) could be collected. The most common symptom was headache found in all patients. The most common location was the frontal sinus (30 cases). Thirty-nine open procedures were performed. Four osteomas were removed under endoscopic assistance. In one case, a combined approach has been used. Overall complication rate was 11.1%. Symptoms improved in all patients. Two recurrences were observed. DISCUSSION: Surgical indications in paranasal sinus osteomas are theorically well codified. However, approaches remain controversial. In our experience, the preferred approach was the open one. Endoscopic techniques, when indicated, are more challenging and need sophisticated instrumentation and a long learning curve.

Osteoma cutáneo múltiple secundario en paciente con foliculitis decalvante / Multiple Secondary Cutaneous Osteomas in a Patient With Folliculitis Decalvans

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Termoablación por radiofrecuencia de osteomas osteoides del extremo proximal del fémur. Utilidad de la ecografía en casos seleccionados / Radiofrequency thermal ablation of osteoid osteomas of the proximal femur. Usefulness of ultrasound guidance in selected cases

Objetivo. Repasar la sintomatología y los hallazgos de imagen de los osteomas osteoides (OO) del extremo proximal del fémur, analizar los resultados de la técnica de la termoablación del nidus con ondas de radiofrecuencia en esa localización y describir la utilidad de la ecografía en la realización de la técnica en casos seleccionados. Material y método. Estudio descriptivo retrospectivo de una serie de 8 pacientes con OO del extremo proximal del fémur tratados mediante termoablación del nidus con ondas de radiofrecuencia desde 1998 hasta 2014. Resultados. El tiempo medio de evolución del dolor hasta la termoablación fue de 11,5 meses (rango: 5-18 meses). No hubo ninguna complicación y todos los pacientes refirieron la desaparición del dolor al día siguiente del procedimiento, con molestias que desaparecieron en la primera semana, salvo en uno, que se prolongaron más de un mes por la dificultad de la técnica. En la actualidad, con un seguimiento medio de 6 años y 2 meses (rango: 6-190 meses), todos los pacientes siguen asintomáticos y realizan una vida rigurosamente normal. Discusión. La termoablación con ondas de radiofrecuencia guiada por TC es un procedimiento seguro, eficaz y eficiente. Conclusiones. La presentación habitual de un OO del extremo proximal del fémur no difiere significativamente de la de un OO de otra localización y el diagnóstico es fácil cuando aquella se conoce. La termoablación del nidus con ondas de radiofrecuencia, que en casos seleccionados podría ayudarse de la ecografía para situar el electrodo en el centro del nidus, nos parece el tratamiento de elección por su eficacia y mínima morbilidad (AU)

Purpose. To review symptoms and imaging findings of proximal femoral osteoid osteomas (OO); to analyse the results of a thermal ablation technique for radiofrequency of the nidus in this location; and to describe usefulness of ultrasound guidance in selected cases. Material and method. Descriptive and retrospective study consisting of 8 patients with OO in the proximal epiphysis of the femur, which were treated by thermal ablation of the nidus with radiofrequency waves from 1998 to 2004. Results. The mean pain period until the performance of the thermal ablation was 11.5 months (range 5-18 months). There were no complications, and all patients stated that the pain was gone by the day following the procedure, with some discomfort during the first week, except for one where it lasted more than one month due to technique difficulties. At present, with a mean follow up of 6 years and 2 months (range 6-190 months), all patients remain asymptomatic and live a rigorous normal life. Discussion. Thermal ablation with CT-guided radiofrequency waves is a safe, effective and efficient procedure. Conclusion. Normal appearance of a proximal femoral OO does not differ significantly from other location osteomas and its diagnosis is easier with previous knowledge. Thermal ablation of the nidus with radiofrequency waves, that may be performed using ultrasound guidance, appears to be the elective treatment of choice due to its efficiency and minimum morbidity (AU)

[Soft-tissue osteomas in buccal space: a case report and review of the literatures].

Osteoma is a benign tumor, which is composed of mature differentiated bone tissue .Osteoma can be central, peripheral or extraskeletal. Extraskeletal osteoma also is called soft-tissue osteoma. Extraskeletal soft-tissue osteoma is exceedingly rare, especially in the oral cavity. This article reported a case with soft-tissue osteomas in buccal space. The histogenesis, differential diagnosis, pathologic type and treatment were discussed. Surgical resection is suggested as the main treatment for this disease.

Endoscopic ultrasonic curette-assisted removal of frontal osteomas.

Indications for endoscopic resection of fronto-ethmoidal osteomas have been progressively expanded thanks to optimization of surgical exposure and the development of dedicated instruments. Curved cutting drills are still suboptimal to treat hard osseous neoplasms of the frontal sinus. We present two patients affected by frontal osteoma treated with an endoscopic procedure using an ultrasonic bone curette. The ultrasonic bone curette may be considered an effective tool to reduce soft tissue manipulation, optimize surgical time and accelerate the healing process. However, the technique requires significant shape innovations to reach the lateral recesses and to manage pure intrasinusal lesions.

Osteoma gigante en mandíbula. Reporte de Caso / Giant osteoma in Jaw. Case Report

El osteoma es una neoplasia benigna poco común, que se caracteriza por presentar un crecimiento óseo progresivo, el cual está  compuesto por la proliferación bien diferenciada de hueso compacto y/o esponjoso. En el área maxilofacial se presenta con mayor frecuencia en la cara lingual posterior de la mandíbula. Se caracteriza por crecimiento lento y asintomático. El caso describe una paciente de 45 ños con un osteoma gigante mandibular de 4 años de evolución tratado quirúrgicamente.

Osteomas are considered a rare benign neoplasm, characterized by a progressive bone growth, which is composed of a proliferation well differentiated of compact or cancellous bone. In the maxillofacial area when present, commonly found in the posterior lingual surface of the mandible. It is characterized by slow growth and asymptomatic. The case describes a mandibular giant osteoma of 4 year of evolution treated with surgical treatment.

[Choroidal osteoma]. / Aderhautosteom.

Choroidal osteoma is a rare benign osseous tumor of the choroid usually affecting young healthy women. The diagnosis can be confirmed by the clinical appearance and with use of fluorescein or indocyanine angiography, optical coherence tomography, computed tomography or magnetic resonance imaging. A direct therapy of the tumor is indicated only for a few cases. The main reasons for vision loss are choroidal neovascularization, subretinal fluid and changes in the photoreceptor layer or the retinal pigment epithelium. Choroidal neovascularization and subretinal fluid in particular can be treated with laser therapy, photodynamic therapy or vascular endothelial growth factor inhibitors.

Acquired plate-like osteoma cutis.

Plate-like osteoma cutis is a rare disorder that has been historically classified as a congenital syndrome. It has a possible relationship to a mutation in the gene (GNAS1) that encodes the α-subunit of the stimulatory G protein, which regulates adenyl cyclase activity. We report a case of extensive plaque-like masses on the scalp and face with no abnormalities in calcium or phosphate metabolism and no preceding inflammatory cutaneous conditions. With less than ten reported cases, to our knowledge, this is one the few cases of acquired plate-like osteoma cutis described in the literature.

Multiple injuries of osteoma skin in the face: therapeutical least invasive in patients with acne sequela - case report.

Osteoma cutis is a bone formation in the dermis can to be primary or secondary forms. Only, multiples, many forms, occurring on either sex, they are a rare cutaneous disease. The pathogenesis and classification remains unclear. Our objective was the diagnostic and small invasive surgery treatment of the osteoma cutis multiple of the face, in patients as a sequel of acne. To remove the osteoma we used needle BD 0,70x25 22G1, without anesthetic topic or inject able site. The small wounds were exposed with scarring balsam. We got an excellent esthetic result after 15 days.

Lesões múltiplas de osteoma cutis na face: terapêutica minimamente invasiva em pacientes com sequela de acne - relato de casos / Multiple injuries of osteoma skin in the face: therapeutical least invasive in patients with acne sequela - case report

Osteoma cutis é a formação óssea no interior da pele, podendo ser primária ou secundária. Única ou múltipla, de tamanhos variados e acometendo ambos os sexos, é uma lesão cutânea rara, de etiopatogenia e classificação ainda discutidas. Nosso objetivo foi relatar o diagnóstico e a terapêutica minimamente invasiva de lesões múltiplas de osteoma cutis na face em pacientes com sequelas de acne. Fizemos a retirada dos osteomas com agulhas BD 0,70 x 25 22G1, sem anestésicos tópicos ou injetáveis no local. As pequenas incisões foram deixadas expostas, com pomada cicatrizante. Obteve-se um excelente resultado estético em 15 dias.

Osteoma cutis is a bone formation in the dermis can to be primary or secondary forms. Only, multiples, many forms, occurring on either sex, they are a rare cutaneous disease. The pathogenesis and classification remains unclear. Our objective was the diagnostic and small invasive surgery treatment of the osteoma cutis multiple of the face, in patients as a sequel of acne. To remove the osteoma we used needle BD 0,70x25 22G1, without anesthetic topic or inject able site. The small wounds were exposed with scarring balsam. We got an excellent esthetic result after 15 days.

[Tumours of the bony face in children the treated at the Paediatric ENT Clinic in Warsaw]. / Guzy twarzoczaszki u dzieci leczonych w Klinice Otolarynologii Dzieciecej w Warszawie.

INTRODUCTION: The tumours of bony face at in children are rare. Among the most commonly found are inflammatory tumours and development anomalies. In histopathology, the most frequent fund are neuroma, fibromas, osteoma, lipomas. In inflammatory tumours there are abscess and inflammatory infiltration. Malignants tumours in this area are rare in children, but are mainly sarcomata or melanoma. Developmental tumours include cyst and fistula. OBJECTIVE: To analyse tumours of the bony face treated in Paediatric ENT Clinic in Warsaw. MATERIAL: There were thirty cases of bony face tumours treated in Paediatric ENT Clinic in Warsaw between 2005 and 2007. RESULTS: One cases (3%) provedto be malignant, and one (3%) locally malignant. Twenty-one cases (70%) were found to be developmental tumours, three cases (10%) of abscesses, and four cases (13%) of benign tumours. CONCLUSIONS: The most frequently-found tumours of bony face in children are developmental tumours. All tumours must be the subject of histopatological examination. In the case of cancers tumours it has to be established if the tumour is a primary or a metastatic. In the group analysed group the rare tumour were epithelioma, ganglioma.

[Long-term follow-up and management of choroidal osteoma].

OBJECTIVE: To report the clinical characteristics, long-term follow-up and management of choroidal osteoma. METHODS: Eighteen eyes of 12 cases (5 male and 7 female) of choroidal osteoma were studied. Best corrected vision, intraocular pressure, perimetry, anterior segment and eye fundus were examined routinely. Special tests included phytochrome of eye fundus, fluorescein angiography and/or indocyanine green angiography; B-ultrasonogram, CT, perimetry and electrophysiology. (1) Eight eyes of 6 cases treated with vitamins and anti-inflammatory drug and followed-up periodically for 1-26 years (median 2.5 years). (2) Four eyes of 2 cases were treated with Krypton laser photocoagulation, 2 of them were superimposed with transpupillary thermotherapy (TTT). (3) TTT was given primarily for 6 eyes of 4 cases with infrared dione laser; the spot size was 3 mm, 1-5 spots were conducted conjunctly to cover the tumor surface. Power was 800-1200 mw at 60-90 seconds. The procedure was completed in 1-3 recessions with an interval of 4-6 weeks. RESULTS: (1) In the medical treatment group, gradual growth of the tumor with pseudopodium along the margin was disclosed. One eye showed spontaneously regression during the long-term follow-up. (2) Laser photocoagulation was effective for 2 eyes, but residual flat serous detachment around the optic disc persisted in another 2 eyes and subsided with TTT. (3) Choroidal osteoma complicated with CNV treated primarily with TTT, prominent improvement was demonstrated. CONCLUSIONS: Choroidal osteoma grows gradually in the natural course and shows pseudopodial margin. Laser photocoagulation was effective for certain cases. TTT is a method of choice either used primarily or supplementary after laser photocoagulation, it is recommended for cases complicated with CNV.

Osteoma Frontal. Presentación de un caso / Frontal sinus osteoma. Case report

Los tumores óseos extraoculares con repercusión ocular han sido descritos hace muchos años, pero no son afecciones frecuentes; existen variados mecanismos por los que producen sintomatología en el globo ocular, en ocasiones el diagnóstico causal es difícil y prolongado. Se presenta un paciente que debuta con signos y síntomas originados por una tumoración ósea del seno frontal. (AU)