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Osteoblastoma of the lateral skull base: work-up, surgical management, and a review of the literature".

Miller C, Khan R, Lemole GM, Jacob A - J Neurol Surg Rep (2013)

Bottom Line: Results A 15-year-old adolescent boy with a greater than 1-year history of right-sided retroauricular pain, a palpable postauricular mass, and chronic headaches presented for evaluation/management.Follow-up imaging studies found no evidence of recurrence.An en bloc resection is important for both diagnosis and definitive treatment of these neoplasms.

View Article: PubMed Central - PubMed

Affiliation: Division of Otolaryngology, The University of Arizona Ear Institute, University of Arizona, Arizona, USA.

ABSTRACT
Objectives To describe the work-up and surgical management of an osteoblastoma involving the lateral skull base. Typically occurring in the spine or long bones, osteoblastomas of the craniofacial skeleton are exceedingly rare and infrequently reported. A review of the current literature regarding temporal bone osteoblastoma, diagnosis, and treatment is described. Methods This case report describes the clinical presentation, radiographic studies, surgical management, histology, and postoperative follow-up of a young man presenting to a tertiary care neurotology practice with osteoblastoma involving the lateral skull base. A review of the current literature regarding osteoblastoma of the skull base, work-up, and treatment is described. Results A 15-year-old adolescent boy with a greater than 1-year history of right-sided retroauricular pain, a palpable postauricular mass, and chronic headaches presented for evaluation/management. Microscope examination of the ears, hearing, and cranial nerve function were normal. High-resolution temporal bone computed tomography and magnetic resonance imaging scans were obtained, which revealed an expansile mass involving the junction of the temporal and occipital bones. The patient underwent a combined retrosigmoid/retrolabyrinthine resection of this extradural tumor. Histology revealed a benign bone neoplasm consistent with osteoblastoma. Complete surgical resection was achieved, and the patient's symptoms fully resolved. Follow-up imaging studies found no evidence of recurrence. The scientific literature relevant to work-up and management of osteoblastoma is reviewed. Discussion Osteoblastomas of the lateral skull base are rare, histologically benign tumors that can present with radiographic features suggestive of malignancy. An en bloc resection is important for both diagnosis and definitive treatment of these neoplasms. The differential diagnosis on imaging and histology is discussed.

No MeSH data available.


Related in: MedlinePlus

(a) Axial T1 precontrast and (b) T1 postcontrast magnetic resonance imaging (MRI) images show a T1 dark mass lesion, which avidly enhances. (c) Axial T2 MRI shows that the lesion is significantly dark, indicating the relative lack of water content in the mass, whereas (d) axial gradient MRI shows extensive dark signal related to the calcification.
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FI120062-2: (a) Axial T1 precontrast and (b) T1 postcontrast magnetic resonance imaging (MRI) images show a T1 dark mass lesion, which avidly enhances. (c) Axial T2 MRI shows that the lesion is significantly dark, indicating the relative lack of water content in the mass, whereas (d) axial gradient MRI shows extensive dark signal related to the calcification.

Mentions: Magnetic resonance imaging (MRI)/magnetic resonance venography (MRV) of the head showed that the majority of the mass avidly enhanced with several small internal foci that did not (Fig. 2a, b). The lesion appeared to be well encapsulated and completely extradural. There was no evidence on any imaging modality to suggest that the lesion had intradural involvement. The lesion had no T2 signal within it (Fig. 2c), and it also demonstrated a large amount of dark signal on the gradient images (Fig. 2d); this indicated a relative lack of water and a large amount of calcification within the lesion, respectively. MRV also showed severe tapering and probable occlusion at the right transverse/sigmoid sinus junction. Differential diagnosis at this time included benign bone processes, such as osteoid osteomas, aneurysmal bone cysts, or fibrous dysplasia, and malignant processes, such as osteogenic sarcomas, chondrosarcoma, or metastatic disease. Even with extensive imaging, a diagnosis was not achieved. Though the heterogeneous nature of the mass directed our decision making toward a bony process. The extradural nature of the mass made surgical en bloc resection an appropriate treatment option.


Osteoblastoma of the lateral skull base: work-up, surgical management, and a review of the literature".

Miller C, Khan R, Lemole GM, Jacob A - J Neurol Surg Rep (2013)

(a) Axial T1 precontrast and (b) T1 postcontrast magnetic resonance imaging (MRI) images show a T1 dark mass lesion, which avidly enhances. (c) Axial T2 MRI shows that the lesion is significantly dark, indicating the relative lack of water content in the mass, whereas (d) axial gradient MRI shows extensive dark signal related to the calcification.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713558&req=5

FI120062-2: (a) Axial T1 precontrast and (b) T1 postcontrast magnetic resonance imaging (MRI) images show a T1 dark mass lesion, which avidly enhances. (c) Axial T2 MRI shows that the lesion is significantly dark, indicating the relative lack of water content in the mass, whereas (d) axial gradient MRI shows extensive dark signal related to the calcification.
Mentions: Magnetic resonance imaging (MRI)/magnetic resonance venography (MRV) of the head showed that the majority of the mass avidly enhanced with several small internal foci that did not (Fig. 2a, b). The lesion appeared to be well encapsulated and completely extradural. There was no evidence on any imaging modality to suggest that the lesion had intradural involvement. The lesion had no T2 signal within it (Fig. 2c), and it also demonstrated a large amount of dark signal on the gradient images (Fig. 2d); this indicated a relative lack of water and a large amount of calcification within the lesion, respectively. MRV also showed severe tapering and probable occlusion at the right transverse/sigmoid sinus junction. Differential diagnosis at this time included benign bone processes, such as osteoid osteomas, aneurysmal bone cysts, or fibrous dysplasia, and malignant processes, such as osteogenic sarcomas, chondrosarcoma, or metastatic disease. Even with extensive imaging, a diagnosis was not achieved. Though the heterogeneous nature of the mass directed our decision making toward a bony process. The extradural nature of the mass made surgical en bloc resection an appropriate treatment option.

Bottom Line: Results A 15-year-old adolescent boy with a greater than 1-year history of right-sided retroauricular pain, a palpable postauricular mass, and chronic headaches presented for evaluation/management.Follow-up imaging studies found no evidence of recurrence.An en bloc resection is important for both diagnosis and definitive treatment of these neoplasms.

View Article: PubMed Central - PubMed

Affiliation: Division of Otolaryngology, The University of Arizona Ear Institute, University of Arizona, Arizona, USA.

ABSTRACT
Objectives To describe the work-up and surgical management of an osteoblastoma involving the lateral skull base. Typically occurring in the spine or long bones, osteoblastomas of the craniofacial skeleton are exceedingly rare and infrequently reported. A review of the current literature regarding temporal bone osteoblastoma, diagnosis, and treatment is described. Methods This case report describes the clinical presentation, radiographic studies, surgical management, histology, and postoperative follow-up of a young man presenting to a tertiary care neurotology practice with osteoblastoma involving the lateral skull base. A review of the current literature regarding osteoblastoma of the skull base, work-up, and treatment is described. Results A 15-year-old adolescent boy with a greater than 1-year history of right-sided retroauricular pain, a palpable postauricular mass, and chronic headaches presented for evaluation/management. Microscope examination of the ears, hearing, and cranial nerve function were normal. High-resolution temporal bone computed tomography and magnetic resonance imaging scans were obtained, which revealed an expansile mass involving the junction of the temporal and occipital bones. The patient underwent a combined retrosigmoid/retrolabyrinthine resection of this extradural tumor. Histology revealed a benign bone neoplasm consistent with osteoblastoma. Complete surgical resection was achieved, and the patient's symptoms fully resolved. Follow-up imaging studies found no evidence of recurrence. The scientific literature relevant to work-up and management of osteoblastoma is reviewed. Discussion Osteoblastomas of the lateral skull base are rare, histologically benign tumors that can present with radiographic features suggestive of malignancy. An en bloc resection is important for both diagnosis and definitive treatment of these neoplasms. The differential diagnosis on imaging and histology is discussed.

No MeSH data available.


Related in: MedlinePlus