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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) Immediate postoperative axial noncontrast computed tomography (CT) image shows the large postoperative skull defect with graft and air. No residual tumor was seen on CT or magnetic resonance imaging (MRI). (b) Postoperative T2 bright fluid in the resection site. No evidence of residual tumor postoperatively. Note overlying mesh lateral to the operative site (arrow). Coronal and axial magnetic resonance venography (MRV) images show narrowing but patency of the right sigmoid sinus, which severely tapers just before the jugular bulb. (c) The jugular bulb was widely patent.
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FI120062-4: (a) Immediate postoperative axial noncontrast computed tomography (CT) image shows the large postoperative skull defect with graft and air. No residual tumor was seen on CT or magnetic resonance imaging (MRI). (b) Postoperative T2 bright fluid in the resection site. No evidence of residual tumor postoperatively. Note overlying mesh lateral to the operative site (arrow). Coronal and axial magnetic resonance venography (MRV) images show narrowing but patency of the right sigmoid sinus, which severely tapers just before the jugular bulb. (c) The jugular bulb was widely patent.

Mentions: Pathologic analysis of permanent specimens identified osteoblastoma, a benign, bone-forming tumor (Fig. 3). To date, this patient has had 12 months of follow-up with no evidence of tumor recurrence. Postoperative temporal bone CT (Fig. 4a) and MRI scans are shown (Fig. 4b). Postoperative MRV again demonstrates probable occlusion of the right sigmoid sinus (Fig. 4c). The patient has no cranial nerve deficits, headaches/postauricular pain have resolved, and hearing is normal. Evaluation by the medical oncology team found no need for adjuvant therapies such as radiation or chemotherapy.


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) Immediate postoperative axial noncontrast computed tomography (CT) image shows the large postoperative skull defect with graft and air. No residual tumor was seen on CT or magnetic resonance imaging (MRI). (b) Postoperative T2 bright fluid in the resection site. No evidence of residual tumor postoperatively. Note overlying mesh lateral to the operative site (arrow). Coronal and axial magnetic resonance venography (MRV) images show narrowing but patency of the right sigmoid sinus, which severely tapers just before the jugular bulb. (c) The jugular bulb was widely patent.
© Copyright Policy
Related In: Results  -  Collection

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

FI120062-4: (a) Immediate postoperative axial noncontrast computed tomography (CT) image shows the large postoperative skull defect with graft and air. No residual tumor was seen on CT or magnetic resonance imaging (MRI). (b) Postoperative T2 bright fluid in the resection site. No evidence of residual tumor postoperatively. Note overlying mesh lateral to the operative site (arrow). Coronal and axial magnetic resonance venography (MRV) images show narrowing but patency of the right sigmoid sinus, which severely tapers just before the jugular bulb. (c) The jugular bulb was widely patent.
Mentions: Pathologic analysis of permanent specimens identified osteoblastoma, a benign, bone-forming tumor (Fig. 3). To date, this patient has had 12 months of follow-up with no evidence of tumor recurrence. Postoperative temporal bone CT (Fig. 4a) and MRI scans are shown (Fig. 4b). Postoperative MRV again demonstrates probable occlusion of the right sigmoid sinus (Fig. 4c). The patient has no cranial nerve deficits, headaches/postauricular pain have resolved, and hearing is normal. Evaluation by the medical oncology team found no need for adjuvant therapies such as radiation or chemotherapy.

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