Case report on parietal osteoma
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This document reports on a rare case of parietal osteoma. A 56-year-old male presented with a spherical swelling on the left parietal bone. CT scan revealed a bony cyst eroding the parietal cortex. The patient underwent craniotomy and excision of the lesion, with reconstruction using titanium mesh. Post-operatively, the patient recovered well and was discharged on medications with no complications. Parietal osteoma is a rare benign bone tumor, usually growing on the skull. Surgical excision is the main treatment approach.
Case report on parietal osteoma
- 1. A RARE CASE ON PARIETAL OSTEOMA 1. ABSTRACT An osteoma is a new piece of bone usually growing on another piece of bone, typically the skull. It is a benign tumor. Osteoma in the occipital and mastoid regions are exceptionally rare with only 137 cases reported in the literature. Osteoma can occur in any part of the skull, in the frontal and parietal rare, other skull and skull base is rare. 2. INTRODUCTION Osteoma is a benign tumor characterized by slow growth, painless and extensive growth. When the bone tumor grows on other bone it is known as "homoplastic osteoma"; when it grows on other tissue it is called "heteroplastic osteoma".Osteomarepresents the most benign neoplasm of the nose and paranasal sinuses. The cause of osteoma is uncertain, but commonly accepted theories propose embryologic, traumatic, or infectious causes. Parietal osteoma ( Cranial Osteoma) is divided into two major groups the bony osteoma and the cancellous osteoma. The bone compact osteoma mostly originates from the outer bone plate, and the inner plate remains intact. Cancellous osteoma originated in fibrous tissue containing more diploetic, and sometimes red bone marrow or bone marrow fat. On the X-ray film of the skull, circular or oval shape and localized high- density shadowcan be seen. The cancellous bone in the bone is loose and the density is uneven. There is calcification in the trabecular bone. The osteoid osteoma usually grows on the outer surface of the skull and rises outward, and the internal structure is dense and even. In frontal and ethmoid sinus osteoma often lobulated. Diagnosis can be confirmed by CT Scan, Magnetic resonance imaging etc. CT examination showed the skull bone changes, visible signs of meningioma. It should be differentiated with fibrous hyperplasia of bone lesions, the latter range widely, to see a face at the top of the orbit, changes in the X-ray and CT showed full-thickness involvement of the skull, boundary-less clear, the density is not the same, there may be other parts of the body to change the blade.
- 2. The treatment of osteoma mainly depends on surgery. The osteoma of the parietal cranium, such as small size, no special symptoms or a few stopped growing osteoma, cannot be treated. Fast growing, affected faces and symptomatic osteoma should be surgically removed. The osteoma which is limited to the outer plate needs to be cut flat or polished, and the residual substrate needs no electric cauterization. Osteoma with large intracranial involvement should be removed by bone flap, and then the bone flap, 30min, inactivation and plastic treatment will be performed. The involvement of paranasal sinus osteoma such as paranasal sinus obstruction has caused should be treated surgically, osteoma by subfrontal extradural approach resection ethmoid osteoma by orbital or orbital plate surgical approaches. Osteoma of cancellous bone needs total resection. CASE REPORT During my clinical posting in ABC hospital. I was Posted in neurological ward. there I observed very a rare case diagnosed as Parietal osteoma., where the patient has a swelling ( left parietal bony cyst eroding from the cortex of skull ). The important significant clinical features includes Spherical shaped Swelling on left parietal cortical region Lesion on the cortex region. Generalized weakness CECT REPORT Left high parietal bony cysteroding to cortex of skull FINAL DIAGNOSIS Left parietal osteoma. Mr ‘X ‘ 56 Years old got submitted to ABC hospital with the complaint of left parietal bony cyst in cortical region. Craniotomy + excision of the lesion + reconstruction using titanium mesh under GA on 30 / 04 /18was done. There were no complications during intraoperative and postoperative period and patient is on medications such as inj Celifna SB I.5 gm IV (BD), inj. Eptoin 100mg IV ( TID), inj. PCT 1 gm IV( BD), and Rantac 50 mg IV BD. Drain was removed. Patient got discharged on 15 /05/2018.
- 3. Advice on Discharge Tab. Eptoin 100 mg TID ( 2 Weeks) Tab. Ultracet BD ( 5 days ) Tab. Rantac 150 mg ( 5 days ) The incidence of parietal osteoma reported in ABC Hospital in the year of 2017 was one CASE DISCUSSION Osteoma is benign tumor characterized by slow growth, painless and extensive growth. The demarcation of the skull is often unclear. Can occur in any part of the skull, in the frontal and parietal rare, other skull and skull base is rare. Cranial osteoma is divided into two major groups the bony osteoma and the cancellous osteoma. The bone compact osteoma mostly originates from the outer bone plate, and the inner plate remains intact. Cancellous osteoma originated in fibrous tissue containing more diploetic, and sometimes red bone marrow or bone marrow fat. Diagnosis can be confirmed by CT Scan, Magnetic resonance imaging etc. CT examination showed the skull bone changes at the same time, visible signs of meningioma etc.
- 4. CONCLUSION osteoma is a new piece of bone usually growing on another piece of bone, typically the skull. It is a benign tumor. Osteoma can occur in any part of the skull, frontal and parietal rare, other skull and skull base is rare. Management measures mainly focus on surgical removal and replacing with bone flap. Proper and Timely management can prevent life-threatening complications. REFERENCE 1.BLACK M. JOYCE, Medical-Surgical Nursing, published by Elsevier, Edition 8th, volume -2, page no : 2.Brunner and Suddarth’s, Textbookofmedical-surgical nursing, published by Lippincott Williams and Wilkins, Edition 11th, volume 1, page no : 3.Lee YG, Cho CW. Benign osteoblastomalocated in the parietal bone. Journal of Korean Neurosurgical Society. 2010 Aug;48(2):170. 4.http://www.aliub.com/what-is-the-skull-parietal-osteoma. 5. Quesnel AM, Lee DJ. Extensive osteomas of the temporal-parietal-occipital skull. Otology & Neurotology. 2011 Jan 1;32(1):e3-4.