Surgical Management of Giant Skull Osteomas in Western UP Region

ABSTRACT

Benign osteoblastic anomalies are uncommon bone tumors and commonly divided into osteoid osteomas and benign osteoblastomas according to their biological behaviour. Among these primary benign bone tumor osteomas are the most commonly found at the site of skull and face. Osteomas are usually asymptomatic as they increase in size slowly. Therefore, present study was designed to evaluate the clinical, radiological, and surgical aspects of osteomas in patients with giant skull lesions. Methods: This study was conducted in CNS Hospital, Centre for Neurosciences and Narayan Superspeciality hospital, Meerut and SVBP Hospital associated with LLRM Medical College, Meerut between the period of 2015 and 2018. The 12 successive patients with giant osteomas were treated surgically in the hospital. The patient population consisted of adult female patient ranging from 12 to 70 years with median age of 40 years and having giant cranial osteomas involving the cranial vault and some with extension into the paranasal sinuses or orbital wall. Results: Most common site of lesions was frontal portion of skull. Further, most common complaint of the patients was headache (50%). Further, slowly growing mass (44.4%) was the second most common complaint followed by proptosis in one patient. The mean diameter was 5.75 cm with range of 3 to 10 cm in all patients. The mean time duration of the patients of the onset of the tumor was 3 years with range from 6 months to 5 years. Histopathology picture of the patients revealed that tumors were composed of oestoid lamina. Further, different quantity of osteoid with major cement lines were found in trabeculae of laminae. Conclusion: Osteomas are normally benign tumors without any symptoms; However, surgical removal could be required for the cosmetic reasons. On the other hand, for the osteomas with different symptoms surgical treatment is the only choice of treatment. A considerable precaution and care of blood supply and surrounding brain tissue should be taken during radical extraction of the giant tumors.