Classic and rare manifestations of multiple osteoma: A case report

Yuni Artha Prabowo Putro; Rahadyan Magetsari; Kartika W Taroeno-Hariadi; Ery Kus Dwianingsih; Amri Wicaksono Pribadi; Karisa Kartika Sukotjo

doi:10.1016/j.ijscr.2023.108713

Classic and rare manifestations of multiple osteoma: A case report

Int J Surg Case Rep. 2023 Sep:110:108713. doi: 10.1016/j.ijscr.2023.108713. Epub 2023 Aug 25.

Authors

Yuni Artha Prabowo Putro¹, Rahadyan Magetsari², Kartika W Taroeno-Hariadi³, Ery Kus Dwianingsih⁴, Amri Wicaksono Pribadi⁵, Karisa Kartika Sukotjo²

Affiliations

¹ Department of Orthopedics and Traumatology, RSUP Dr. Sardjito Hospital, Jl. Kesehatan Sendowo No.1, Sleman 55281, D.I.Yogyakarta, Indonesia; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sendowo, Sekip Utara, Sleman 55281, D.I.Yogyakarta, Indonesia. Electronic address: yuniarthaprabowoputro@ugm.ac.id.
² Department of Orthopedics and Traumatology, RSUP Dr. Sardjito Hospital, Jl. Kesehatan Sendowo No.1, Sleman 55281, D.I.Yogyakarta, Indonesia; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sendowo, Sekip Utara, Sleman 55281, D.I.Yogyakarta, Indonesia.
³ Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sendowo, Sekip Utara, Sleman 55281, D.I.Yogyakarta, Indonesia; Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Jl. Farmako, Sendowo, Sekip Utara, Sleman 55281, D.I.Yogyakarta, Indonesia.
⁴ Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sendowo, Sekip Utara, Sleman 55281, D.I.Yogyakarta, Indonesia; Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Jl. Farmako, Sendowo, Sekip Utara, Sleman 55281, D.I.Yogyakarta, Indonesia.
⁵ Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sendowo, Sekip Utara, Sleman 55281, D.I.Yogyakarta, Indonesia; Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sendowo, Sekip Utara, Sleman 55281, D.I.Yogyakarta, Indonesia.

Abstract

Introduction and importance: Osteoma is a benign tumor that can arise from compact or cancellous bone and is more commonly found in the face or skull. The incidence of osteoma believed to be underreported as most are asymptomatic. To date, the best modality to diagnose osteoma is CT scan. We report a unique case of osteoma presenting with cranial and extracranial manifestations and highlight the importance of bone survey in evaluating patients with osteoma.

Case presentation: A 26-year-old female complained of bilateral pain in the jawbone and several areas of her head. On physical examination, there were several masses in the head with the largest on the left mandible measuring 5.6 × 6.0 × 4.5 cm from MSCT examination. Hemi-mandibulectomy, histopathological and cytopathology examination were performed on the tissue obtained from the left mandible which concluded osteoma. Post-operative bone survey was performed and found osteoma on left ulna and bilateral fibula. Suspected Gardner syndrome with multiple osteoma manifestation was excluded from normal results of colon in-loop examination. We conservatively monitored the patient and most recent 6-month follow-up found no complaint nor changes in the extracranial osteoma manifestation on left ulna and both fibulas.

Clinical discussion: The benign tumor osteoma is incredibly uncommon to present both intra and extracranially. We suggest thorough skeletal studies such as bone survey to be performed as they are crucial in the full evaluation of patients with multiple osteomas. Osteoma treatment is based on the patient's symptoms, surgery for patients with symptoms and periodic monitoring for asymptomatic patients.

Conclusion: It is necessary to consider radiological modality for diagnosing osteoma patients. The majority of osteomas are asymptomatic and the choice of radiological examination sometimes still misses the lesion. It is important to evaluate histologically if the lesion difficult to diagnose.

Keywords: Benign bone tumor; Case report; Multiple osteoma; Oncology.

Publication types

Case Reports