Osteoma
Introduction
Introduction to osteoma Osteoma often occurs in the osteogenesis of the membrane, most commonly seen in the craniofacial bone, called osteosarcoma; occasionally see soft tissue, it is called extra-osseous osteoma, intramedullary osteoblasts can stop growing as the bone matures. And no malignant, its prognosis is generally good, however, cervical vertebrae are rare. In addition, multiple osteoma, such as intestinal polyposis, is called Garder syndrome, the disease is hereditary, osteoma is a benign tumor caused by abnormal proliferation of bone tissue caused by abnormal periosteal osteogenesis, Wills (1953), Paron (1964) argues that it is not a true tumor, but a hamartoma, and is also considered to be a dense proliferation of bone tissue abnormalities. basic knowledge The proportion of illness: 0.005% Susceptible people: good for teenagers and youth Mode of infection: non-infectious Complications: headache, epilepsy
Cause
Cause of osteoma
(1) Causes of the disease
The reason is unknown. According to the literature, there are embryonic residues, trauma, infection, endocrine disorders and genetic theory, but more literature supports the tendency of embryonic residue theory - and it is believed that in the occurrence of the disease, tumors may occur at the junction of two different tissues. , various parts of the skull, or intramembranous osteogenesis, or endochondral ossification (in the occurrence of learning, the skull must undergo two stages of changes before ossification: 1 the mesenchymal thickening of the invading cerebral vesicle is a membrane 2, followed by transformation into cartilage, where the ossification of cartilage, for cartilage osteogenesis, such as the bones of the skull and the outer part of the sphenoidal wing, all the skull base bone, where the non-cartilage stage, directly by the membrane Occurrence of ossification is intramembranous osteogenesis, for example, all the skulls that form the cranial sac, except for a part of the occipital bone. The formation of the nasal cavity is basically an intra-chondral osteogenesis, so there is called intranasal osteogenesis. Occurs between the frontal bone and the ethmoid bone, between the sphenoidal wing and the frontal humerus or in the maxilla. The osteoma is derived from membranous tissue and develops into a rigid osteoma, derived from cartilage tissue. For cancellous osteoma, come at the same time To both organizers (above mandible), the development of hybrid osteoma.
(two) pathogenesis
Osteoma is a benign lesion that is more common in the skull and bones. It consists of osteofibrous fibrous tissue, osteoblasts and new bones produced by it. It contains well-differentiated mature bone tissue and has The obvious lamellar structure, the osteoma grows with the development of the human body. When the human body matures, most of the tumors also stop growing. The multiple osteoma is called Gardner syndrome, and there are intestinal polyps and soft tissue lesions.
The tumor bone is yellow-white, with bone-like hardness, uneven surface, covered with pseudo-envelope, microscopically composed of fibrous tissue and new bone, enlarged bone cells, uneven staining of the matrix, no malignant changes of fibroblasts and osteoblasts. phenomenon.
Prevention
Osteosarcoma prevention
Patients with malignant osteoma need to strengthen nutrition and enhance physical fitness.
Complication
Osteoma complications Complications, headache, epilepsy
Osteosarcoma is the most benign of bone tissue tumors. There are few malignant changes. Most of the patients are juveniles and young people. The skull and upper and lower jaws are good for their hair growth, slow growth and few symptoms. When they protrude from the skull, eyelids, In the nasal cavity and nasal sinus, it can cause compression symptoms. When it develops to the surface of the skull, it can cause abnormalities in the appearance. After the fusion of the whole body, the tumor stops growing on its own, so it must be given a more serious compression symptom or excessive deformity. Except for surgical resection, it is not necessary to consider treatment; however, it should continue to be observed. Occasionally, osteoma may have malignant changes. The tumor should be surgically removed during treatment, and a few normal bones around the tumor should be included. Otherwise, the tumor can recur and even malignant.
When it occurs in the inner plate of the skull and develops into the brain, it can cause an increase in intracranial pressure, headache, dizziness or concomitant epilepsy.
Symptom
Osteosarcoma Symptoms Common Symptoms Bone Destruction Diffuse Osteoporosis Growth Slow Eyeball Highlights Skull Hyperplasia Dizziness
1. Occurs in the skull, face bone and mandible, generally asymptomatic, the course of disease for several years or decades.
2. If it occurs in the inner plate of the skull, it may cause increased intracranial pressure and symptoms of brain compression, such as dizziness, headache, and even epilepsy.
3. When the tumor occurs in the outer skull of the skull, it can cause abnormalities in the appearance. If it occurs in the mandible, the oral cavity or the nasal cavity often causes compression symptoms.
4. External bone tumors in the skull area may sometimes have malignant changes.
5. X-ray film: the skull often has a uniform density and increased bone protrusion, and the outer edge is smooth and its base is connected with the bone plate.
The clinical manifestations of patients with cervical osteoma are mainly due to the compression of the surrounding tissues by the tumor itself; therefore, the severity of clinical symptoms is related to the size of the tumor, the growth rate and the compression of adjacent tissues. Small osteomas are generally asymptomatic, and cervical X-ray films are often accidentally found for other reasons. Large osteoma, depending on the tissue that is compressed by the tumor, has corresponding compression symptoms.
Examine
Osteosarcoma examination
X-ray film performance: If the tumor occurs in the vertebral body, it will show a uniform dense whitening shadow, which is also a feature of vertebral osteoma.
Imaging diagnosis
The dense osteoma shows a bulge, the external ratio is smooth, the base of the skull osteoma is broad and wavy, and the inner plate is thickened, the bone density is evenly increased, the degree of bone destruction and ossification are often inconsistent, and the epiphysis is often pedicled. The cartilage can be calcified and cauliflower-like. On the X-ray film of the craniofacial bone, the original bone destruction can be seen and the ossification is different. The boundary is clear, the tumor protrudes outside the bone or the cavity, and the tumor is visible in the tibia. It is a dense bone-like mass, located on one side of the cortical bone. It is a smooth, sharp-edged scorpion, which is like the outward extension of the bone, and has a tendency to grow around the bone. The degree of ossification of the tumor is different, and the tumor is highly ossified. The fine texture structure is called ivory osteoma, and the osteoma is mostly single and occasionally multiple.
Diagnosis
Diagnosis and diagnosis of osteoma
Diagnose based on
1. Adolescents, skulls, painless, slow-growing masses, and the mass stops growing after the epiphysis is closed.
2. X-ray film can help diagnose.
Differential diagnosis
(1) The osteoma that occurs in the paranasal sinus is more common in the forehead and ethmoid sinus. It is often lobulated, with pedicles, neat edges, uniform density, growing up to fill the sinus cavity, and even sinus wall. Forehead deformity, general diagnosis is not difficult.
(B) occurs in the skull should be associated with meningioma, frontal plate hyperplasia and fibrosis:
1. Meningioma: rapid growth, no plastic new bone hyperplasia, bone-like changes, tumor base wide, and craniocerebral osteolytic changes, increased blood supply to the tumor, resulting in increased vascular groove shadow in the vicinity, eyelid screen The osteoma is sometimes indistinguishable from the meningioma of the olfactory sulcus.
2. Frontal plate hyperplasia: is a wave of bone hyperplasia, patients often have headaches, obesity, loss of libido, more common in women after menopause, sometimes accompanied by diabetes or diabetes collapse.
3. Cranial fibrous heterogeneous hyperplasia: extensive lesions, wide base, multiple pathogenesis, involving the dysplasia and the skull, other bones of the body can also occur, and there is a unilateral trend.
(3) It should be distinguished from osteochondroma and osteosarcoma in the limbs:
1. Exogenous osteophytes: If the whole body bone is osteoma, it is actually osteochondroma, which contains calcification of cartilage components. The two are difficult to distinguish, depending on the disease.
2. Endogenous tendon (Enoslosis), also known as Bone Spot or Bone Islaand, is a bone dysplasia in the cancellous bone. The bone is nest-shaped and may have trabecular bone and is not a tumor.
3. Osteosarcoma: rapid growth, characterized by malignant bone tumors, with or without age and location, easy to distinguish.
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