Osteoma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Osteoma must be differentiated from other diseases that cause sinus or facial pain, headache, and changes to or loss of sense of smell, such as other osteogenic tumours, fibrous displasia, and chronic sinusitis.

Differential Diagnosis

The table below summarizes the findings that differentiate osteoma from other conditions that also cause facial pain and headache:

Differential Diagnosis	Similar Features	Differentiating Features
Fibrous dysplasia	Benign, often an incidental finding, affects the same group of patients, and symptoms include facial pain and headache.	In fibrous dysplasia, differentiating features include: More common presentation is on ribs: 28%, no gender predilection, and complete resection is usually not possible.
Osteoblastoma	Benign, incidental, and male predilection.	In osteoblastoma, differentiating features include: normally affect the axial skeleton, lesions are typically larger than 2 cm, and surgical excision is often the treatment of choice.
Adamantinomas	Benign, slow growing, and similar clinical onset.	In adamantinomas, differentiating features include: locally aggressive tumor, common in the 3rd to 5th decades of life, and location is usually confined to the jaw.
Chronic sinusitis	Affects same group of population (young to middle aged adults) and the clinical presentation is similar.	In chronic sinusitis, differentiating features include: fever, previous history of acute sinusitis, lack of facial deformation or imaging findings compatible with osteoma.