Osteoma pathophysiology

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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 is a slow growing benign tumor of bone, occurring most commonly in the craniofacial skeletal structures, primarily in the nasal and paranasal (75-90%) cavities. Osteoma arises from bone overgrowth, which is normally composed of connective tissue. Osteomas are slow growing tumors composed of compact or mature trabecular bone limited to craniofacial bones. The most common gene affected in multiple osteoma is the APC gene.

Pathogenesis

• Osteoma arises from bone overgrowth, which is normally composed of connective tissue.
• Osteomas are slow growing tumors composed of compact or mature trabecular bone limited to craniofacial bones.
• Osteomas have a particular frequency distribution within the paranasal sinuses: frontal sinuses 80%, ethmoid air cells 15%, maxillary sinuses 5% and sphenoid sinus rare.
• The most common gene affected in multiple osteoma is the APC gene.

Genetics

• The hallmark of multiple osteomas is a mutation in the APC gene, that results in the Gardner syndrome.

Associated Conditions

• Gardner syndrome

Gross Pathology

• On gross pathology, osteomas have a spongy to densely appearance, conformed of in a polypoid and lobullated shape.
• The median size tumor size is 3.0 cm (range 0.5-8 cm).
• Osteomas have a smooth surface. Normally it is composed of dense compact bone (ivory osteoma), trabecular bone (mature osteoma, or both patterns).

Microscopic Pathology

• On microscopic pathology, slow-growing, bone-forming tumor can be shown with the presence of dense compact mature bone in paucicellular fibrous stroma.
• Large trabeculae of mature lamellar bone can be also be seen.

Gallery

• 

  Micropathology osteoma: normal bone appearence.