Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Report
Case Series
Commentary
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Report
Case Series
Commentary
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Technical Note
Techniques in Neurosurgery
View/Download PDF

Translate this page into:

Images in Neurosciences
2 (
1
); 103-104
doi:
10.4103/0976-3147.80088

Cloud-like pattern of mineralization in skull base osteosarcoma

Address for correspondence: Dr. Lakshmi Narayan Garg, Department of ENT, MM Institute of Medical Sciences & Research Maharishi Markandeshwar University, Mullana- Ambala, 133-203 (Haryana), India. E-mail: dr.lngarg@gmail.com
Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications and was migrated to Scientific Scholar after the change of Publisher; therefore Scientific Scholar has no control over the quality or content of this article.

Source of Support: Nil

Conflict of Interest: None declared.

Osteosarcoma derives from primitive bone-forming mesenchymal cells, although it is the most common primary bone malignancy,[12] osteosarcoma of the skull base is very rare.[136] A 40-year-old woman, a known case of left temporal bone osteosarcoma operated 3 years back, now presented with progressively increasing swelling over the previously operated site for the previous 6 months and foul smelling discharge for 3 days. Not able to take food, breathing difficulty, and was in altered sensorium. At the time of initial presentation (3 years back) there was pinkish, firm to hard, moderately vascular, nonsuckable tumor, infiltrating into the temporal muscle and fascia with ill-defined plane of cleavage. The tumor was adherent to the dura but there was no dural invasion. Histologically the tumor comprised highly pleomorphic tumor cells, findings suggestive of anaplastic variant of osteosarcoma and a poor prognosis was predicted. The patient received a course of chemotherapy but did not receive radiotherapy. Plain axial CT images of the head soft tissue and bone showed an aggressive, densely ossified bone-forming tumor with extensive involvement of the soft tissue and bony destruction of the anterior, middle, and part of the posterior cranial fossa on left side [Figure 1]. The patient was managed conservatively but did not do well and expired after 3 days of admission.

Figure 1: Plain axial CT images of the head soft tissue and bone showing an aggressive, densely ossifi ed bone-forming tumor with extensive involvement of the soft tissue and bony destruction of the anterior, middle, and part of the posterior cranial fossa on left side producing cloud-like pattern of mineralization

Fibro-osseous lesions are characteristically centered within bone and surface fibro-osseous lesions prompt consideration of parosteal osteosarcoma, which is rare but well documented in the skull.[7] Because of the superimposed bony structures, conventional radiographs are of limited worth in evaluating head and neck osteosarcomas.[8] However, CT and plain films are superior to MR in detecting the matrix calcifications and bone destruction or reaction.[8] CT provides excellent detection of tumor calcification, cortical involvement, and, in most instances, soft tissue as well as intramedullary extension[8] as in the present case, on axial CT poorly defined destructive osteosarcoma that neoplasm extends into the soft tissues produces cloud-like pattern of mineralization.[2] The key to disease-free survival in treating primary osteosarcoma of the calvarium is complete surgical resection with immediate reconstruction followed by adjuvant chemotherapy.[4] In skull base osteosarcoma, prognosis is poor even in patients who have received adequate therapy.[6]

References

  1. , , . The epidemiology of osteosarcoma. Cancer Treat Res. 2009;152:3-13.
    [Google Scholar]
  2. , , . Update on bone forming tumors of the head and neck. Head Neck Pathol. 2007;1:87-93.
    [Google Scholar]
  3. , , , , . Osteosarcoma of the skull base: Case report and review of literature. Int J Pediatr Otorhinolaryngol. 2008;72:115-9.
    [Google Scholar]
  4. , , , , , , . Long-term management of craniofacial osteosarcoma. J Craniofac Surg. 2009;20:406-9.
    [Google Scholar]
  5. , , , , , , . Craniofacial reconstruction of primary osteogenic sarcoma of the skull. J Plast Reconstr Aesthet Surg. 2010;63:1265-8.
    [Google Scholar]
  6. , , , , . [Osteosarcoma of the skull base: A case report] Neurochirurgie. 2007;53:483-5.
    [Google Scholar]
  7. , , , , , . Protuberant fibro-osseous lesion of the temporal bone: “Bullough lesion”. Am J Surg Pathol. 2010;34:1217-23.
    [Google Scholar]
  8. , , , , , . Craniofacial osteosarcomas: Plain film, CT, and MR findings in 46 cases. AJR Am J Roentgenol. 1988;150:1397-402.
    [Google Scholar]

    Fulltext Views
    19

    PDF downloads
    0
    View/Download PDF
    Download Citations
    BibTeX
    RIS
    Show Sections