Tumors and Tumorlike Lesions of Bone and Joints by Fritz Schajowicz M.D. (auth.)

By Fritz Schajowicz M.D. (auth.)

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8) according to our classification (Schajowicz and Lemos 1970). A similar case located at the external surface of an occipital bone turned out to be a periosteal "circumscribed osteoblastoma" (osteoid osteoma) (see Fig. 23) . " Osteomas arising from the inner table of the skull (Echlin 1934) should be differentiated from hyperostosis resulting from meningioma, or from hyperostosis frontalis interna. Pathologic Findings. Most osteomas are dense and compact (ivorylike) bone masses adjacent to the underlying cortex with a well-defined, often lobulated surface (compact type) , covered by a thin, fibrous membrane that sometimes appears to be in continuity with the periosteum (Fig.

Similar cases were reported by Sherman (1947), Goidanich and Battaglia (1959), and Meary et aI. ( 1965 ). " More interesting are the two cases of juxtacorticaI location localized in the ethmoid and in the pubis, respectively. Roentgenologic and pathologic examination of the resection specimens showed multiple circumscribed images of nidal type, of different size, each with a picture both macro- and microscopically identical to that of "osteoid osteoma," surrounded by an extensive block of sclerotic bone (Fig.

The carpal bones were rarely involved, but not so the terminal phalanx, contrary to the statement of Caroll (1953), Dunitz I. Bone-forming Tumors et al. (1957), and Rosborough (1966): 12 of our phalangeal tumors were located in a terminal phalanx (10 in the hand and 2 in the foot). The location in the skull seems to be extremely rare, and we have observed only two cases at this location. Symptoms. The classic, most frequent symptom is pain of increasing severity that is not relieved by rest and is often more intense at night.

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