Multiple Peripheral Osteomas of Forehead: Report of a Rare Case
A 39-year-old female patient reported with a complaint of facial asymmetry due to the presence of multiple swellings on the forehead. The swellings had been present for a period of around ten years. Patient didn’t give any specific history regarding the onset of the swelling. Patient noticed gradual increase in number and size of the swelling, since last three to four years. The swellings were not associated with a history of trauma or symptoms like pain, pressure sensation, paraesthesia and sinusitis. Only concern of the patient was related to the appearance.\nOn clinical examination, the patient appeared to be overall in good systemic health, except for the presence of the swellings, all the vital signs being within normal limits. Examination of the face revealed multiple, localized, oval shaped swellings on the forehead; located near the midline 3 cm above the glabella, the largest of which was of 4 × 4 mm in size []. The skin over the swelling was of normal in colour and texture, with no signs of ulcerations or scars. Similar, but smaller swellings were seen on the anterior portion of the scalp. The lesions were hard, non-tender and non-bleeding with smooth surface and diffuse margins. Fluctuancy, reducibility, compressibility and pulsatility were absent. The lesions were fixed to underlying bone, but overlying skin was pinchable. Regional lymph nodes were not involved.\nLateral skull and lateral cephalometric projections were taken, which revealed localized areas of thickening of outer cortical table of frontal bone []. A computed tomography (CT) study of the head and neck revealed multiple lentiform hyper dense lesions involving the outer table of frontal bone []. The lesions appeared to be well defined and with its densities matching that of the osseous structure of the surrounding areas, it suggested the diagnosis to be a benign bony lesion. Based on the reported history, clinical and imaging findings we arrived at a diagnosis of multiple peripheral osteomas of frontal bone.\nSurgical removal of the bony masses was done under general anesthesia and the specimen was sending for histopathologic examination. Patient reported with no symptoms on follow-up visit one month after the surgery [].