Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2021; 9(8): 1863-1870
Published online Mar 16, 2021. doi: 10.12998/wjcc.v9.i8.1863
Intradural osteomas: Report of two cases
Li Li, Guang-Yu Ying, Ya-Juan Tang, Hemmings Wu
Li Li, Guang-Yu Ying, Ya-Juan Tang, Hemmings Wu, Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Li L, Ying GY, and Tang YJ participated in the diagnosis and management of this case; Li L wrote the manuscript; Wu H revised the manuscript for important intellectual content; all authors read and approved the final manuscript.
Supported by Zhejiang Medicine and Health Science and Technology Project, No. 2017KY072.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare having no conflicts of interest in relation to these cases and their treatment or publication.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Li, MD, Doctor, Research Fellow, Surgeon, Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. touchspark@zju.edu.cn
Received: August 30, 2020
Peer-review started: August 30, 2020
First decision: December 21, 2020
Revised: January 3, 2021
Accepted: January 20, 2021
Article in press: January 20, 2021
Published online: March 16, 2021
Processing time: 187 Days and 0.7 Hours
Abstract
BACKGROUND

Intradural osteoma is very rarely located in the subdural or subarachnoid space. Unfortunately, intradural osteoma lacks specificity in clinical manifestations and imaging features and there is currently no consensus on its diagnosis method or treatment strategy. Moreover, the pathogenesis of osteoma without skull structure involvement remains unclear.

CASE SUMMARY

We describe two cases of intradural osteomas located in the subdural and subarachnoid spaces, respectively. The first case involved a 47-year-old woman who presented with a 3-year history of intermittent headache and dizziness. Intraoperatively, a bony hard mass was found in the left frontal area, attached to the inner surface of the dura mater and compressing the underlying arachnoid membrane and brain. The second case involved a 56-year-old woman who had an intracranial high-density lesion isolated under the right greater wing of the sphenoid. Intraoperatively, an arachnoid-covered bony tumor was found in the sylvian fissure. The pathological diagnosis for both patients was osteoma.

CONCLUSION

Surgery and pathological examination are required for diagnosis of intradural osteomas, and craniotomy is a safe and effective treatment.

Keywords: Osteoma; Intradural; Craniotomy; Pathogenesis; Neural crest cell; Case report

Core Tip: Intradural osteoma is very rarely located in the subdural or subarachnoid space; although, there are disease associations related to sex, ethnicity, and intracranial locations. Intradural osteomas usually require surgery and pathological examination for diagnosis, and craniotomy is considered a safe and effective treatment. In this paper, we describe two cases of intradural osteomas located in the subdural and subarachnoid spaces, respectively, and provide a review of the related literature. The neural crest cell hypothesis is proposed to explain the pathogenesis of this rare tumor localization.