Bose Bikash
Department of Neurosurgery, Christiana Care Health Care System, Newark, Delaware, USA.
Surg Neurol. 2002 Sep-Oct;58(3-4):234-9; discussion 239-40. doi: 10.1016/s0090-3019(02)00864-9.
An osteogenic sarcoma of the skull is rare, particularly as a primary tumor. The incidence of primary osteogenic sarcomas of the skull is about 1 to 2% of all skull tumors.
A 21-year-old male was initially evaluated because of a large mass that had been growing for 7 months. The patient had been experiencing frequent headaches and tenderness at the site of the lump for about a month before being seen by the neurosurgeon. A computed tomography scan revealed a large mass, 12 cm x 7 cm, involving the scalp extending from the right temporal region to the vertex. A magnetic resonance imaging (MRI) scan showed a large mass arising from the posterolateral aspect that was 90% extracranial and 10% intracranial on the right side of the skull. The MRI showed marked vascularity and neovascularity of the tumor. An angiogram was performed, which demonstrated that the mass was fed by the branches from the right external carotid artery. The patient subsequently underwent surgery for embolization of the right occipital and superficial temporal arteries and removal of the mass. Pathology evaluation of a specimen revealed a high-grade osteoblastic osteosarcoma.
We review the literature of reported cases of primary osteogenic sarcomas of the skull to discuss the common clinical presentation, evaluation methods, and recommended treatment plans.
颅骨骨肉瘤罕见，尤其是作为原发性肿瘤。颅骨原发性骨肉瘤的发病率约占所有颅骨肿瘤的1%至2%。
一名21岁男性因一个已生长7个月的巨大肿块而首次接受评估。在神经外科医生接诊前约一个月，患者一直频繁头痛且肿块部位压痛。计算机断层扫描显示一个12厘米×7厘米的巨大肿块，累及头皮，从右侧颞区延伸至头顶。磁共振成像（MRI）扫描显示一个从后外侧长出的巨大肿块，在颅骨右侧90%位于颅外，10%位于颅内。MRI显示肿瘤有明显的血管化和新生血管。进行了血管造影，显示肿块由右侧颈外动脉分支供血。患者随后接受了右枕动脉和颞浅动脉栓塞及肿块切除手术。标本的病理评估显示为高级别成骨细胞性骨肉瘤。
我们回顾了已报道的颅骨原发性骨肉瘤病例的文献，以讨论其常见临床表现、评估方法和推荐的治疗方案。
