Khalil Yousuf, Lane John I, Molligan Jeremy F, Van Gompel Jamie J, Tasche Kendall K, Carlson Matthew L
Alix School of Medicine, Mayo Clinic.
Department of Radiology, Mayo Clinic.
Otol Neurotol. 2025 Jun 1;46(5):e198-e201. doi: 10.1097/MAO.0000000000004481. Epub 2025 Feb 24.
Although osteosarcoma represents the most common primary malignant bone tumor in children, they comprise only 0.2% of all cancers. Osteosarcoma frequently involves long bones; however, 8% of osteosarcomas involve the skull or mandible. Osteosarcoma is generally categorized based on location within the bone (central, surface, or extraskeletal) and histological grade (high-grade or low-grade). Osteoblastic osteosarcoma is a central, high-grade subtype and may be difficult to diagnose; it may present similarly to osteoblastoma, another rare, but benign, type of osteoblastic bone tumor. In this report, we present a rare case of osteoblastic osteosarcoma involving the temporal-occipital skull.
Case report and systematic review.
Tertiary referral center.
A 21-year-old male presented for assessment of a mass appearing over his left mastoid region, first noticed within the previous 12 months. He experienced growth of the lesion and pain that increased when pressure was applied to the mass. Results from fine needle aspiration and CT-guided core biopsy were positive for osteosarcoma, osteoblastic-type. Magnetic resonance imaging of the brain and skull base revealed the mass to be 2.8 cm in maximal diameter. Given a somewhat favorable location, the tumor could be completely excised en bloc with negative margins, and the patient subsequently received adjuvant chemotherapy. The patient is doing well at last follow-up 10 months after surgery, with no evidence of recurrence to date.
The temporal bone is an uncommon location for a primary osteosarcoma, and there are numerous conditions that could present in a similar manner. This case highlights this rare occurrence of osteoblastic osteosarcoma of the temporal bone without previous exposure to radiation. There are a limited number of similar cases in the literature, and our report serves to bring awareness to this potential diagnosis and considerations related to treatment.
尽管骨肉瘤是儿童最常见的原发性恶性骨肿瘤，但它们仅占所有癌症的0.2%。骨肉瘤常累及长骨；然而，8%的骨肉瘤累及颅骨或下颌骨。骨肉瘤一般根据其在骨内的位置（中央型、表面型或骨外型）和组织学分级（高级别或低级别）进行分类。成骨细胞型骨肉瘤是一种中央型、高级别亚型，可能难以诊断；它的表现可能与成骨细胞瘤相似，成骨细胞瘤是另一种罕见但良性的成骨细胞性骨肿瘤。在本报告中，我们介绍了一例累及颞枕部颅骨的成骨细胞型骨肉瘤罕见病例。
病例报告和系统评价。
三级转诊中心。
一名21岁男性因左侧乳突区出现肿物前来评估，该肿物在过去12个月内首次被发现。他经历了肿物的生长，且按压肿物时疼痛加剧。细针穿刺和CT引导下的粗针活检结果显示为成骨细胞型骨肉瘤阳性。脑部和颅底的磁共振成像显示肿物最大直径为2.8厘米。鉴于位置较为有利，肿瘤可完整切除且切缘阴性，患者随后接受了辅助化疗。在术后10个月的最后一次随访中，患者情况良好，迄今无复发迹象。
颞骨是原发性骨肉瘤的罕见发病部位，有许多情况可能表现相似。本病例突出了这种未曾接受过放疗的颞骨成骨细胞型骨肉瘤的罕见情况。文献中类似病例数量有限，我们的报告旨在提高对这一潜在诊断以及相关治疗考虑因素的认识。
