Ann Dermatol.  2015 Aug;27(4):394-397. 10.5021/ad.2015.27.4.394.

Button Osteoma: A Review of Ten Cases

• Chae SY
• Sim HB
• Kim MJ
• Jang YH
• Lee SJ
• Kim DW
• Lee WJ

• KMID: 2171495
• DOI: http://doi.org/10.5021/ad.2015.27.4.394

Abstract

BACKGROUND
Button osteoma presents as small circumscribed ivory-like lumps on the skull vault. Although not rare, its diagnosis can be challenging for dermatologists.
OBJECTIVE
To clarify the clinical characteristics of button osteoma by reviewing 10 cases.
METHODS
Ten patients diagnosed with button osteoma at the Department of Dermatology, Kyungpook National University Hospital, between January 2011 and August 2014 were enrolled. We retrospectively reviewed medical records and analyzed demographic and clinical characteristics including sex, age, sites, number of lesions, symptoms, duration, histopathological finding, radiological findings, and treatment.
RESULTS
All patients presented with an asymptomatic small circumscribed hard lump fixed to a bony structure. There were 9 female and 1 male patient, and the mean age was 54 years (range, 28approximately61 years). The most common site was the forehead, and disease duration ranged from 2 weeks to more than 20 years. The differential diagnosis included cranial exostosis, ballooned osteoma, epidermal cyst, and lipoma. Simple radiography, ultrasonography, and computed tomography (CT) were used to make a confirmative diagnosis. Histopathological findings showed lamellated bony structures with poor vascularization. Ostectomy was performed for 5 patients, and no recurrence was detected within an average of 13.4 months after treatment.
CONCLUSION
This review characterized button osteoma. Surgical excision is a useful therapeutic modality after CT-based diagnosis. Further studies with more patients are required to confirm the findings.

Keyword

Button osteoma

MeSH Terms

Dermatology
Diagnosis
Diagnosis, Differential
Epidermal Cyst
Exostoses
Female
Forehead
Gyeongsangbuk-do
Humans
Lipoma
Male
Medical Records
Osteoma*
Radiography
Recurrence
Retrospective Studies
Skull
Ultrasonography

Figure

• 

  Fig. 1 A solitary well-defined asymptomatic nodule 1.3 cm in diameter is seen on the forehead. Inset: close-up view of the lesion.

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  Fig. 2 (A) Simple radiography shows a well-defined smooth homogenous bony density (arrow) on the frontal bone. (B) Ultrasonography shows a 1.4 cm smooth and round bony protuberance (arrow) on the frontal bone. (C) Computed tomography shows a 1.3 cm well-defined homogenous radiopaque lesion (arrow) on the frontal area.

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  Fig. 3 Histopathological examination shows compact and mature bone with lacunae (H&E, ×200).

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