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Mastoid osteoma

Case contributed by Shervin Sharifkashani
Diagnosis almost certain

Presentation

The painless hard bulge on the superior posterior region of the auricle of the right ear.

Patient Data

Age: 60 years
Gender: Female
ct

Large benign-appearing osseous mass lesion axial width up to 30x18mm on the superior posterior cortex of the right mastoid is seen that the sclerotic medulla of the mass is in continuity with the adjacent calvarium diploe. There is no associated soft tissue mass lesion. Small focal cortical bone thickening in the left side frontal calvarium outer table is also seen.

Annotated image

The arrow refers to round abnormal density on the posterior fossa close to upper margin of mastoid shadows on this lateral head and neck X-ray scout view.

Case Discussion

The case illustrates the large mastoid osteoma which is a rare bone tumor of the mastoid and is usually painless. The imaging modality of choice for mastoid osteoma is an MDCT scan. These lesions are slow-growing and can lead to pain, hearing loss, and cosmetics problems but do have not any tendency for malignant transformation. In the case of cosmetic problems or symptoms, surgical resection is the treatment of choice.

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