Learning Radiology xray montage

Osteoma of the Skull

General Considerations
  • Benign mature osteogenic lesions
  • Arise from membranous bones in the skull and face
  • Highest incidence in 6th decade
  • Female to male ratio of 3:1
  • Usually involve the frontal bone

Clinical Findings

  • Asymptomatic
  • Slow-growing, painless mass

Imaging Findings

  • Rounded, sclerotic lesions usually arising from the outer table
    • The diploe are spared
  • Their borders are usually smooth
  • The underlying cortex is not involved
  • “Mature osteomas” may consist of a radiolucent nidus surrounded by  dense sclerosis (ivory osteoma)
    • They have no Haversian canals and no fibrous component
  • Trabecular osteomas are composed of cancellous bone surrounded by denser cortex
  • Gardner Syndrome is multiple skull, sinus or mandible  osteomas associated with colon polyps and soft tissue skin tumors


  • Not needed unless for cosmetic reasons or from obstruction of a sinus producing mucocoele formation


 Osteoma of the Skull

Osteoma of the Skull. A smoothly marginated, very dense exostosis arises from the outer table of the occipital bone (red arrow) with an associated soft tissue mass.

P Bulloughs, Orthopaedic Pathologv (3rd edition), Times Mirror International Publishers Limited, London, 1997