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Exophytic Osteochondroma of the Brow
Frederick A Jakobiec1, Fouad R Zakka, Nahyoung Grace Lee
1*The David Cogan Ophthalmic Pathology Laboratory, †Massachusetts Eye and Ear Infirmary, and ‡The Ophthalmic Plastic and Reconstructive Surgery Service, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Abstract:
Most bony and cartilaginous lesions of the orbit and periorbital compartments are benign, grow endophytically, and are composed of dense lamellar bone (eburnated or ivory osteomas). An 87-year-old woman had a well-circumscribed, firm, round, and exophytic lesion of the brow region for at least 15 years. Excisional surgery disclosed an osteocartilaginous lesion with an enveloping pseudocapsule (periosteum/perichondrium) and a narrow stalk connecting it to the frontal bone. The periphery of the lesion displayed lamellar bone which appeared to be replacing a central cartilaginous zone. The adjacent deep preaponeurotic fat displayed nodules of collagen with myxoid change and occasional CD34 spindle cells suggestive of a spindle cell lipoma. Because of the osteochondroma's deep location in the preaponeurotic fat, the lesion differs from an osteoma cutis found in the dermis which fails to exhibit a cartilaginous component or a periosteum. Other clinically simulating lesions are described.
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