Recurred forehead osteoma disseminated after previous osteoma excision: A case report

Forehead osteoma is a commonly encountered benign facial bone tumor. Endoscopic excision of benign forehead masses is widely performed. Here, we report a rare case of recurrent forehead osteoma that disseminated after a previous osteoma excision.

A 54-year-old female patient had previously undergone endoscopic removal of a single forehead osteoma at 30 years of age. However, she had a recurrent osteoma around the same site and underwent another endoscopic resection at 40 years of age. During her first visit to our outpatient clinic, she presented with a cobblestone-like irregular surface on the forehead and a 3D facial bone computed tomography scan revealed a widely ragged surface of the inoculated osteoma on the outer table of the frontal bone. Under general anesthesia, we performed a radical complete excision of the disseminated osteoma through a bicoronal incision using an osteotome, chisel, mallet, and rasping. We hypothesized that the recurrence may have been caused by the inoculation of residual osteoma remnants from the previous procedure. Craniofacial surgeons should be cautious when removing osteoma particles, particularly when using an endoscopic approach.

To prevent recurrence, it is essential to conduct additional meticulous burring and a thorough inspection of the surface after copious irrigation.