Hyperostosis of the Skull

skull hyperostosis

This patient has an olfactory groove meningioma extending into the roof of the nasal cavity. Typical of meningioma, hyperostosis of the skull may imply invasion (this point is controversial).

The differential diagnosis for hyperostosis of the skull depends on whether it is focal or diffuse.

Diffuse:

  • Paget’s disease of bone
  • metastatic disease, especial prostate carcinoma
  • chronic, severe anemia
  • hyperparathyroidism
  • acromegaly
  • osteopetrosis
  • hyperostosis frontalis interna
  • long term dilantin administration
  • genetic diseases (rare)
    • Camurati-Engelmann’s disease
    • frontometaphyseal dysplasia
    • craniodiaphysial dysplasia

Focal:

  • meningioma
  • fibrous dysplasia
  • Paget’s disease of bone
  • metastatic disease, especial prostate carcinoma
  • esthesioneuroblastoma – only rarely demonstrates hyperostosis.

References:

  1. 1. Pieper, D “Hyperostosis Associated with Meningioma of the Cranial Base: Secondary Changes or Tumor Invasion.” Neurosurgery. 44(4):742-746, April 1999.
  2. 2. Primer of Diagnostic Imaging by Weissleder

Credit: Dr Frank Gaillard