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Osteoma Cutis — SCE Dermatology MCQ

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HardDermatological SurgeryOsteoma CutisSCE Dermatology

A slowly enlarging hard forehead mass is shown on CT to arise continuously from the outer table of the frontal bone. Histology shows mature lamellar bone. Which diagnosis best fits this anatomy?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Peripheral cranial osteoma arising continuously from the frontal cortex

Explanation lettering: E = shown as A · C = shown as B · A = shown as C · B = shown as E

D is correct. Osteoma cutis is heterotopic mature bone within dermis or subcutis and is not continuous with the underlying skeleton. A hard lesion arising directly from the outer frontal cortex is instead a peripheral cranial osteoma, even though both contain mature lamellar bone. Calcinosis lacks organized bony architecture, while pilomatrixoma has basaloid and ghost-cell components and only secondary calcification or ossification. Cross-sectional anatomy therefore corrects the original misclassification and determines whether maxillofacial or craniofacial assessment is needed.

Reference: NCBI Bookshelf: osteoma cutis: https://www.ncbi.nlm.nih.gov/books/NBK559216/