- Discussion:
    - osteoma is a rare benign tumor of bone;
    - occurs most often in adolescents;
    - skull, mandible, & middle third of tibia are most common involved sites;
    - osteoma may produce no pain but will produce a visible and palpable enlarging bony mass;
- X-rays:
    - reveals radiodense & smooth bony mass attached to surface of cortex;
    - differential dx:
         - Osteochondroma
         - Parosteal osteosarcoma;
- CT scan:
    - may be needed to delineate the margins of tumor & r/o any extension into medullary canal;
- Histology:
    - outer fibrous layer continuous w/ periosteum;
    - beneath fibrous layer there is a zone of proliferating osteoblasts that produces active intramembranous ossification;
    - immature bone goes on to form haversian systems;
Treatment:
   - active treatment should consist of en bloc excision with a marginal margin;
   - latent tumors can be removed in piecemeal