Abstract
Hyperostosis frontalis interna (HFI) is a condition characterized by abnormal bone outgrowth on the inner surface of the frontal bone. Most HFI cases occur in post-menopausal elderly women. The pathology of HFI development is uncertain. The estimated incidence of HFI ranges from 5 to 12% in Western countries, but few cases have been reported in the Japanese population. Here, we report a case of HFI in an 86-year-old Japanese female cadaver. Macroscopically, the internal surface of the frontal bone exhibited bilateral nodular protrusion with sparing of the midline, while the external surface was normal. According to the morphological classification of HFI proposed by Hershkovitz et al. this case belongs to type D, the most severe type. Using computed tomography (CT), we defined five layers, designated as I–V from the inner to the outer layer, in the nodular region of HFI; however, the normal frontal bone is composed of three layers. Histological results demonstrated that layers I, III, and V consisted of the cortical bone, and layers II and IV consisted of the trabecular bone. We also observed increases in the numbers of lamellar bone and blood vessels on the dural side of layer I, indicating increased vascularization and active osteogenesis. These results indicate that layer II represents a new diploe within the inner table, which split into layers I and III, suggesting that diploization within the inner table by activated remodeling may be involved in the development of hyperostosis in this case.
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We thank Editage (www.editage.com) for the English language editing of our paper.
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KM and AN conducted the dissections. AN and YI designed the anatomical investigations. KM, AN, MN, AT, and YI contributed to the data acquisition and analysis. YI wrote the manuscript. All authors read and approved the final manuscript.
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Morita, K., Nagai, A., Naitoh, M. et al. A rare case of hyperostosis frontalis interna in an 86-year-old Japanese female cadaver. Anat Sci Int 96, 315–318 (2021). https://doi.org/10.1007/s12565-020-00577-5
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DOI: https://doi.org/10.1007/s12565-020-00577-5