Hyperostosis frontalis interna associated with hypogonadism in an elderly man

Abstract

Hyperostosis frontalis interna (HFI), symmetric thickening of the inner table of the frontal bone, is relatively common in women but very rare in men. We report the case of an elderly male patient with HFI. This patient was accompanied by primary hypogonadism, which may be related to the underlying pathogenesis of HFI.

Intracranial volume, cranial thickness, and hyperostosis frontalis interna in the elderly

“…The most acceptable hypothesis regarding HFI etiology is hormonal imbalance of the gonads (Hershkovitz et al, 1999;May et al, 2010a;Moore, 1955;Perou, 1964;Ramchandren and Liebeskind, 2007;Yamakawa et al, 2006). The size of the brow ridges and the EOPs are the most sexually dimorphic characteristics of the skull; males manifest larger brow ridges and more pronounced occipital protuberances than females (Bass, 1995).…”

Hyperostosis frontalis interna: What does it tell us about our health?

“…It is extremely rare among historic populations (following age adjustment), whereas in modern populations, HFI is a common phenomenon with a 5% frequency in males and 25% in females (Antón, 1997;Armelagos and Chrisman, 1988;Hershkovitz et al, 1999;Lazer, 1996;Moore, 1955). HFI etiology has not yet been fully clarified; however, previous studies have associated it with hormonal imbalance due to its high prevalence and severity in postmenopausal females, and the fact that only males with hypogonadism manifest advance stages of HFI (Hershkovitz et al, 1999;Moore, 1955;Perou, 1964;Ramchandren and Liebeskind, 2007;Yamakawa et al, 2006). With growing evidence of hormonal interference in HFI, we demonstrated in our previous study that the rate of HFI among a large population of males with prostate cancer, who had undergone chemical castration, was significantly higher than in healthy males (May et al, 2010a).…”

Increased osseous thickening of the inner surface of the frontal bone

“…While most of these studies were just case presentations, only a few contained comprehensive details. Thus, in existing studies, the results confirm the variability in almost all the measured osseous thickening parameters, including the length and the width, but detailed information considering variety in thickness is seldom (2,19,23,25).…”

“…In these studies, a variety of factors have been examined but the presence and incidence of osseous thickening in the ISFB were largely associated with hormonal disturbances such as pregnancy osteophytes, acromegaly, Paget's disease, osteoid osteoma, lentiasis ossea or senile hyperostosis (7,12,25). The osseous thickening areas of the ISFB were located in the groove of the sagittal sinus (sagittal sulcus) and groove of the middle meningeal artery (sulci arteriosi) (6,10,23).…”