Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely As Orbital Cellulitis

Abstract

Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. These lesions have overlapping clinical, radiologic and pathologic features causing difficulty in diagnosis. Neoplastic fibro-osseous paranasal sinus lesions can be benign or malignant. The benign fibro-osseous lesions described are: ossifying fibroma (and its histologic variants) and fibrous dysplasia. The variants of ossifying fibroma differ in the nature of calcified material (i.e. cementum versus bone), in the location of the lesion (oral versus paranasal sinus or orbital), other morphologic variations (presence of psammomatoid concretions) and biologic behavior (aggressive versus stable). Presence of cementum or bone classifies the lesion as cementifying fibroma or ossifying fibroma respectively while lesions with mixture of both cementum and bone are called cemento-ossifying fibroma. We describe a case of a young adult male with cemento-ossifying fibroma of paranasal sinus presenting acutely as left orbital cellulitis with proptosis.

CT and MR imaging characteristics of histological subtypes of head and neck ossifying fibroma

“…2 In our study, COFs frequently showed homogeneous groundglass appearance similar to that observed in fibrous dysplasia [five of eight (63%)]; however, large COFs may appear as heterogeneous masses. 2,10,11 The relatively small size of COFs in our study [mean maximum diameter, 20.3 mm (range, 7-33 mm)] may have affected the intratumoral homogeneity.…”

“…Indeed, fluid-fluid levels have been reported in OFs with secondary aneurysmal bone cysts. 8,10,[13][14][15][16] In a study, 15 out of 438 (3.42%) patients with OFs in the paranasal sinus showed fluid-fluid levels; the histological subtypes included COF in 10 patients (66.7%), JPOF in 4 (26.7%), and JTOF in 1 (6.7%). 13 However, in our study, fluid-fluid level was not observed in any OF.…”

Fibro-osseous lesions of jaws: Analysis of three cases

“…As the lesion matures, there are increasing calcific flecks progressing to a radio opaque mass. [15] This case manifested as a well circumscribed radiolucent lesion with internal radiopacities and root resorption was also noted. CT image revealed an osteolytic lesion with the expansion of bucco-lingual cortices and there was no cortical violation.…”