Fronto-orbital osteoma. Answer to the e-quid “Unilateral exophthalmos in a 30-year-old man”

Fronto-Ethmoidal Osteoma with Orbital Extension: Case Report

“…Osteomas are rare slow-growing, benign bone tumors. It is the most frequent benign tumor of the paranasal sinuses [4,5], affecting in descending order of frequency: the frontal sinuses (50%), the ethmoidal cells (40%), the maxillary sinuses (6%), and the sphenoidal sinuses (4%) [5][6][7]. Orbital involvement is a rare occurrence, following the extension from the frontal sinus or the ethmoidal cells, that can lead to ocular symptoms [4,8,9].…”

“…Our patient had a fronto-ethmoidal osteoma with orbital extension. Osteomas can occur at any age [5], with most cases diagnosed during the 4th and 5th decade of life [10][11][12][13], and there seems to be a slight gender predilection, as 60% of the reported cases are males [10,12,14].…”

“…CT scan is considered the golden standard for diagnosis [3,15]. Images show a dense, homogenous mass, with regular limits, arising from paranasal sinuses, well defined, and resembling the cortical bones in its ivory form or with a ground-glass appearance in its spongy form [5]. It is important to note that osteomas are discovered incidentally in 3% of CT scans [13,[19][20][21][22].…”

Removal of a Frontal Sinus Osteoma and Reconstruction by a Custom-Made Implant with Neuronavigation Assistance

“…This resection may be performed in a single block or by fragmentation. The surgical approach depends on the osteoma stage, determined by the various imaging examinations 17…”

“…The orbital damage is often only an extension of the frontal sinus or ethmoidal cells. Fronto-orbital osteomas account for 0.4 to 5% of orbital tumors and from 0.6 to 2.5% of the causes of tumor-related exophthalmos 1. Orbital osteoma needs to be differentiated from other bone tumors such as fibrous dysplasia, ossifying fibroma, osteoblastoma, osteosarcoma, and osteoblastic metastases 2.…”