Ossifying fibroma: an uncommon differential diagnosis for T2-hypointense sinonasal masses

Abstract

Ossifying fibroma is a benign fibro-osseous lesion that occurs most commonly in the mandible of female patients. In rare cases, it affects the nasal cavity. The magnetic resonance imaging features may vary depending on the amount of fibrous and bony tissue in its composition. In these tumors, T2-hypointensity is a feature described in the peripheral ossified areas of the lesion, but it may present diffusely, especially when the degree of ossification is extensive. In this scenario, this particular characteristic on T2-weighted imaging is superimposable to the commonly described appearance of other lesions, such as non-Hodgkin's lymphoma, melanoma, and other sinonasal neoplasms with high cellularity and high nucleocytoplasmic ratio. In the present study, we report a case of ossifying fibroma of the nasal cavity that presented as a diffusely and homogeneously T2-hypointense mass, a finding that may cause difficulty in the differential diagnosis with other expansive sinonasal lesions.

Primary Extracranial Fibrous Meningioma of the Maxillary Sinus: A Case Report and Literature Review

“…Thus, primary, fibrous meningioma of the maxillary sinus is extremely rare, with only 3 reported cases using CT or MRI findings (Table 1) area on T2-weighted images. Depending on the degree of calcification, it may present as a diffuse and homogeneous T2-hypointense mass, but can be more locally aggressive than in our case (9). Fibrous dysplasia of the sinonasal cavity must also be included in the differential diagnosis.…”

Ossifying fibroma as a cause of blindness in a 5‐year‐old Quarter Horse gelding

“…Causes of T2‐hypointense signal features can be explained due to the low cellularity and high nucleocytoplasmic features of these neoplasms (Salina et al . ). Previously reported CT and MRI of an ex vivo mandibular EJOF in a 5‐month‐old Draught horse showed similar findings to those described in human subjects with a medium intensity in all sequences and planes of MRI (Van Thielen et al .…”

Ossifying fibroma in the mandibular angle mimicking metastatic clear cell renal cell carcinoma

“…Although OF is best imaged by CT, additional imaging examinations might play an important role in the differential diagnosis of osteolytic lesions in patients with malignant diseases. OF usually has low to intermediate signal intensity on T1 weighted images and variable signal intensity on T2 weighted images on MRI [13] . On T2 weighted images, low signal intensities may be predominant depending on the degree of calcification [13] .…”

“…OF usually has low to intermediate signal intensity on T1 weighted images and variable signal intensity on T2 weighted images on MRI [13] . On T2 weighted images, low signal intensities may be predominant depending on the degree of calcification [13] . Furthermore, low signal intensity is typically observed in the ossified peripheral areas, and high signal intensity is observed in the non-ossified central areas on T2 weighted images in cases of OF [13] .…”

“…On T2 weighted images, low signal intensities may be predominant depending on the degree of calcification [13] . Furthermore, low signal intensity is typically observed in the ossified peripheral areas, and high signal intensity is observed in the non-ossified central areas on T2 weighted images in cases of OF [13] . Although the MRI findings of the mandibular lesion in this case were consistent with the previous report of OF, these could not deny the possibility of metastasis from clear cell RCC to the mandible because these were not specific findings.…”