Ossifying Fibroma of the Maxillary Sinus: A Case Report

• Published in: Skull Base Vol. 19; no. S 02
• Main Authors: Kotsis, G., Papacharalampous, G., Vontas, Ch, Katsis, A., Davilis, D.
• Format: Conference Proceeding Journal Article
• Language: English
• Published: 04.06.2009
• ISSN: 1531-5010; 1532-0065
• DOI: 10.1055/s-2009-1224469

Background and Aim: Ossifying fibromas are true benign tumors of mesenchymal origin that have a strong predilection for the tooth-bearing portion of the jaws. They are fibro-osseous lesions containing fibrous tissue and varying amounts of calcified tissue. Although these lesions are usually located in the jaws, they may rarely involve other craniofacial bone structures. Ossifying fibromas usually affect patients during their third and fourth decades of life, with a female preference. The aim of this study is to report a rare case of ossifying fibroma of the maxillary sinus, including its clinical and radiographic appearance, differential diagnostic dilemmas, surgical treatment, and histopathological findings. Case Report: The authors present a 44-year-old woman referred to the consulting room of their ENT Department complaining about typical persisting symptoms of chronic sinusitis. The radiographic study revealed a mass in the right maxillary sinus. The benign fibro-osseous lesions of the jaws share similarities in radiographic and clinical appearance, histogenesis, and histopathology, and, consequently, pose difficulty in classification and treatment. Ossifying fibromas are amenable to enucleation and curettage if detected early, or resection for larger lesions. In this particular case, due to its increased dimensions, the intact lesion was completely excised using the Caldwell-Luc technique. Histological examination of the lesion confirmed the diagnosis. A 5-year follow-up demonstrated that the patient remained free of symptoms and no recurrence occurred. Conclusions: Differential diagnosis of benign fibro-osseous lesions can be made if clinical behavior, radiographic features, and hematologic changes are correlated with the histological picture. Representatives of this group include true fibrous dysplasia, ossifying fibroma (both central and peripheral types), osteoid osteoma, osteoblastoma, cementifying fibroma, florid osseous dysplasia, proliferative periostitis of Garré, focal sclerosing osteomyelitis, and osteitis deformans (Paget's disease).