Cartilaginous Fibrous Osteoma of the Ethmoid Sinus

Wesam Alkhatatba,Saad Alqarni

doi:10.7759/cureus.19378

Abstract

Fibro-osseous lesions are common in the paranasal sinuses. The incidence of fibrous dysplasia (FD) in the ethmoid sinus is rare. Patients with such lesions are usually asymptomatic until the lesion is large enough to start compressing adjacent structures and organs. Common presentations include nasal obstruction, headache, eye swelling, and diplopia. Meanwhile, less common signs can include decreased visual acuity. We present a case of a 65-year-old male with comorbidities who presented to the clinic complaining of a chronic nasal obstruction, headache, and decreased visual acuity in the right eye. On endoscopic examination, a lesion was identified in the ethmoid sinus. Computed tomography was performed and confirmed the positioning of the lesion within the ethmoid sinus compressing the optic nerve. Total excision was performed through a direct nasal endoscopic approach. The lesion was excised completely with no recurrence. Histopathology report confirmed the lesion to be of cartilaginous nature, and a final diagnosis of cartilaginous fibrous osteoma was made. Such lesions are usually benign and symptomless. Excising the lesion completely is the best approach to decrease the chances of recurrence.

Highlights

The ethmoid sinus is one of the four paired paranasal sinuses in the human body
Paranasal fibro-osseous lesions are benign, common, slow-growing bony and fibrous growths that occur mainly in the frontal and ethmoid sinuses and are often asymptomatic [2]. They are divided into fibrous dysplasia (FD), osteomas, and ossifying fibromas [3]
FD is an uncommon lesions that may occur as an isolated asymptomatic monostotic lesion or a severe polyostotic disease resulting in fractures and deformities [8]

Summary

Introduction

The ethmoid sinus is one of the four paired paranasal sinuses in the human body. It is formed from air cells within the ethmoid bone between the eyes and nose [1]. Paranasal fibro-osseous lesions are benign, common, slow-growing bony and fibrous growths that occur mainly in the frontal and ethmoid sinuses and are often asymptomatic [2]. They are divided into fibrous dysplasia (FD), osteomas, and ossifying fibromas [3]. The tumor was sent for histopathology in a 10% neutral buffered formalin It was a bony mass of the ethmoid sinus with several pieces of brownish-white bony tissue fragments with a total measurement of 5 x 5 x 1 cm. It included a greyish-white capsulated mass of 3 x 2 x 1.3 cm

Discussion

Conclusions

Findings

Disclosures

Boyce AM