Chronic focal sclerosing osteomyelitis accompanied with bony mass protrusion into the maxillary sinus: a case report

Abstract

This paper describes the first documented case of chronic focal sclerosing osteomyelitis accompanied by bony mass protrusion into the maxillary sinus manifested in a 34-year-old Japanese woman. The lesion was a circumscript radiopaque mass in the left maxillary sinus close to the apex of the left upper second molar. The tooth and adjacent molars were vital, and there was no apparent inflammation, though diffuse and sclerotic changes were observed around the left molar region of the maxilla on simple X-ray and CT images. Histopathological examinations of resected tissue showed that the protrusive hard mass was composed of dense bony trabeculae with prominent mature lamella covered by mucosal epithelia of the maxillary sinus with an inner granulation tissue zone, and of fibrous granulation tissue fragments with focal dense inflammatory cells including foamy macrophages and plasma cells and prominent Russell body formations. The patient was finally diagnosed as having chronic focal sclerosing osteomyelitis based on the radiographic and clinicopathological findings. As of about 35 months after the operation, there has been no sign of recurrence.