Fibrous dysplasia and ossifying fibroma of the paranasal sinuses

Abstract

Fibro-osseous lesions involving the paranasal sinuses, the mid-face and anterior skull base are uncommon. In addition, there appears to be no clear pathological or clinical classification that embraces the variety of lesions that exhibit such diverse pathological and clinical behaviour, yet may still be referred to as a fibro-osseous lesion. The diagnosis of fibrous dysplasia and ossifying fibroma is made on a combination of clinical, radiological and pathological criteria.This paper emphasizes the clinical and pathological differences between fibrous dysplasia and ossifying fibroma. The more aggressive clinical behaviour of the latter is highlighted and a more radical surgical approach i s recommended. In contradistinction, fibrous dysplasia can exhibit a more benign behaviour and radical surgery s i not always justified.A clinicopathological distinction between these two conditions is important from a management perspective despite the fact that they both may be encompassed under the ‘umbrella’ term fibro-osseous lesion.

A possible case of an ossifying fibroma in a Late Neolithic population from Portugal

“…Although found predominantly in the mandible (around 70 per cent), ossifying fibromas may arise within the paranasal sinus and the base of the skull (Shafer et al, 1983;Commins et al, 1998;Barberi et al, 2003). It can occur over a wide age range but it is more common between the second and fourth decades.…”

“…It can occur over a wide age range but it is more common between the second and fourth decades. Females seem to be more frequently affected than males (2:1) (Speight and Carlos, 2006;Regezi et al, 2000;Soames and Southam, 2005;Commins et al, 1998). The lesion can remain inactive for long periods of time or evolve in spurts (Colard et al, 2008).…”

“…Since this tumour is generally asymptomatic, it may be present for some years before discovery; swelling of the face and displacement of teeth are early clinical features (Shafer et al, 1983;Barberi et al, 2003). Tumours within the mandible tend to behave in a more indolent way in comparison to those in the paranasal sinuses (Commins et al, 1998). When the orbital bone and nasal cavity are involved, the individuals may develop exophthalmos, visual acuity loss, bulbar displacement and nasal obstruction (Commins et al, 1998;Sun et al, 2007).…”

“…Tumours within the mandible tend to behave in a more indolent way in comparison to those in the paranasal sinuses (Commins et al, 1998). When the orbital bone and nasal cavity are involved, the individuals may develop exophthalmos, visual acuity loss, bulbar displacement and nasal obstruction (Commins et al, 1998;Sun et al, 2007).…”

Frontal Sinus Osteoma with Osteoblastoma-like Histology and Associated Intracranial Pneumatocele

“…It is decried that there is no clear pathological or clinical classification for fibro-osseous lesions involving the paranasal sinuses that embraces the variety of lesions that exhibit such diverse pathological and clinical behavior [9]. Fibrous dysplasia, ossifying fibroma, and osteoma are three distinct entities that lie along a continuum containing the least to the most bony content [10].…”