The potential aggressiveness of sinus osteomas

Abstract

The fronto-ethmoidal osteoma is a relatively rare radiological finding and its growth potential, as well as the complications it may lead to, are often underestimated. Osteomas are a frequent cause of mucoceles and sinusitis due to blockage of the nasal ducts but can also present with more dramatic signs such as orbital or intracranial invasion. This knowledge must draw our attention to the need for follow-up of these tumors, whose growth apparently continues after puberty, especially when they are of the spongy type.

Huge aggressive mixed-type osteoma in a young patient

“…Moreover, sinusitis and even a mucocele may develop secondary to the occlusion of the frontal canal. [1][2][3] There was no sinusitis or mucocele in our patient despite the presence of a huge Computed tomography (CT) images reveal a bony mass extending to the right frontal sinus, orbital space, ethmoid cells, frontal lobe, and medially to the frontal process of the maxilla, nasal bone, and crista galli, crossing the midline. The periphery is lobulated, and it appears denser in the lateral half osteoma.…”

“…Cancellous osteomas are located mostly in the maxillary and ethmoid sinuses and grow relatively quickly. 2,5 We present a 14-yearold male patient with a mixed type osteoma, determined by radiologic and pathologic examinations, who presented with proptosis due to orbital involvement.…”

“…The exact etiology of osteoma is unknown. They are common in adult male E 2 Paranasal sinus osteomas originate from the sinus wall and usually fill the sinus cavity. They are mostly welllocalized lesions that contain mature osseous tissue, and they may extend to the orbit, 3 although osteomas extending to the orbit are quite rare in adults, and more so in pediatric patients.…”

Surgical management and outcome of large orbitocranial osteomas

“…The causes of osteoma are controversial; the most accepted theories are genetic, traumatic, embryological, and infectious causes. 10,16,17,19,22,26 According to the genetic theory, genetic factors probably play an important role in the development of osteomas included in Gardner syndrome, characterized by intestinal polyps and multiple osteomas. 28 Theories of traumatic and embryological causes explain the metaplasia of the connective tissue and the sinusal mucosa behaving like a periost and developing a bony substance.…”

Osteoid-Producing Tumors of Bone

“…Rarely, larger lesions may result in symptoms related to mass effect with obstruction of a paranasal sinus, encroachment upon the orbital contents or the skull base, or interference with normal dental formation and function. 3 Histologically, osteomas are well-defined lesions composed of dense lamellar or cortical bone often covered by a thin layer of spindle cells. On radiographs, osteomas typically appear as homogeneous dense, round or ovoid lesions with smooth sharply demarcated margins arising on the outer surface of bone (Fig.…”