Ekzoftalmusun nadir bir nedeni: Semento-ossifiye fibroma

Semento-ossifiye fibroma içinde fibröz doku ve kemik, sementum ya da her ikisini andıran kalsifi- ye doku içeren benign fibro-osseöz bir lezyondur. Sıklıkla mandibula ve maksillayı, nadiren de etmoid sinüsü etkiler. Bu yazıda, etmoid sinüste gelişen ve ekzoftalmus oluşturan ossifiye fibromaya ait bilgisa- yarlı tomografi bulguları sunuldu. Yirmi beş yaşın- daki bir kadın hasta, altı aydır var olan ekzoftalmus, baş ağrısı ve burunda konjesyon yakınmalarıyla başvurdu. Fizik muayenede, nazal septumun sağ tarafında sert bir kitle ve aynı tarafta ekzoftalmus saptandı. Göz hareketleri, görme ve fundus normal bulundu. Aksiyel ve koronal bilgisayarlı tomografi görüntülerinde, sağ etmoid sinüste, sınırları belirgin, yuvarlak ve sağ göz çukuru kenarından sağ nazal kaviteye kadar uzanan, 4x4.5x3 cm büyüklüğünde bir kitle görüldü. Kitle lateral rinotomi ve medial mak- sillotomi yaklaşımıyla tama yakın çıkarıldı. Histolojik ve radyolojik bulgular ışığında tanı ossifiye fibroma olarak kondu

A rare cause of exophthalmos: cemento-ossifying fibroma

Cemento-ossifying fibroma is a benign fibroosseous lesion that contains fibrous tissue and calcified tissue resembling bone, cementum or both. It is frequently seen in the mandibula and maxilla, but it may rarely affect the ethmoid sinus. In this report, we presented computed tomography findings of an ossifying fibroma of the ethmoid sinus associated with exophthalmos. A 25-year-old woman presented with complaints of exophthalmos, headache, and nasal congestion of six-month history. Physical examination showed a firm mass on the right side of the nasal septum and right-sided exophthalmos. Eye movements, vision, and the fundus were normal. Axial and coronal computed tomography scans showed a well-delineated, round mass, 4x4.5x3 cm in size, in the right ethmoid sinus, extending from the right orbital rim to the right nasal cavity. Near-total excision of the mass was performed by a lateral rhinotomy and medial maxillotomy approach. Based on histologic and radiological findings, the diagnosis was made as ossifying fibroma.

___

  • Choi YC, Jeon EJ, Park YS. Ossifying fibroma arising in the right ethmoid sinus and nasal cavity. Int J Pediatr Otorhinolaryngol 2000;54:159-62.
  • Margo CE, Ragsdale BD, Perman KI, Zimmerman LE, Sweet DE. Psammomatoid (juvenile) ossifying fibroma of the orbit. Ophthalmology 1985;92:150-9.
  • Engelbrecht V, Preis S, Hassler W, Lenard HG. CT and MRI of congenital sinonasal ossifying fibroma. Neuroradiology 1999;41:526-9.
  • Kendi AT, Kara S, Altinok D, Keskil S. Sinonasal ossi- fying fibroma with fluid-fluid levels on MR images. AJNR Am J Neuroradiol 2003;24:1639-41.
  • Yazgan C, Fitoz S, Atasoy P, Akyar S. Case report: Cemento-ossifying fibroma of the ethmoidal sinus presenting with exophthalmos. [Article in Turkish] Tani Girisim Radyol 2003;9:192-4.
  • Kara CO, Ardıç FN, Topuz B, Bayramoğlu H, Edalı N. Cemento-ossifaying fibromaya bağlı gelişen anevriz- mal kemik kisti. Kulak Burun Bogaz Ihtis Derg 1999; 6:104-6.
  • Yang X, Su K, Zhang H, He L. Ossifying fibroma in nasal cavity and paranasal sinus (with 9 cases reported). Lin Chuang Er Bi Yan Hou Ke Za Zhi 2004;18:266-7. [Abstract]
  • Sciubba JJ, Younai F. Ossifying fibroma of the mandi- ble and maxilla: review of 18 cases. J Oral Pathol Med 1989;18:315-21.
  • Commins DJ, Tolley NS, Milford CA. Fibrous dyspla- sia and ossifying fibroma of the paranasal sinuses. J Laryngol Otol 1998;112:964-8.
  • MacDonald-Jankowski DS. Fibro-osseous lesions of the face and jaws. Clin Radiol 2004;59:11-25.