Cystic shape cemento-ossifying fibroma of ethmoid sinus

Shejbal, Dražen and Vonsović, Gabrijela and Baudoin, Tomislav and Vagić, Davor (2015) Cystic shape cemento-ossifying fibroma of ethmoid sinus. Acta Stomatologica Croatica, 49 (2). pp. 158-161. ISSN 0001-7019

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Abstract

Cemento-ossifying fibromas are a group of rarely occurring benign tumours, developing from the periodontal membrane and varying considerably in appearance and in the progress of the disease. Their common feature is higher or lower production of cemental tissue. In most cases the tumours are small because their cementoma mature quickly and become inactive, which causes the tumour to stop growing. They develop most frequently in the mandible and also in the maxilla. Other sites, such as paranasal cavities, soft tissues and bones of the head, are extremely rare. The case of a cemento-fibrosing tumour with psammoma infiltrations, developing from the ethmoid sinus in a nine-year-old girl is reported. Due to frontal headaches and sight defects as well as impaired vision on the right side, NMR was done, which showed a mucocele of the front and rear ethmoid with destruction of the orbital wall and a breakthrough into the orbit. The right maxillary sinus showed a visible retention and a thickened mucous membrane. A rhinoscopy revealed a ball-shaped spherical mass in the medial nasal meatus, which was defined as concha bullosa. An endoscopic examination showed that the tumour protruded in front of the medium nasal concha into the right nasal cavity, softened the ethmoid roof, penetrated toward the base of the skull, adhered and pushed the orbit. It was removed by FESS technique, and PHD revealed subsequently that it was not a mucocele but a cemento-ossifying fibroma.

Abstract in Croatian

Cementofibromi skupina su rijetkih dobroćudnih tumora koji nastaju iz peridontalne membrane. Njihov izgled i klinička slika variraju. Zajednička im je veća ili manja produkcija cementnoga tkiva. U većini slučajeva tumori su mali jer im cementomi brzo dozrijevaju i postaju neaktivni, pa novotvorina prestaje rasti. Najčešće se razvijaju u mandibuli, a zatim slijedi maksila. Ostale lokacije, poput paranazalnih šupljina te mekih tkiva kostiju i glave, iznimno su rijetke. Opisan je slučaj devetogodišnje djevojčice koja je imala cementni fibrozirajući tumor sa psamomskim uklopinama, a nastao je u etmoidnom sinusu. Zbog frontalnih glavobolja i smetnji s vidom desno učinjen je NMR koji je pokazao mukocelu prednjega i stražnjega etmoida s destrukcijom orbitalne stijenke i probojem u orbitu. U desnom maksilarnom sinusu uočena je retencija i zadebljana sluznica. Rinoskopski vidjela se kuglasta tvorba u srednjem nosnom hodniku koja je imponirala kao konha buloza. Endoskopski je ustanovljeno da je tumor prominirao ispred srednje nosne školjke u desni kavum nosa, razmekšao krov etmoida, prodirao prema bazi lubanje te adherirao i potiskivao orbitu. Uklonjen je FESS tehnikom, a PHD je naknadno pokazao da nije bila riječ o mukokeli, nego o cementofibromu.

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