PMC8571263_01
Preoperative coronal (a) and sagittal (b) head computed tomography scan images with bone algorithm and 3D-reconstruction (c) in series showing a left fronto-orbitoethmoidal intradiploic lesion, with frontal sinus involvement.
SNI-12-485-g002.jpg
PMC8571263_01_SNI-12-485-g002.jpg
F2
The lesion's maximal diameter was about 5 cm, and it was surrounded by a heterogeneous bone shell filled internally by hypodense tissue with multiple sepimentations [Figure 2].
Preoperative coronal (up) and axial (down) brain T1-weighted Magnetic resonance imaging images after Gadolinium administration showing a left inhomogeneous multiloculated intradiploic fronto-orbito-ethmoidal lesion.
SNI-12-485-g003.jpg
PMC8571263_01_SNI-12-485-g003.jpg
F3
Medial and superior rectus and superior oblique muscles were compressed and dislocated [Figure 3].
Routine histology showing neoplastic proliferation of medium-sized spindle tumor cells with no atypia, forming fascicles in metaplastic bone tissue and spreading in normal trabecular bone (up); neoplastic cells with epithelial membrane antigen immunoreactivity (Epithelial Membrane Antigen) (down).
SNI-12-485-g004.jpg
PMC8571263_01_SNI-12-485-g004.jpg
F4
Postoperative axial head computed tomography scan images in series (a), with bone algorithm (b) and with 3D-reconstruction (c) showing a proper reconstruction of the left orbital roof and the medial orbital wall with split calvarial bone graft and bone defect reconstruction with methyl-methacrylate paste, obtaining good cosmetic and functional results.
SNI-12-485-g005.jpg
PMC8571263_01_SNI-12-485-g005.jpg
F5
Postoperative CT scan showed a total removal of the lesion, with an optimal reconstruction of the medial wall and the roof of the left orbit, in the absence of complications [Figure 5].
Axial head computed tomography scan (a) and coronal T2-CISS 3D magnetic resonance imaging (b) showing the presence of pneumocephalus with a small defect in the posterior ethmoidal plane close to the spheno-ethmoidal suture with pneumocephalus.
SNI-12-485-g006.jpg
PMC8571263_01_SNI-12-485-g006.jpg
F6
When she arrived at the Neurosurgical department of the "Spedali Civili" Hospital in Brescia, the patient underwent a brain CT and MRI that showed the presence of pneumocephalus with a small defect in the posterior ethmoidal plane close to the spheno-ethmoidal suture with pneumocephalus [Figure 6].
Three-month postoperative sagittal T2-CISS 3D magnetic resonance imaging showing the posterior ethmoidal space, filled with free fatty tissue and no residual or recurrent disease.
SNI-12-485-g007.jpg
PMC8571263_01_SNI-12-485-g007.jpg
F7
The 3-month postoperative MRI showed no residual or recurrent disease [Figure 7].