PMC10130680_01
Preoperative maxillofacial CT showed an expansive bony mass of the right ethmoid expanding ipsilaterally into the nasal cavity, the orbit, and the maxillary sinus, and displacing the nasal septum. (A) Axial CT scan; (B) coronal CT scan. CT, computed tomography.
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The CT showed an expansive bony mass originating from the right ethmoid that expanded into the ipsilateral nasal cavity, the orbit, and the maxillary sinus (Figure 1).
Histological HE pictures of the tumor. (A) Microscopic findings showed uniform spherical curved small ossicles:psammoma-like bodies, within a fibroblastic stroma of uniform stellate, or spindle shaped cells (HE, x100); (B) the ossicles are fused to form bone trabeculae, and reversal lines (HE, x200); (C) pseudocystic, haemorragic degeneration surrounded by multinucleated giant cells, similar to aneurismal bone cyst (HE, x400). HE, hematoxylin and eosin.
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The neoformation was biopsied under general anaesthesia with endoscopic control by 0  optics; the histological examination definitively confirmed a juvenile ossifying fibroma of the psammomatoid subtype (Figure 2). At the periphery of the lesion, the ossicles were fused and formed bone trabeculae showing numerous reversal lines (Figure 2B). Spherical small ossicles called psammonma-like bodies were founded in the sample examined (Figure 2A). There was focal pseudocystic haemorrhagic degeneration bordered by multinucleated giant cells similar to an aneurysmal bone cyst (Figure 2C).
CT performed urgently in the emergency room. The axial (A) and the coronal (B) plans show an ethmoidal bony "shell" with convexity expanding on the median wall of the orbit. CT, computed tomography.
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Follow-up CT images after ESS revision. The orbit's median wall was preserved, ethmoid and maxillary sinuses were free from disease, with intact maxillary antrostomy. (A) Axial CT scan; (B) coronal CT scan. CT, computed tomography; ESS, endoscopic sinus surgery.
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