A Case of Juvenile Psammomatoid Ossifying Fibroma in the Ethmoid Sinus

Morishita Hiroyuki, Kobayashi Masayoshi, Takeuchi Kazuhiko

doi:10.7248/jjrhi.59.6

<p>Juvenile psammomatoid ossifying fibroma (JPOF) is a type of benign fibro-osseous lesion. Although histologically benign, JPOF is characterized by local invasiveness and a high postoperative recurrence rate. Here we report a case of JPOF arising from the ethmoid sinus, which was extracted and diagnosed endoscopically. The patient was a 13-year-old boy who noticed dacryorrhea from his left eye one month before the first visit. A left ethmoid sinus tumor was detected on follow-up MRI at the department of pediatrics in another hospital and he was referred to our hospital. His left eye was protruded and a neoplastic lesion from the left middle meatus to the common nasal meatus was observed. A CT scan showed a mass of 5cm in diameter arising from the left ethmoid sinus, with bone defects in the orbital wall and anterior skull base. In addition, a multilocular cyst was found inside the mass on MRI T2-weighted imaging. Preoperative biopsy did not give a malignant finding, but endoscopic resection was performed in consideration of the possibility of malignancy. Since JPOF was suspected in a rapid pathological examination performed during the operation, we preserved the skull base and orbital wall, and performed segmental resection. The postoperative diagnosis was JPOF. Three years after the operation, the symptoms have disappeared and the tumor remains on the base of the skull and orbital wall without regrowth. JPOF is a rare disease and other benign fibro-osseous lesions and malignancies such as sarcoma should be differentially diagnosed by imaging examination. Based on clinical imaging findings, it is possible to predict JPOF prior to surgery.</p>

A Case of Juvenile Psammomatoid Ossifying Fibroma in the Ethmoid Sinus

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