Collin M, Roman S, Fernandez C, Triglia J-M, Nicollas R
Service d'ORL et chirurgie cervico-faciale pédiatrique, pôle de pédiatrie médico-chirurgicale, hôpital d'enfants de La Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
Service d'anatomopathologie, hôpitaux de La Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2014 Jun;131(3):193-5. doi: 10.1016/j.anorl.2013.04.002. Epub 2013 Oct 15.
Ossifying fibroma (OF) is a rare benign fibro-osseous tumor, mainly located in the head and neck region. Most often, it affects the mandible but rare involvement of paranasal sinuses has been reported, associated with more locally aggressive behavior.
We report the case of an 8-year-old boy with OF of the middle turbinate, revealed by ethmoiditis. Total resection was performed on an endoscopic approach. The patient was free of clinical or radiological recurrence at 3 years' follow-up. This was the youngest patient with OF of the middle turbinate so far reported in the international literature.
Presumptive diagnosis is established by clinical examination and CT scan (location, oval-shaped mass, heterogeneous tumor with a thin bony rim). Definitive diagnosis is founded on histological examination (psammomatous bodies, osteoblastic rim, trabecular bone). Treatment in paranasal sinus OF is surgical, preferentially on an endoscopic approach. Resection should be as complete as possible to minimize risk of recurrence, especially in sinonasal locations, known to be more aggressive. Ethmoiditis in an unusual age-range should suggest tumoral etiology.
骨化性纤维瘤(OF)是一种罕见的良性纤维骨性肿瘤,主要位于头颈部区域。最常见的是累及下颌骨,但也有报道称其罕见地累及鼻窦,且具有更强的局部侵袭性。
我们报告一例8岁男孩,患有中鼻甲骨化性纤维瘤,由筛窦炎发现。通过内镜手术进行了全切除。在3年的随访中,患者无临床或影像学复发。这是国际文献中迄今报道的最年轻的中鼻甲骨化性纤维瘤患者。
通过临床检查和CT扫描(位置、椭圆形肿块、具有薄骨质边缘的异质性肿瘤)进行初步诊断。确诊基于组织学检查(砂粒体、成骨细胞边缘、小梁骨)。鼻窦骨化性纤维瘤的治疗为手术治疗,优先采用内镜手术。切除应尽可能彻底,以降低复发风险,尤其是在鼻窦部位,已知该部位更具侵袭性。在不寻常年龄出现的筛窦炎应提示肿瘤病因。