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Orbit ossifying fibroma – Case report and literature review – DX NEURO

Orbit ossifying fibroma – Case report and literature review

Rabelo, Nicollas ; Da Silva, Vinicius Trindade Gomes ; Do Espírito Santo, Marcelo Prudente ; Solla, Davi ; Oberman, Dan Zimelewicz ; Da Costa, Bruno Sisnando ; Frassetto, Fernando Pereira ; Teixeira, Manoel Jacobsen ; Figueiredo, Eberval Gadelha . Orbit Ossifying Fibroma - Case Report And Literature Review. Surgical Neurology International, 2020.

Abstract

Background: Ossifying fibroma (OF) is benign bone lesions, most frequent in young children, more common in the maxillary sinus and mandible (75–89%), the pathogenesis of the tumor is not clear, there are many subtypes of OF. This paper aims to report an OF a case and literature review.

Case Description: Male, 19 years old, with a progressive history proptosis since 2012, diagnosed as a right supraorbital lesion at an external service and assigned to conservative management. Then, he evolved with double vision, which worsened in February of 2018, associated with a moderate headache. On admission: proptosis and downward deviation of the right orbit was noticed on the physical exam and with exception of limited right upgaze, external ocular movements were maintained. Head computed tomography showed a multiloculate expansive osteolytic lesion at the right orbital roof. On magnetic resonance imaging, the lesion had an inner content with septations, T1-weighted imaging heterogeneous signal, T2-weighted imaging high signal intensity, and peripheral contrast enhancement. The patient underwent a right frontal craniotomy with a gross total resection and the postoperative follow-up was uneventful. Menzel reported the first case in 1782. The clinical findings depend on localization. There are five subtypes. In general, the lesions have a radiological appearance with hyperdense boundary and cause deformity and destruction in bones with high recurrence risk. Radical resection is curative.

Conclusion: As a result, the correlation of clinical, radiologic, and pathologic data is significant while going for a specific diagnosis in cases of craniofacial fibrous lesions. Total excision is the best treatment, but it can recur.