Long-Term Clinical Course of Benign Fibro-Osseous Lesions in the Paranasal Sinuses
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Objectives. Fibro-osseous lesions of the paranasal sinuses can present various clinical manifestations. This study aimed to report the long-term clinical course of benign fibro-osseous lesions (BFOLs) in the paranasal sinuses, including clinical and radiologic features. Methods. Radiologically confirmed BFOLs between 1994 and 2016, with the exclusion of osteoma cases, were retrospectively reviewed. We compared demographic characteristics between the surgery and observation groups. The reasons for the imaging study, radiographic features, histopathology, and clinical course based on serial image scans were analyzed. Results. In total, 183 subjects were selected from a thorough review of head and neck radiologic tests (n=606,068) at a tertiary referral hospital over 22 years. Patients’ mean age was 28.6±18.1 years, and 56.3% were males. A diagnostic imaging workup was performed in 55.7% of patients due to facial asymmetry, headache, skull mass, or other symptoms related to BFOLs. In other patients (37.7%), BFOLs were found incidentally on computed tomography or magnetic resonance imaging. The most common diagnosis was fibrous dysplasia, followed by ossifying fibroma, based on both radiologic exams and histopathologic results. In total, 42.6% of the patients underwent surgery because of subjective symptoms or esthetic concerns. The patients who underwent surgery were younger (P<0.001) and had a longer follow-up duration (P<0.001) than those who underwent observation. Patients who experienced lesion growth (11.5%) were younger (P<0.001) and had more lesion sites (P=0.018) than those who did not, regardless of surgical treatment. Five patients underwent optic nerve decompression, and one patient experienced malignant transformation. Conclusion. BFOL in the paranasal sinuses is a rare disease, and most cases were observed without specific treatment. Surgical treatment should be considered in symptomatic patients with aggressive clinical features. Regular observation and management are needed, particularly in younger patients in their teens.
Abstract
Objectives. Fibro-osseous lesions of the paranasal sinuses can present various clinical manifestations. This study aimed to report the long-term clinical course of benign fibro-osseous lesions (BFOLs) in the paranasal sinuses, including clinical and radiologic features. Methods. Radiologically confirmed BFOLs between 1994 and 2016, with the exclusion of osteoma cases, were retrospectively reviewed. We compared demographic characteristics between the surgery and observation groups. The reasons for the imaging study, radiographic features, histopathology, and clinical course based on serial image scans were analyzed. Results. In total, 183 subjects were selected from a thorough review of head and neck radiologic tests (n=606,068) at a tertiary referral hospital over 22 years. Patients’ mean age was 28.6±18.1 years, and 56.3% were males. A diagnostic imaging workup was performed in 55.7% of patients due to facial asymmetry, headache, skull mass, or other symptoms related to BFOLs. In other patients (37.7%), BFOLs were found incidentally on computed tomography or magnetic resonance imaging. The most common diagnosis was fibrous dysplasia, followed by ossifying fibroma, based on both radiologic exams and histopathologic results. In total, 42.6% of the patients underwent surgery because of subjective symptoms or esthetic concerns. The patients who underwent surgery were younger (P<0.001) and had a longer follow-up duration (P<0.001) than those who underwent observation. Patients who experienced lesion growth (11.5%) were younger (P<0.001) and had more lesion sites (P=0.018) than those who did not, regardless of surgical treatment. Five patients underwent optic nerve decompression, and one patient experienced malignant transformation. Conclusion. BFOL in the paranasal sinuses is a rare disease, and most cases were observed without specific treatment. Surgical treatment should be considered in symptomatic patients with aggressive clinical features. Regular observation and management are needed, particularly in younger patients in their teens.
참고문헌 (21)
- Waldron CA, "Benign fibro-osseous lesions of the jaws: a clinical-radiologic-histologic review of sixty-five cases", Oral Surg Oral Med Oral Pathol, 35(2), pp.190~201 (1973)
- Eversole R, "Benign fibro-osseous lesions of the craniofacial complex: a review", Head Neck Pathol, 2(3), pp.177~202 (2008)
- El-Mofty SK, "Fibro-osseous lesions of the craniofacial skeleton: an update", Head Neck Pathol, 8(4), pp.432~444 (2014)
- Godt A, "Dislocation of an upper third molar by an ossifying fibroma: case report", J Craniomaxillofac Surg, 36(6), pp.360~364 (2008)
- Nelson BL, "Benign fibro-osseous lesions of the head and neck", Head Neck Pathol, 13(3), pp.466~475 (2019)
- Efune G, "Paranasal sinus and skull base fibro-osseous lesions: when is biopsy indicated for diagnosis?", Int Forum Allergy Rhinol, 2(2), pp.160~165 (2012)
- Zeng HF, "Surgical treatment of craniomaxillofacial fibrous dysplasia: functionally or aesthetically?", J Craniofac Surg, 24(3), pp.758~762 (2013)
- Hocaoglu E, "Computed tomography imaging findings of craniofacial fibrous dysplasia", J Craniofac Surg, 25(4), pp.1175~1177 (2014)
- Fadle KN, "Orbitocranial fibrous dysplasia: outcome of radical resection and immediate reconstruction with titanium mesh and pericranial flap", J Craniofac Surg, 27(8), pp.e719~e723 (2016)
- Turin SY, "Fibrous dysplasia and juvenile psammomatoid ossifying fibroma: a case of mistaken identity", Cleft Palate Craniofac J., 56(8), pp.1083~1088 (2019)
- Veltrini VC, "Can non-collagenous proteins be employed for the differential diagnosis among fibrous dysplasia, cemento-osseous dysplasia and cemento-ossifying fibroma?", Pathol Res Pract, 215(7), pp.152450~ (2019)
- Liu Y, "Ossifying fibromas of the jaw bone: 20 cases", Dentomaxillofac Radiol, 39(1), pp.57~63 (2010)
- Wang K, "Skull base juvenile psammomatoid ossifying fibroma: clinical characteristics, treatment, and prognosis", World Neurosurg, 125, pp.e843~e848 (2019)
- Liens D, "Long-term effects of intravenous pamidronate in fibrous dysplasia of bone", Lancet, 343(8903), pp.953~954 (1994)
- Plotkin H, "Effect of pamidronate treatment in children with polyostotic fibrous dysplasia of bone", J Clin Endocrinol Metab, 88(10), pp.4569~4575 (2003)
- Duan C, "Characteristics of sinonasal fibrous dysplasia: experience from a single department", Acta Otolaryngol, 138(1), pp.50~55 (2018)
- Ciniglio Appiani M, "Ossifying fibromas of the paranasal sinuses: diagnosis and management", Acta Otorhinolaryngol Ital, 35(5), pp.355~361 (2015)
- Ramsey HE, "Fibrous dysplasia of the craniofacial bones", Am J Surg, 116(4), pp.542~547 (1968)
- Zenn MR, "Treatment of fibrous dysplasia of the mandible with radical excision and immediate reconstruction: case report", J Craniofac Surg, 12(3), pp.259~263 (2001)
- Lee JS, "Normal vision despite narrowing of the optic canal in fibrous dysplasia", N Engl J Med, 347(21), pp.1670~1676 (2002)
- Cutler CM, "Long-term outcome of optic nerve encasement and optic nerve decompression in patients with fibrous dysplasia: risk factors for blindness and safety of observation", Neurosurgery, 59(5), pp.1011~1017 (2006)