Endoscopically managed giant frontoethmoidal osteoma with orbital extension

BMJ Case Rep. 2024 Jun 26;17(6):e259236. doi: 10.1136/bcr-2023-259236.

Abstract

A patient in his 20s presented with a change in the appearance of his left eye with evidence of relative afferent pupillary defect. Imaging revealed a giant frontoethmoidal osteoma, a benign sinonasal tumour, invading three-quarters of the orbit. Multidisciplinary discussion involving opthalmology, maxillofacial surgery, neurosurgery and otolaryngology resulted in the decision to attempt entirely endoscopic excision of this lesion, which was performed with successful outcomes. This case demonstrates how a sinonasal osteoma should be considered in the differential diagnosis for a patient presenting with proptosis or other eye signs suggestive of compression of the orbital compartment. This case report and literature review highlights the possibility of managing giant sinonasal osteomas with orbital extension through a completely endoscopic approach.

Keywords: Ear, nose and throat; Otolaryngology / ENT.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Endoscopy* / methods
  • Ethmoid Bone / diagnostic imaging
  • Ethmoid Bone / pathology
  • Ethmoid Bone / surgery
  • Ethmoid Sinus / diagnostic imaging
  • Ethmoid Sinus / pathology
  • Ethmoid Sinus / surgery
  • Exophthalmos / etiology
  • Exophthalmos / surgery
  • Frontal Sinus / diagnostic imaging
  • Frontal Sinus / pathology
  • Frontal Sinus / surgery
  • Humans
  • Male
  • Orbit / diagnostic imaging
  • Orbit / pathology
  • Orbit / surgery
  • Orbital Neoplasms / diagnostic imaging
  • Orbital Neoplasms / pathology
  • Orbital Neoplasms / surgery
  • Osteoma* / diagnostic imaging
  • Osteoma* / pathology
  • Osteoma* / surgery
  • Paranasal Sinus Neoplasms* / diagnostic imaging
  • Paranasal Sinus Neoplasms* / pathology
  • Paranasal Sinus Neoplasms* / surgery
  • Tomography, X-Ray Computed
  • Young Adult