Case report: frontal sinus ossifying fibroma

VRU 2023

Alice Birckhead, Ann Carstens, Erik Geiss, Fui Yap, Xander Huizing

Background
This study describes the computed tomographic (CT) characteristics and clinical management of a frontal sinus ossifying fibroma in a dog, which is rare among canine fibro-osseous lesions. This represents the first documented case of frontal sinus ossifying fibroma in a dog and the second report detailing cranial CT features of such a lesion.

Methods
A 10-year-old spayed female Kelpie cross presented with a frontal sinus mass was evaluated using CT imaging. The scan utilized a 64-slice scanner with standard imaging protocols, including pre- and post-contrast studies. Surgical debulking was performed via a frontal sinusotomy, and histopathological analysis was conducted on the excised tissue.


Results
CT revealed a well-defined, lobulated, and heterogeneously mineralized mass (18 mm × 27 mm × 29 mm) arising from the rostral sagittal septum, extending into both frontal sinuses. Imaging indicated a benign process without invasion into the calvarium or nasal cavities. Histopathology confirmed ossifying fibroma with focal atypia. Surgical resection was incomplete due to involvement of critical structures like the cribriform plate. Post-surgical recovery was uneventful, with no evidence of bacterial or fungal involvement.


Limitations
Complete resection of the mass was not feasible due to its anatomical location, complicating definitive management. Additionally, histopathological findings could not entirely exclude neoplastic transformation, necessitating long-term monitoring.


Conclusions
This case highlights the utility of CT imaging for the diagnosis and surgical planning of rare canine ossifying fibromas. The findings expand the knowledge of such lesions in dogs, underscoring the importance of recognizing their imaging characteristics for accurate diagnosis and treatment planning.

F I G U R E 2 Transverse (A), dorsal (B), and sagittal (C) bone-window survey CT images showing a large, well-defined, heterogeneously mineral attenuating, lobulated frontal sinus mass (white arrow). Mild ventral and caudal displacement of the underlying calvarium is seen (black arrow). A, B, Left is to the right of the image.

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