Eccentric, mature osseous cap: A distinct imaging feature of sinonasal osteoblastoma.

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Eccentric, mature osseous cap: A distinct imaging feature of sinonasal osteoblastoma.

Am J Rhinol Allergy. 2018 Mar;32(2):82-84

Authors: Dua SG, Locker PH, Rossi IR, Jandali D, Gattuso P, Batra PS, Tajudeen BA

Abstract
BACKGROUND: With the exception of osteomas, bone neoplasms that originate in the sinonasal cavity are seldom diagnosed on preoperative imaging due to a lack of characteristic radiographic features. Here we described the unusual occurrence of an osteoblastoma in the paranasal sinuses, and we drew focus to its salient imaging features. A highly unique imaging sign was indicated, and its pathologic basis was explained, with concurrent review of the literature.
METHODS: Case series and review of the literature.
RESULTS: Two cases of sinonasal osteoblastoma were managed by definitive surgical resection. Both tumors on preoperative computed tomography demonstrated an expansile, heterogeneous fibro-osseous lesion with an eccentric, mature osseous cap. The dense osseous cap seen on imaging corresponded to a rim of mature bone on histopathology. A review of existing literature revealed the presence of this imaging sign in all reported cases.
CONCLUSION: Sinonasal osteoblastoma is an extremely rare entity with undefined imaging characteristics to guide preoperative decision-making. Here we reported, to our knowledge, the first description of a characteristic imaging sign of an eccentric, mature osseous cap, which corresponded histologically to a single peripheral layer rim of osteoblasts, a unique trait of osteoblastoma.

PMID: 29644901 [PubMed - in process]

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