Transcranial resection of a large sinonasal juvenile psammomatoid ossifying fibroma.
BACKGROUND
Juvenile psammomatoid ossifying fibroma (JPOF) is a benign but potentially locally aggressive fibroosseous lesion predominantly arising in the paranasal sinuses in children and young adults. Intracranial extension is rare but occurs sometimes. In such cases, tumor resection may often require the combination of neurosurgical and facial approaches. Histological diagnosis remains a challenge because the lesion can be easily mistaken for another fibroosseous lesion or for a meningioma.


METHODS
We report the case of a 12-year-old boy with a JPOF arising from the right paranasal sinuses and extension towards the anterior skull base and the orbit. Despite the tumor had eroded through nasal septum, medial orbit wall, and right maxilla, it could be entirely removed performing an extended frontobasal approach via a bifrontoorbital craniotomy, obviating the need for a transfacial approach.


CONCLUSIONS
Radiologically and histologically, the lesion could be mistaken either for a meningioma or another type of ossifying fibroma. Histological aspects and alternative surgical approaches to these rare entities are discussed.
Noudel
Rémy
R
Department of Neurosurgery, Maison Blanche Hospital, University of Reims, Reims, France. remynoudel@yahoo.fr
Chauvet
Edouard
E
Cahn
Virginie
V
Mérol
Jean Claude
JC
Chays
André
A
Rousseaux
Pascal
P
D002648:Child; D003399:Craniotomy / Q000379:methods; D003937:Diagnosis, Differential; D018214:Fibroma, Ossifying / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D011379:Prognosis; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery; D012888:Skull Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome