CASE 64

Clinical Presentation

A 21-year-old man presented with progressive inferior displacement of the right globe.

Figure 64A

Figure 64B

Radiologic Findings

CT scans of the sinuses (Fig. 64A, coronal, and Fig. 64B, axial) reveal a dense, homogeneously mineralized mass in the right frontal sinus that is extending through the roof of the orbit and displacing the globe inferiorly. The overlying cortical bone remains intact. The mineralization has a cloudlike appearance, consistent with osteoid mineralization. The lesion has a nonaggressive appearance without associated periosteal reaction or soft-tissue mass.

Diagnosis

Differential Diagnosis

• Parosteal osteosarcoma
  
• Osteochondroma
  
• Periosteal osteoblastoma
  
• Ossified parosteal lipoma
  
• Myositis ossificans
  
• Calcified meningioma (when on the inner table of the skull)

Discussion

Background

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