Incidental Finding of Ethmoidal Osteoma on Cone Beam Computed Tomography

Case Report

J Dent App. 2015;2(6): 240-242.

Incidental Finding of Ethmoidal Osteoma on Cone Beam Computed Tomography

Bissoon AK1*, Scipio JE2 and Harrynarine DK3

1Department of Oral Diseases, University of the West Indies, Trinidad and Tobago, West Indies

2Maxillofacial Surgery Centre, Woodbrook, Trinidad and Tobago, West Indies

3Department of Oral Diseases, University of the West Indies, Trinidad and Tobago, West Indies

*Corresponding author: Bissoon AK, Department of Oral Diseases, University of the West Indies School of Dentistry, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago, West Indies

Received: January 29, 2015; Accepted: April 08, 2015;Published: April 10, 2015


Osteomas are slow- growing, benign bony tumours that occasionally occur in the paranasal sinuses. They consist of mature compact or cancellous bone. The aim of this report is to describe a case of incidental finding of this tumour in the ethmoidal sinus in a patient presenting with symptomatic florid cementoosseous dysplasia of the mandible diagnosed radiographically. The importance of comprehensive evaluation of large field of view cone beam computed tomography (CBCT) scans is highlighted.

Keywords: Ethmoidal osteoma, incidental finding, cone beam computed tomography


Osteomas are benign osteogenic neoplasms characterized by the proliferation of compact or cancellous bone with sparse marrow. Maxillofacial osteomas most commonly occur in the mandible, followed by the paranasal sinuses of which the frontal sinus is the most frequent site followed by the ethmoid, maxillary and very rarely the sphenoid sinus [1,2]. These tumours are usually asymptomatic but may extend to surrounding structures such as the orbit and nasal cavity causing symptoms [3-7]. Many osteomas are discovered accidentally on sinus radiographs [8-10]. We report on a case of incidental ethmoidal osteoma diagnosed radiographically from cone beam computed tomography (CBCT).

Case Report

A 30- year- old female of Afro- Trinidadian descent presented to the Maxillofacial Surgery Centre, Trinidad with palpation discomfort bilaterally in the first molar regions of the mandible. The associated teeth were non- carious and vital to electric pulp testing. Clinically expanded facial cortices were observed bilaterally in the mandibular premolar/ first molar regions. Dental panoramic radiography revealed multiple mixed radiolucent/radiopaque lesions in the mandibular premolar/molar regions bilaterally. The patient was subsequently referred for a cone beam computed tomography scan (CBCT) to further investigate the extent and effect of the mixed lesions on surrounding structures. A large field of view (FOV) CBCT scan was taken. A radiographic differential diagnosis of florid cementoosseous dysplasia was given the mixed lesions in the mandible.

The radiologist reporting on the scan also observed a welldefined, non-enhancing, high density, circular mass 2.6 mm x 2.9 mm present in the right ethmoidal sinus arising from the medial wall. The mass was seen on the axial, coronal and sagittal sections (Figures 1- 3) through the ethmoid sinus. There was no effect on adjacent vital structures ascertained from the CBCT scan. The lesion appeared to be unrelated to the presenting complaint and a differential diagnosis of ethmoidal osteoma was suggested given the radiographic features observed. Given the asymptomatic nature of the lesion the referring practitioner was advised to inform the patient of the presence of the mass and if any symptoms arise related to it consider re-imaging.