Aggressive middle turbinate osteoblastoma with intracranial extension: a case report

Abstract

Introduction: Osteoblastoma is an uncommon benign bone tumor that accounts for 1 percent of all primary bone tumors. About 30 to 40 percent of all osteoblastoma cases involve the spine. Osteoblastoma involving the nasal cavity is rare, with only 11 reported cases in the English-language literature, while only four cases of turbinate osteoblastoma have been described.

Case presentation: We report an unusual case of middle turbinate osteoblastoma associated with right-sided nasal obstruction and severe headache in a 14-year-old Caucasian girl. The tumor involved the right middle turbinate, complete anterior and incomplete posterior ethmoidal cells, and the frontal sinus ostium. Cribriform lamina was, in the most part, consumed by the tumor growth, while the skull base was mostly of normal bone structure.

Conclusions: To the best of our knowledge, this is the first case of middle turbinate osteoblastoma with intracranial spread. Surgical treatment is the only therapeutic option for osteoblastoma.

Figure 1

Osteoblastoma of the right middle turbinate.

Figure 2

Sagittal multislice computed tomography showed a clearly delineated, heterogeneous (hyperechoic) tumor growth with inhomogeneous central portion and marginal mineralization.

Figure 3

Coronal multislice computed tomography image of osteoblastoma.

Figure 4

Excised specimen.

Figure 5

Pathohistologic finding of osteoblastoma, hemotoxylin and eosin x 60.

Figure 6

Sagittal multislice computed tomography one year postoperatively.

Figure 7

Coronal multislice computed tomography one year postoperatively.

Figure 8

Axial multislice computed tomography one year postoperatively.