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Ossifying Fibroma of the Orbit

Abstract

Osificirajući fibrom glave i vrata rijedak je tumor koji najčešće zahvaća gornju i donju čeljust. Javlja se u trećem i četvrtom desetljeću života. Lezija je obično solitarna, dobro ograničena. Postupnim rastom stanjuje okolno zdravo koπtano tkivo. Radiološka slika ovisi o trajanju bolesti. U ranome stadiju prikazuje se kao oštro ograničeno prosvjetljenje s pojedinačnim nakupinama kalcifikata. U daljnjem tijeku, uz oštro ograničenu zonu prosvjetljenja na periferiji, središnje smještene nakupine kalcifikata postaju gušće. Histološku sliku karakterizira fibrozno tkivo isprepleteno koštanim trabekulama lamelarne kosti koje su obrubljene osteoblastima i mjestimice miksomatoznom stromom. Terapija je kirurška i sastoji se u potpunoj resekciji tumora, koja jedino može spriječiti pojavu lokalnoga recidiva. U radu smo prikazali rijedak slučaj osificirajućeg fibroma orbite koji je zahvatio zigomatičnu kost i proširio se preko velikoga krila sfenoida do optičkoga kanala. Specifičnost terapije u naše bolesnice jest u tome što je unatoč doticaja tumora s prednjom lubanjskom bazom nije upotrijebljen neurokirurški pristup.Ossifying fibroma of the head and neck is a rare tumour which most frequently involves the upper and lower jaw. It occurs during the third and fourth decade of life. The lesion is usually solitary and well circumscribed. It grows slowly, thinning the surrounding healthy bone tissue. Radiographic appearance depends on the duration of the disease. In the early stage it presents as a sharply circumscribed zone of translucency with single accumulations of calcification. During the further course, with the sharply circumscribed zone of translucency on the periphery, the centrally located accumulations of calcification become denser. The histological appearance is characterised by fibrous tissue, interwoven with bony trabeculae of lamellar bones, which are bordered with osteoblasts and scattered myxomatous stroma. Therapy is surgical and consists of total resection of the tumour, which is the only way to prevent the occurrence of a local recurrence. In this paper we present a rare case of ossifying fibroma of the orbit which involved the zygomatic bone and spread/extended via the large branch of the sphenoid up to the optic canal. The specificity of the therapy in our female patient was that in spite of contact of the tumour with the frontal base of the skull, a neurosurgical approach was not used

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