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Arch Otolaryngol Head Neck Surg. 2004;130:481-482.

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Diagnosis: Isolated fibrous dysplasia of the sphenoid sinus

The T1-weighted MRI scan (Figure 1) demonstrated a mass with imaging characteristics consistent with soft tissue, which largely disappeared on the T2-weighted MRI scan (Figure 2). The axial CT scan (Figure 3) showed inhomogeneous opacification with a patchy "ground glass" appearance within the right sphenoid sinus. There appeared to be a bony shell over the anterior aspect of the lesion and no expansion or erosion of the cortical walls of the sinus.

Figure appears in full text version. Figure 1.

Figure appears in full text version. Figure 2.

Figure appears in full text version. Figure 3.

The patient was taken to the operating room, at which time the face of the sphenoid sinus was identified and removed by enlarging the natural ostium. Within the sphenoid sinus, a smooth bony cap was identified, behind which was a very firm bony lesion. A curette was used to fragment the bone, which appeared cancellous in nature, and specimens were sent to the pathology laboratory.

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