Brown Tumor of the Facial Bones

A 37-year-old woman had a 9-year history of chronic renal failure on dialysis. She presented with a nasal mass of approximately 6 months duration. Examination revealed a firm mass pushing the right nasal bones outward as well as a mass obstructing the right nasal fossa. Paranasal sinus radiographs revealed a large soft-tissue mass in the region of the right ethmoidal sinus with bone erosion of the medial orbital wall. Partial opacification of the right frontal and maxil­ lary sinuses was present. A CT scan showed a mass arising in the right ethmoidal sinus causing destruction and expansion medially toward the nasal septum, inferiorly into the maxillary sinus , and laterally to involve the medial orbital wall. Scattered fl ecks of calcifi­ cation were present within the soft-tissue component (Fig. 1 ). Surg ery revealed a hard , almost bonelike tissue obliteratin g and occupying the entire right ethmoidal sinus and involving the maxillary sinus. The nasal septum was not involved. The sphenoidal and frontal sinuses were clear of disease. The tumor was completely removed, as were the medial portion of the infraorbital rim, the nasal bone on the right, the entire ethmoidal sinus, and the medial maxilla. Histologic diagnosis of the specimen was Brown tumor.