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Orbital cellulitis mimicking ossifying fibroma

Poster Details

First Author: H. El Belidi MOROCCO

Co Author(s):    Y. Saoiba   L. Cherkaoui                 

Abstract Details


Orbital cellulitis is an inflammatory process that involves the tissues located posterior to the orbital septum .It is encountered at all age groups, but more frequently affects the pediatric population, with an incidence of 1.6 per 100,000. In childhood, the cardinal signs of orbital inflammation are usually caused by sinus-related orbital cellulitis. More rarely, acute orbital inflammation may express the occurrence of malignancies, especially rhabdomyosarcoma, neuroblastoma, and acute myeloid leukemia. Ossifying fibroma is a benign fibro-osseous neoplasm that is reported to be more aggressive in the pediatric population and in rare instances can affect the orbit .




We report an 8-year-old girl who was referred for evaluation of left acute orbital inflammation . Diagnosis of left orbital cellulitis was made clinically. A computed tomography revealed a grade 1 exophthalmos and a heterogeneous expansive process of the left nasal cavity and the ethmoidal cells with intra-orbital extension . The inflammatory signs were fully controlled with intravenous antibiotics ; A magnetic resonance imaging was performed. Patient subsequently underwent endoscopic examination under general anesthesia followed by resection of the mass. Final diagnosis of fibro-osseous lesion consistent with ossifying fibroma was made.


Orbital cellulitis in children poses diagnostic difficulties due to the many possible etiologies. Aside from sinusitis, the most important etiologies to pursue are lacrimal system infections and tumors. When confronted with a non-specific clinical presentation, thorough etiologic work-up is essential. This case shows that an acute rapid-onset progressive proptosis may have special attention for diagnosis and management. Orbital cellulitis may mimic ossifying fibroma . Ossifying fibroma is a rare bone tissue-derived benign tumor occurring in the craniofacial bone. Of all cases, 70% occur in the maxilla and mandible . Extension and invasion may lead to involvement of the orbit.


Rarely sinonasal masses can present with acute orbital cellulitis. In a young patient with a well-defined sinonasal mass showing distinct boundaries and areas of speckled calcification, ossifying-fibroma should be considered.

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