Idiopathic exostosis: rarity on maxillary sinus

Abstract

Introduction: Exostoses in the paranasal sinuses have been reported in a greater number in the dental radiological literature, despite the extensive citation in the otorhinolaryngology literature. Objective: This case report was a rare idiopathic expression that grew in the maxillary sinus. Case report: A 68-year-old black patient, BGS, followed up by the Odontology Service of Cancer Hospital for treating oral lesions (Mucositis) and other conditions resulting from radiation therapy and hormone therapy (Tamoxifen), presented malignant neoplasm at the right breast in 2015; an exostosis biopsy was not performed, since the patient is being treated and followed up by the hospital service. Panoramic radiography and clinical examination were performed. By analyzing the tests, it was possible to notice an image with double radiodensity, more radiopaque in the external portion and less radiopaque in the internal portion, with an aspect of trabecular bone, circumscribed, unilocular, in the region of pedunculated premolar, inside the left maxillary sinus. In order to have a better assessment and diagnostic hypothesis of the case, a CT scan was performed, a tool was applied to measure the density of the profile of the lesion, thus evidencing that the supposed injury invaginates to the interior of the maxillary sinus and had bone density similar to the alveolar crest bone. Conclusion: Simultaneously to other lesions, exostoses are benign lesions, present low aggression and rare symptomatology; exeresis is indicated only when it prevents functioning, or for aesthetics reasons, or when it is not possible to make prostheses. Many cases are incidentally diagnosed from routine radiographic review in medical or dental offices and should be followed up for analysis and verification of their growth.