A case of isolated ossifying fibroma of the mastoid cavity of the temporal bones

OBJECTIVES: To describe an isolated ossifying fibroma of the mastoid cavity that did not invade the inner ear and middle ear cavity. STUDY DESIGN: Case report. SETTING: Department of Otolaryngology, College of Medicine, Pusan National University, a tertiary care center in Busan, South Korea. PATIENTS AND INTERVENTION: A 34-year-old woman had an episode of acute right ear otalgia. A computed tomography scan and magnetic resonance imaging scan showed a well-circumscribed, lobulated, 3 x 3 x 3-cm sized tumor mass that was localized to the temporal bone with bony erosion including tegmen mastoid and partial bony destruction and no invasion of the middle and inner ear. A large tumor mass was removed through a simple mastoidectomy. The permanent pathological report confirmed the diagnosis of ossifying fibroma. The patient returned with complaints of recurring right otalgia, 3 years postsurgery. The previous mastoidectomy cavity was filled with a red sandpaperlike lesion; a 3 x 2-cm sized bony defect was also found,and the dura was exposed after removing the eroded tegmen mastoid. Permanent pathological diagnosis was again an ossifying fibroma,and there were no postoperative complications. CONCLUSION: To prevent clinically evident recurrences and potentially life-threatening complications, early complete resection is advised in aggressive and recurring ossifying fibroma involving the temporal bone. Close long-term postoperative follow-up with physical examinations and temporal bone computed tomography will offer the greatest chance of early detection of recurrence.