Osteoma — ORE Part 1 MCQ

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HardOral PathologyOsteomaORE Part 1

A 40-year-old patient presents with a unilateral swelling of the right cheek that has been slowly growing over several years. CT scan shows a well-defined expansile radiopacity within the right maxillary sinus attached to the alveolar bone. Histopathology reveals the lesion is composed of mature lamellar bone. What is the most likely diagnosis?

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Correct answer: A — Osteoma

Explanation lettering: E = shown as B · B = shown as D · D = shown as E

The answer is A—Osteoma. The definitive diagnostic feature is the mature lamellar bone composition revealed histopathologically. Osteomas are benign, slow-growing tumors composed of dense, well-differentiated lamellar bone, presenting as well-defined radiopaque lesions. Maxillary sinus osteomas, though rare, fit this presentation perfectly: unilateral, slow growth, and mature bone architecture. Fibrous dysplasia (B) is excluded because it characteristically fails to form mature lamellar bone, instead showing woven bone and a ground-glass radiographic pattern. Osteosarcoma (D) would show aggressive radiographic features (permeative borders, destruction of cortical outlines, stippled pattern) and rapid growth, not slow evolution. Cementoblastoma (C) is odontogenic and typically radiolucent. Paget disease (E) is systemic and polyostotic. The mature lamellar bone is pathognomonic for osteoma in this clinical and radiographic context.

Reference: An Isolated Laminar Osteoma Arising in the Maxillary Sinus. PubMed (2023). https://pubmed.ncbi.nlm.nih.gov/36967573/; supported by Maxillary sinus osteoma: From incidental finding to surgical management (PubMed 2013) and Peripheral Osteoma of the Maxillary Sinus case report (PMC 2025).