Desmoplastic fibroma of the mandible: review and report of two cases

Unraveling the challenges in the diagnosis and management of desmoplastic fibroma of the mandible-a case report

Desmoplastic fibroma (DF) is an uncommon bone tumor that originates from the mesenchymal tissue and despite being benign, exhibits aggressive behavior locally. The following report describes the case of a 7-year-old boy with a rapidly enlarging swelling on the right side of the mandible. After a thorough clinical examination, radiographic imaging, and histopathological analysis, the diagnosis of DF was confirmed. Treatment planning was formulated considering both the tumor's tendency for local recurrence and the patient's well-being. Due to the patient's young age, segmental resection was not deemed appropriate, and an aggressive curettage and enucleation of the lesion followed by the bone graft was performed instead. The patient was kept under close follow-up for the first month of post-surgery and later reviewed after 3, 6, 9, and 12 months, respectively. Good bone healing was observed on radiographs. The patient did not show any signs of recurrence based on clinical or radiographic assessments and did not exhibit any neurosensory deficits as well.

Desmoplastic Fibroma of the Mandible: A Case Without Recurrence After Enucleation

Desmoplastic fibroma (DF) is a rare, benign, yet locally aggressive bone tumor. It frequently affects the facial bones, and the mandible is the most commonly affected site. Treatment of choice is the removal of the tumor with resection of surrounding bone due to its aggressive behavior. We report a case of DF where the tumor showed resolution and almost complete bone deposition following enucleation. Although DF has a high recurrence rate, the patient remains disease-free 31 months post-surgery.

Desmoplastic fibroma of the Mandible with unusual histopathological features

Desmoplastic fibroma (DF) is a rare myofibroblastic primary tumor of bone that histologically and biologically mimics the extra-abdominal desmoid tumor of soft tissue. The surgical management of this tumor has been a matter of controversy and its recurrence has been a matter of clinical relevance. In this case report, we describe an unusual case of DF in a 15-year-old male patient who presented with a slow-growing mass in the right posterior mandibular region of 2 years duration. The presence of areas mimicking Giant cell angiofibroma (GCA) is the highlight of the case. The possibility of misdiagnoses is more in early lesions since the available literature shows that immunohistochemistry (IHC) is not of much benefit while differentiating DFs from other spindle cell lesions.

Desmoplastic Fibroma of the Jaws: A Case Series and Review of Literature

Desmoplastic fibroma (DF) is a benign, locally aggressive neoplasm that rarely occurs in the facial skeleton. It usually presents during the first three decades of life. Due to its aggressiveness and high recurrence rate, early diagnosis is imperative, and complete surgical removal of the lesion is the treatment of choice. Herein, we present three cases of DF namely a 2 year-old girl with a mandibular DF, a 9 year-old boy with a maxillary lesion and a 1.5-year old boy with a mandibular DF. Complete clinicopathological information, treatment plan and long-term follow-up of patients are discussed. Histopathologic features of 3 cases revealed non-capsulated spindle cell tumor with fascicular or swirling patterns in incisional biopsy. Immunohistochemical staining was performed to make a definitive diagnosis. Strongly positive nuclear immunoreactivity for β-catenin confirmed the diagnosis of desmoplastic fibroma in 3 cases. Segmental mandibulectomy, partial maxillectomy and hemimandibulectomy were done for the cases. There was no recurrence in our reported cases after 8 and 11 months and 3 years follow up, respectively. It is noteworthy that despite the aggressive nature of DF, young patients often respond well to wide resection treatment.

Desmoplastic fibroma of the mandible: a rare gnathic bone tumor with a review of the literature

Desmoplastic fibroma (DF) is a rare bone tumor, which is known to involve mostly the gnathic bones. In this setting, the clinical presentation is usually represented by a bulging tumor of the face. Radiologically, the tumor is usually characterized by an expansile lytic bone lesion. The histopathology of the tumor shows a poorly circumscribed hypocellular lesion rich in collagen fibers with interspersed spindle cells having bland nuclear chromatin. Despite the lack of mitoses and nuclear pleomorphism, DF has an aggressive nature, presenting as a destructive growth causing entrapment of neuro-vascular bundles, sinusitis, or trismus. Some cases of DF show mutations in the adenomatous polyposis coli pathway shown by nuclear localization of the β-catenin protein. Few reports showed an association with tuberous sclerosis, though most of these cases were sporadic. We discuss a rare case of desmoplastic fibroma involving the mandible, and a review of the literature of the DF cases involving the gnathic bones.

Desmoplastic Fibroma of the Pediatric Cranium: An Aggressive Skull Tumor with Local Recurrence

Cranial desmoplastic fibroma (DF) is extremely rare and only 20 cases, including only 7 pediatric cases, have been reported previously. We describe the first case of a child with cranial DF that increased in size over a short-term and recurred after resection. The aim of this case report was to discuss the clinical, radiological, and histological characteristics and optimal treatment for this rare and aggressive skull tumor.

Desmoplastic Fibroma-A Rare Case Report

Desmoplastic fibroma (DF) is a benign intra-osseous neoplasm, that is, recognized as the intra-osseous counterpart of soft tissue fibromatosis in both gnathic and extra-gnathic sites. It has a propensity for locally aggressive behavior and local recurrence. An occurrence of intra-osseous lesion other than that of odontogenic origin is rare in the jaws. In this case report, we define the clinico-pathological and radiographic features of DF of the mandible in a 35-year-old female, who presented to the Outpatient Department with a 3-year history of a slowly expanding painless mass in the left mandibular posterior region. Thus, we present a classic case of DF exhibiting characteristic features along with a review of the literature.

Desmoplastic fibroma of the mandible: a series of three cases and review of literature

The desmoplastic fibroma (DF) is a rare, fibroblastic lesion of bone that histologically resembles the desmoid tumor of soft tissue. Although classified as benign, it frequently demonstrates aggressive behavior, often causing tooth mobility, extensive bone destruction, and has a moderate to high recurrence rate. We present three cases of DF in the mandible: the first in a 13 year old female involving the mandibular body in the region of teeth #s 27-#28, the second in a 57 year old female with a lesion apical to tooth #30, and the third in a 20-year-old female involving the left posterior mandible. Clinical, histologic, immunohistochemical (IHC) and radiographic features of this rare neoplasm are discussed. The challenges encountered in establishing an accurate diagnosis due to significant microscopic overlap with other spindle cell lesions are also detailed. Additionally, the findings of IHC stains including vimentin, smooth muscle actin, S-100 protein, β-catenin, HHF-35 and proliferation marker, Ki-67 on 3 cases are reported. The potential for misdiagnosis is high, especially in early lesions, since immunohistochemistry has been reported in literature to be inconsistent when differentiating DFs from other spindle cell lesions. A comparative review of DF and similar entities in the jaws with current considerations in treatment and prognosis is presented.

Desmoplastic fibroma of the rib with cystic change: a case report and literature review

Desmoplastic fibroma (DF) is a rare, locally aggressive, solitary tumor microscopically composed of well-differentiated myofibroblasts with abundant dense collagen deposition. The most common sites are the long tubular bones and mandible. To our knowledge, only five cases of DF in the ribs have been reported. Here, we report a case of DF in this rare location with unusual radiological findings. A 40-year-old man presented with a 4-year history of swelling of the right chest wall. Radiographs revealed a mass at the right 9th rib, and computed tomography demonstrated a mass of 14 × 12 × 8 cm at the right 9th rib with expanded cystic change and marked calcification that appeared to have arisen from the bone. Open biopsy suggested DF. Total excision was performed, and the chest wall was reconstructed. The surgical specimen was a yellowish tumor with multilocular cystic change containing a viscous liquid. The tumor was composed of a proliferation of less-atypical spindle-shaped cells in a collagenous background. The cystic change was observed in the extra-osseous lesion. No β-catenin cytoplasmic/nuclear accumulation was detected, and no β-catenin or GNAS genetic mutations were detected. A final diagnosis of DF was made on the basis of the pathological and radiological findings. The patient was successfully treated with total excision of the tumor with no evidence of recurrence 6 months after surgery.

Maxillary desmoplastic fibroma with initial symptoms suggestive of sinusitis

Desmoplastic fibroma (DF) is a benign intra-osseous neoplasm characterized by the formation of abundant collagen fibers. It arises most commonly in the jaws and exhibits local aggressiveness and high recurrence rates after local resection. An uncommon case of expansive DF involving the right maxilla, maxillary sinus, and inferior orbital wall of a 49-year-old man whose initial symptoms were similar to acute sinusitis is presented, and the criteria for diagnosis and clinical management are discussed.

Desmoplastic fibroma of the cranium in a young man

Desmoplastic fibroma, which develops predominantly in long bones and the mandible, is a rare and benign but locally aggressive tumor. Desmoplastic fibroma of the cranium is extremely rare. We report a case of desmoplastic fibroma of the frontal bone in a young man. Because of its locally aggressive behavior, complete surgical excision with a safety margin is essential.

Gnathic desmoplastic fibroma mimicking a dentigerous cyst: a case report

Desmoplastic fibroma (DF) is a rare, well-differentiated fibrous tumor, which is slow in growth but has an aggressive potential. In its clinical and radiographic presentation it mimics many unusual pathologies of the jaws. This case report presents a DF in the mandible, which in its clinical presentation and radiographic appearance mimicked a dentigerous cyst highlighting the importance of detailed histopathological examination in the diagnosis of jaw pathologies.

Desmoplastic fibroma of the mandible--review of the literature and presentation of a rare case

Desmoplastic fibroma (DF) is a rare, benign but locally aggressive, intraosseous lesion with a high tendency of local recurrence. In this report the actual literature is reviewed regarding epidemiological data, pathology, clinical diagnostic criterias, therapy and prognosis. Moreover, a report of an interesting case is included localized in the mandibular corpus.

Case report: desmoplastic fibroma of the mandible in a child presenting with TMJ dysfunction

BACKGROUND

Desmoplastic fibroma of bone is a rare intraosseous benign but locally aggressive tumor of connective tissue origin. The lesion may affect the metaphyses of the long bones but it may also involve the skull bones and more specifically the mandible, with most lesions appearing in the ramus-angle area. Treatment is surgical although additional chemotherapy or radiation has been applied.

CASE REPORT

A 10-year-old boy initially presented with restriction and deviation of mouth opening. Clinical and radiological examination revealed a tumor-like lesion of the mandible extending into the soft tissues, which on biopsy proved to be a desmoplastic fibroma.

TREATMENT

The surgical treatment included peripheral ostectomy of the mandible, via an intraoral approach, for the removal of the lesion and restoration of the bone defect with an iliac bone autograft.

FOLLOW-UP

The high recurrence rate of this type of lesion, demands a strict follow-up schedule. In the case presented, 5 years post-operatively, there are no signs of local recurrence.

CONCLUSION

Changes in mouth opening when not attributed to obvious reasons, such as trauma, should make a dentist suspicious and lead to further investigation. In the case presented, a central lesion was revealed in the radiograph and the patient was referred and treated early. Extended surgical removal of the tumor, with wide margins, proved to be the appropriate treatment.

Desmoplastic fibroma of the jaw: a case report and review of literature

Desmoplastic fibroma is a benign intraosseous neoplasm that is recognized as the intraosseous counterpart of soft tissue fibromatosis in both gnathic and extragnathic sites. It has a propensity for locally aggressive behavior and local recurrence. In the present report, we define the clinicopathological and radiographic features of a desmoplastic fibroma of the mandible in an 8-year-old white boy who initially presented with a 2-month history of a rapidly expanding, painless mass along the right inferior border of his mandible. A critical and comprehensive review of the English language literature is also provided.

Case report of intra-osseous fibroma: a study on odontogenic and desmoplastic fibromas with a review of the literature

Intra-osseous fibromas of the jaw are classified by origin. Intra-osseous odontogenic fibromas have odontogenic epithelia, while desmoplastic fibromas do not. However, it is often difficult to determine the odontogenic origin for central fibromas. Three subjects with a diagnosis of intra-osseous fibroma were examined. Case 1 was a 35-year-old man found to have a panoramic radiograph from the right premolar to the mandibular ramus in the mandible that exhibited multilocular radiolucency. Within the radiolucency, small-radioopaque bodies were observed. Case 2 was a 13-year-old female, in whom a panoramic radiograph from the left premolar to the molar in the mandible showed multilocular radiolucency. Case 3 was a 51-year-old female who exhibited a heart-shaped radiolucency in the panoramic radiograph of the left first molar area in the mandible. We also reviewed the literature for previously reported cases of intra-osseous odontogenic and desmoplastic fibroma. In 64 cases of intra-osseous odontogenic fibroma and 68 cases of desmoplastic fibroma we extracted data on age, sex, location, and radiographic findings. Based on the analysis of the reported literature cases, re-evaluation of the patients in our study revealed that case 1 could be classified as desmoplastic fibroma, while cases 2 and 3 were intra-osseous odontogenic fibromas.

Desmoplastic fibroma of the cranium: case report and review of the literature

OBJECTIVE AND IMPORTANCE

Desmoplastic fibroma is a benign bone tumor that can be locally aggressive. It usually occurs in the long bones and mandible. We report on a patient with a desmoplastic fibroma arising in the temporal bone and review previously published cases of desmoplastic fibroma originating within the cranium.

CLINICAL PRESENTATION

A 43-year-old woman presented with a 12-year history of progressively worsening head asymmetry. Magnetic resonance imaging and computed tomography demonstrated a mass originating from the bone and involving the adjacent soft tissues.

INTERVENTION

A temporal parietal craniectomy was performed with excision of a large tumor involving the bone. An acrylic cranioplasty was used to replace the bone. Pathological examination of the lesion identified desmoplastic fibroma of the cranium. After surgery, the patient's cranial asymmetry was corrected.

CONCLUSION

Desmoplastic fibroma of the cranium is rare. Surgical resection is the treatment of choice.

Desmoplastic fibroma of the mandible: report of a case

This paper describes a case of desmoplastic fibroma in a 4-year-old patient with a history of a small slowly growing swelling at the right angle of the mandible over a 3-month period. Desmoplastic fibroma was diagnosed on histological and immunohistochemical bases. The lesion responded well to thorough curettage and has not shown signs of recurrence 3 years after the surgical intervention. The clinical picture, the pathology and the management of the case are described, and the differential diagnosis and treatment are discussed.