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Aravindan V, Kumar SP, Murugan P S, Krishnan M, Sneha A. A Rare Case of Cemento-Ossifying Fibroma: A Case Report. Cureus 2023; 15:e38685. [PMID: 37292559 PMCID: PMC10244260 DOI: 10.7759/cureus.38685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/10/2023] Open
Abstract
Benign fibro-osseous lesions are a group of pathological conditions characterized by the replacement of normal bone with cellular fibrous connective tissue that undergoes mineralization. The most common types of benign fibro-osseous lesions include fibrous dysplasia, ossifying fibroma, and osseous dysplasia. However, diagnosing these lesions can be challenging due to their overlapping clinical, radiological, and histological features, which can cause a diagnostic dilemma for surgeons, radiologists, and pathologists. One rare type of benign fibro-osseous lesion is the cemento-ossifying fibroma (COF), which is a definitive form of a benign fibro-osseous tumor that affects the craniofacial region, particularly the jaws (70%). Here, we present a case of COF in a 61-year-old female patient in the maxillary anterior region. Due to a clear distinction between the lesion and healthy bone, the lesion was treated with conservative surgical excision followed by curettage and primary closure. However, differential diagnosis of COF can be highly challenging for clinicians due to its overlapping features with other fibro-osseous lesions like Paget's disease and fibrous dysplasia. Ossifying fibroma and fibrous dysplasia often present a histopathological, clinical, and radiological overlap. The post-operative follow-up after eight months was unpredictable, with a radiological picture showing the increased thickness of the frontal bone, parietal bone, and maxilla with obliteration of marrow spaces, alteration of the trabecular pattern with a cotton wool/ground glass appearance, and reduced maxillary sinus space. Proper evaluation and diagnosis of fibro-osseous lesions are necessary before arriving at a final conclusion. Cemento-ossifying fibroma in the maxillofacial skeleton is uncommon, and after eight months, the recurrence rate is rare. This case highlights the importance of considering COF as a differential diagnosis for fibro-osseous lesions in the maxillofacial region and the necessity for proper evaluation and diagnosis to determine the appropriate treatment plan and prognosis. In summary, the diagnosis of benign fibro-osseous lesions can be challenging due to their overlapping features, but early diagnosis and proper evaluation are essential for successful treatment outcomes. COF is a rare type of benign fibro-osseous lesion where other fibro-osseous lesions in the maxillofacial region should be considered as a differential diagnosis, and the necessary steps should be taken to confirm the diagnosis before arriving at a final conclusion.
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Affiliation(s)
- Vedha Aravindan
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Santhosh P Kumar
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Senthil Murugan P
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Alladi Sneha
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Complete Spontaneous Bone Regeneration following Surgical Enucleation of a Mandibular Cemento-Ossifying Fibroma. Case Rep Dent 2022; 2022:7902602. [PMID: 36034160 PMCID: PMC9411006 DOI: 10.1155/2022/7902602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background Cemento-ossifying fibroma (COF) is a type of benign fibro-osseous tumor that mainly occurs in the maxillofacial region. Bone reconstruction after the surgery is often performed with bone transplantation. However, the present case report describes the accurate diagnosis and successful surgical resection of a COF with periosteum preservation, after which the defect was completely and spontaneously filled with the newly formed bone through a natural process. Case Presentation. A 32-year-old Iranian female patient presented with a history of gradual development of painful swelling, spontaneous pain, and lower lip and chin hypoesthesia in the lower third of the left side of her face. The dome-shaped swelling was tender. The patient was suffering from renal infection and urethral prolapse and was taking folic acid. She also mentioned a positive family history of similar swellings in her mother and uncle. Intraoral examination indicated a lesion in buccal and lingual vestibules extending from the first premolar to the third molar teeth. It had a firm consistency, and the covering mucosa was normal in terms of color and texture. The aspiration test was negative. The lesion had caused severe mobility of the second premolar and first and second molar teeth. Panoramic radiography revealed an extensive well-defined unilocular radiolucency. Significant knife-edge resorption of the first and second molar roots at the involved site and thinning of the alveolar crest and inferior border of the mandible were also clear. Cone-beam computed tomography showed severe expansion in the buccal and moderate expansion in the lingual aspect, causing thinning of both the buccal and lingual cortical plates. Histopathological analysis revealed neoplastic tissue mixed with fibrous connective tissue and several round and oval-shaped calcification foci. Immunohistochemical analysis confirmed the final diagnosis (COF) with the presence of SMA-8. The lesion was removed by enucleation and curettage, while the periosteum was carefully preserved. Fixation with screw and plate was also performed. Conclusions Correct diagnosis of COF and precise implementation of the periosteal osteogenesis technique, in this case, resulted in entirely and spontaneously bone regeneration, which was a rare and favorable outcome with minimum cost and complications for the patient.
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Venkataramana NK, Rao SAV, Kirshna Chaitanya N. Cementifying Fibroma of the Sphenoid Wing in a Child: A Case Report. J Pediatr Neurosci 2021; 16:49-54. [PMID: 34316308 PMCID: PMC8276958 DOI: 10.4103/jpn.jpn_162_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 06/25/2012] [Accepted: 10/22/2020] [Indexed: 11/08/2022] Open
Abstract
"Cementifying fibroma" is a benign tumor of the fibroblastic tissue containing masses of cementum-like calcified tissue, usually occurring between the third and fourth decades. Cementifying-ossifying fibromas are rare non-odontogenic, fibro-osseous tumors of the periodontal ligament that arise from the mesodermal germ layer3. We report a 12-year-old male child, who presented with a swelling in the left temporal region near the angle of the left eye. These non-neoplastic, locally destructive tumors present as an osseous lesion involving the mandible, maxilla, zygoma, paranasal sinuses, orbit, and rarely the petromastoid regions. The preoperative diagnosis was not clear even with CT and MRI, and, hence, all fibro-osseous lesions were considered as differential diagnosis. The lesion was surgically resected completely, and the histology confirmed it as a cementifying fibroma. According to the WHO classification, this is a variant of cementifying fibromas, which represent a subgroup of cementomas, that is, fibro-osseous lesions containing cementum. Histologically, these are fibrous tissues with calcified structures resembling bone and cementum. Cranioplasty was done simultaneously, with successful clinical results.
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Affiliation(s)
- N K Venkataramana
- Departmentt of Neurosurgery, Brains Hospital, Bangalore, Karnataka, India
| | - Shailesh A. V. Rao
- Departmentt of Neurosurgery, Brains Hospital, Bangalore, Karnataka, India
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Nilesh K, Punde P, Patil NS, Gautam A. Central ossifying fibroma of mandible. BMJ Case Rep 2020; 13:e239286. [PMID: 33372024 PMCID: PMC7772295 DOI: 10.1136/bcr-2020-239286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 12/30/2022] Open
Abstract
Ossifying fibroma (OF) is a rare, benign, fibro-osseous lesion of the jawbone characterised by replacement of the normal bone with fibrous tissue. The fibrous tissue shows varying amount of calcified structures resembling bone and/or cementum. The central variant of OF is rare, and shows predilection for mandible among the jawbone. Although it is classified as fibro-osseous lesion, it clinically behaves as a benign tumour and can grow to large size, causing bony swelling and facial asymmetry. This paper reports a case of large central OF of mandible in a 40-year-old male patient. The lesion was treated by segmental resection of mandible. Reconstruction of the surgical defect was done using avascular fibula bone graft. Role of three-dimensional printing of jaw and its benefits in surgical planning and reconstruction are also highlighted.
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Affiliation(s)
- Kumar Nilesh
- Oral & Maxillofacial Surgery, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Prashant Punde
- Oral & Maxillofacial Surgery, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Nitin Shivajirao Patil
- Department of Orthopedics, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Amol Gautam
- Department of Radiodiagnosis, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
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Katti G, Khan MM, Chaubey SS, Amena M. Cemento-ossifying fibroma of the jaw. BMJ Case Rep 2016; 2016:bcr-2015-214327. [PMID: 27174452 DOI: 10.1136/bcr-2015-214327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Cemento-ossifying fibroma is a benign growth, considered to originate from the periodontal ligament. It is often encapsulated and predominantly located in the mandible, and presents as a slow-growing lesion, but may cause deformity if left untreated. The definitive diagnosis of these lesions requires integration of its clinical, radiological and histological features. We present a case of cemento-ossifying fibroma in relation to the lower left one-third of the face, and its management.
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Affiliation(s)
- Girish Katti
- Department of Oral Medicine and Radiology, Al-Badar Dental College and Hospital, Gulbarga, Karnataka, India
| | - Mohammed Munnawarulla Khan
- Department of Oral Medicine and Radiology, Al-Badar Dental College and Hospital, Gulbarga, Karnataka, India
| | | | - Mehroz Amena
- Deoartment of Oral Medicine, Al-Badar Rural Dental College and Hospital, Gulbarga, Karnataka, India
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Mohapatra M, Banushree CS, Nagarajan K, Pati D. Cemento-ossifying fibroma of mandible: An unusual case report and review of literature. J Oral Maxillofac Pathol 2016; 19:405. [PMID: 26980975 PMCID: PMC4774300 DOI: 10.4103/0973-029x.174646] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The term ossifying fibroma (OF) has recently been included under fibro-osseous lesions. Cemento-OF (COF) is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. These tumors occur in the third and fourth decades of life with a predilection for women. The mandible is more commonly involved than the maxilla. This lesion has caused considerable controversy regarding the use of terminology, origin and diagnostic criteria. This article describes an unusual case of COF presenting as unilocular lytic lesion of mandible in a 38-year-old male patient with review of literature.
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Affiliation(s)
- Mounabati Mohapatra
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - C S Banushree
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - K Nagarajan
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Debashish Pati
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Naik RM, Guruprasad Y, Sujatha D, Gurudath S, Pai A, Suresh K. Giant cemento-ossifying fibroma of the mandible. J Nat Sci Biol Med 2014; 5:190-4. [PMID: 24678226 PMCID: PMC3961933 DOI: 10.4103/0976-9668.127326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Cemento-ossifying fibroma (COF) is classified as a fibro-osseous neoplasm and included among the non-odontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential for forming fibrous tissue, cementum and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women between the third and fourth decades of life. Case reports of massive expansile COF, measuring more than 10 cm are rarely reported in the literature. We report a case of giant cemento-ossifying fibroma of the mandible in a 34 year old female patient.
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Affiliation(s)
- Raghavendra Mahadev Naik
- Department of Oral Medicine and Radiology, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Yadavalli Guruprasad
- Department of Oral and Maxillofacial Surgery, AME's Dental College Hospital and Research Centre, Raichur, Karnataka, India
| | - D Sujatha
- Department of Oral Medicine and Radiology, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Shubha Gurudath
- Department of Oral Medicine and Radiology, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Anuradha Pai
- Department of Oral Medicine and Radiology, Oxford Dental College and Hospital, Bangalore, Karnataka, India
| | - Kv Suresh
- Department of Oral Medicine and Radiology, Krishna School of Dental Sciences, Karad, Maharashtra, India
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Massive expansile ossifying fibroma of the mandible with osteomyelitis. Oral Radiol 2014. [DOI: 10.1007/s11282-013-0164-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mohanty S, Gupta S, Kumar P, Sriram K, Gulati U. Retrospective Analysis of Ossifying Fibroma of Jaw Bones Over a Period of 10 Years with Literature Review. J Maxillofac Oral Surg 2013. [PMID: 26225029 DOI: 10.1007/s12663-013-0545-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The purpose of this retrospective analysis is to document and discuss the features, treatment rendered and result of 25 histologically proven cases of ossifying fibromas of jaw bones operated by a single surgeon over a period of 10 years. MATERIALS AND METHODS The records of ossifying fibroma were obtained from the archives of Oral and Maxillofacial Surgery at Maulana Azad Institute of Dental Sciences (MAIDS) from 2001 to 2011. Only those cases were included in the study where definitive surgery was performed based on clinical, radiological & histopathological features. RESULTS Twenty-five patients were analyzed with a final diagnosis of ossifying fibroma comprising of 14 males (56 %) and 11 females (44 %). The age range was 11-45 years with a mean of 24.12 years. Mandible was involved in 72 % and maxilla in 28 % cases with a predominance of mandibular posterior [19 (76 %)] cases. The study showed similar findings in regard to clinical, radiographic & histological features of ossifying fibroma as compared to other studies. It also showed that the treatment rendered in the form of eneucleation, curettage or resection of the lesion depending on its stage and extent were adequate, as no recurrence has been reported till date. CONCLUSION Enucleation is preferred in small and well demarcated lesions. Curettage should be done in relatively large lesions with ill defined borders, not involving basal bone of mandible or cortical perforation. Resection should be reserved for aggressive and extensive cases with involvement of basal bone or perforation of cortices.
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Affiliation(s)
- Sujata Mohanty
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, MAMC Campus, New Delhi, 110002 India
| | - Sunita Gupta
- Department of Oral Medicine, Diagnosis and Radiology, Maulana Azad Institute of Dental Sciences, MAMC Campus, New Delhi, 110002 India
| | - Priya Kumar
- Department of Oral and Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, MAMC Campus, New Delhi, 110002 India
| | - K Sriram
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, MAMC Campus, New Delhi, 110002 India
| | - Ujjwal Gulati
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, MAMC Campus, New Delhi, 110002 India
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Boffano P, Roccia F, Gallesio C, Berrone S. Pathological mandibular fractures: a review of the literature of the last two decades. Dent Traumatol 2013; 29:185-96. [PMID: 23294978 DOI: 10.1111/edt.12028] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2012] [Indexed: 12/17/2022]
Abstract
Pathological mandibular fractures are rare, accounting for fewer than 2% of all fractures of the mandible. They could be defined as fractures that occur in regions where bone has been weakened by an underlying pathological process. Pathological fractures usually may follow surgical interventions such as third molar removal or implant placement, result from regions of osteomyelitis, osteoradionecrosis, and bisphosphonate-related osteonecrosis of the jaw, occur because of idiopathic reasons or be facilitated by cystic lesions, benign, malignant, or metastatic tumors. Pathological mandibular fractures may be challenging to treat because of their different etiology and peculiar local and general conditions, often requiring a more rigid fixation. In patients with poor medical conditions, simpler and more limited options may be preferred.
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Affiliation(s)
- Paolo Boffano
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
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12
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Keles B, Duran M, Uyar Y, Azimov A, Demirkan A, Esen HH. Juvenile ossifying fibroma of the mandible: a case report. J Oral Maxillofac Res 2010; 1:e5. [PMID: 24421970 PMCID: PMC3886046 DOI: 10.5037/jomr.2010.1205] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 03/07/2010] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fibro-osseous lesions of the jaws, including juvenile ossifying fibroma, pose diagnostic and therapeutic difficulties due to their clinical, radiological and histological variability. The aim of this study was to report the outcome of a 9 years old girl with diagnosed juvenile ossifying fibroma treatment. METHODS A 9 years old girl presented with a 6 x 8 cm sized hard fixed tumour on right ramus and corpus of the mandible. On the radiological examination tumour showed an irregular but well bordered, unilocular and expansive lesion on the right corpus and ramus of the mandible. There was no teeth displacement or teeth root resorbtion. Microscopically, the tumour had trabeculae, fibrillary osteoid and woven bone. After the clinical, radiological (panoramic radiography, computed tomography and magnetic resonance imaging) and histologic analysis it was diagnosed juvenile ossifying fibroma. In the history of the patient there has been an acute lymphocytic leukaemia in the remission for 3 years. RESULTS Because of large size of mandibular tumour, resultant expansion and destruction of mandibular cortex, the patient underwent right hemimandibulectomy using transmandibular approach. There was no recurrence or complications for two years follow-up. CONCLUSIONS Although juvenile ossifying fibroma is an uncommon clinical entity, its aggressive local behaviour and high recurrence rate means that it is important to make an early diagnosis, apply the appropriate treatment and, especially, follow-up the patient over the long-term.
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Affiliation(s)
- Bahar Keles
- Department of Otorhinolaryngology and Head & Neck Surgery, Meram Medical Faculty, Selçuk University, Konya Turkey
| | - Mutlu Duran
- Department of Otorhinolaryngology and Head & Neck Surgery, Meram Medical Faculty, Selçuk University, Konya Turkey
| | - Yavuz Uyar
- Department of Otorhinolaryngology and Head & Neck Surgery, SSK Okmeydani Education Hospital, Istanbul Turkey
| | - Ahmet Azimov
- Department of Otorhinolaryngology and Head & Neck Surgery, Meram Medical Faculty, Selçuk University, Konya Turkey
| | - Abdullah Demirkan
- Department of Otorhinolaryngology and Head & Neck Surgery, Meram Medical Faculty, Selçuk University, Konya Turkey
| | - Haci Hasan Esen
- Department of Pathology, Meram Medical Faculty, Selçuk University, Konya Turkey
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Juvenile Aggressive Psammomatoid Ossifying Fibroma: An Interesting, Challenging, and Unusual Case Report and Review of the Literature. J Oral Maxillofac Surg 2009; 67:200-6. [DOI: 10.1016/j.joms.2007.12.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2007] [Revised: 05/31/2007] [Accepted: 12/10/2007] [Indexed: 11/21/2022]
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Mohd Jamal Alsharif, Sun ZJ, Chen XM, Wang SP, Zhao YF. Benign Fibro-Osseous Lesions of the Jaws: A Study of 127 Chinese Patients and Review of the Literature. Int J Surg Pathol 2008; 17:122-34. [PMID: 18480400 DOI: 10.1177/1066896908318744] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study is to analyze all the cases of benign fibro-osseous lesions treated at School and Hospital of Stomatology, Wuhan University, to compare the results obtained in this study with those previously documented by other authors. The 127 cases diagnosed as a fibro-osseous lesion were retrieved, and information about these lesions was documented. In all, 127 cases of benign fibro-osseous lesions were surgically treated. Of these, 55 were cemento-ossifying fibroma, 43 ossifying fibroma, and 29 fibrous dysplasia. Cemento-ossifying fibromas mostly occur in men of the second decades, mostly in the mandible. Ossifying fibromas had almost equal sex predilection and age distribution peaked in the second decades, mostly in the mandible. Fibrous dysplasia also had equal sex predilection, and age distribution peaked in the second and third decades, with equal occurrence in both jaws. The tumors needed to have a regular follow-up after the surgery.
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Affiliation(s)
- Mohd Jamal Alsharif
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology
| | - Zhi-Jun Sun
- Department of Oral and Maxillofacial Surgery, Key Laboratory of Oral Biomedical Engineering, Ministry of Education
| | - Xin-Ming Chen
- Department of Oral Pathology, School and Hospital of Stomatology Wuhan University, Wuhan, Hubei, China
| | - Shi-Ping Wang
- Department of Oral Pathology, School and Hospital of Stomatology Wuhan University, Wuhan, Hubei, China
| | - Yi-Fang Zhao
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology
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Dalghous A, Alkhabuli JO. Cemento-ossifying fibroma occurring in an elderly patient. A case report and a review of literature. Libyan J Med 2007; 2:95-8. [PMID: 21503260 PMCID: PMC3078280 DOI: 10.4176/061220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Cemento-ossifying fibromas (COF) are benign lesions affecting the jaws and other craniofacial bones. They commonly affect adults between the third and fourth decade of life. Radiographically, they appear as well-defined unilocular or multilocular intraosseous masses, commonly in the premolar/molar region of the mandible. The lesion is invariably encapsulated and of mixed radiolucent densities. The tumour may grow quite extensively, thus the term aggressive is some times applied. Their clinical, radiographical and histopathological features and those of fibro-osseous lesions are overlapping and may cause confusion in classification, diagnosis, and treatment. The histopathology is composed of fibrous tissues with calcified structures resembling bone or cementum. Surgical enucleation or resection is the treatment of choice. They are insensitive to radiotherapy and recurrences are uncommon. This case report presents a case of COF in 70 years old female patient that was asymptomatic. Clinically, there was an expansion of the buccal plate but not the lingual plate of the right mandible. The covering mucosa was normal and there was no tenderness or paraesthesia. Radiographically, the lesion extends superio-inferiory from the alveolar ridge to the area of inferior dental canal and mesiodistally from the premolar region to the retro-molar area. The lesion was of mixed radiolucent densities. The patient was followed up periodically for 5 years without any treatment. The patient continued to be asymptomatic with minimum changes. Occurrence of cemento-ossifying fibroma in patients over 60 years of age is unusual and had not been reported. The clinical, radiographic, histopathology and literature review are discussed.
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Affiliation(s)
- Abdulbaset Dalghous
- Oral & Maxillofacial Surgery, Pinderfields General Hospital, Wakefield, West Yorkshire
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Chi HP, Ho KY, Tsai KB, Lee KW, Ta CF, Wang LF, Kuo WR. Fibro-osseous lesion of the external auditory canal: a case report. Kaohsiung J Med Sci 2004; 20:31-5. [PMID: 15481564 DOI: 10.1016/s1607-551x(09)70081-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to differentiate a novel type of benign circumscribed bone lesion of the external auditory canal from lesions described previously, such as exostoses and osteomas. We present a 43-year-old male patient who suffered from ear discharge of the right ear. Local findings showed bloody discharge from his right auditory canal, which was occupied by a mass-like tissue. Computerized tomography (CT) carried out before resection of the lesion disclosed the absence of a bony connection to the underlying structures. The pathologic findings showed lesions consisting of an osteoma-like bone formation with sparse osteoblastic areas. Mature lamellar bone and bone marrow containing adipose tissue were also noted. There was no evidence of a relationship to the cartilaginous tissue or bony structures of the external auditory canal. Therefore, we present this rare case and review the reported literature in which clinical, CT, surgical, and pathologic findings suggest that this lesion was unlike those previously known, and may be related to ossifying reactions in other parts of the organism.
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Affiliation(s)
- Hung-Pin Chi
- Department of Otolaryngology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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17
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Barth H, Maune S, Schlüter E, Schrader B, Buhl R, Hugo HH, Mehdorn HM. [Benign fibro-osseous tumors of the frontal skull base with intracranial extension. Report of 2 cases]. HNO 2004; 52:140-4. [PMID: 14968317 DOI: 10.1007/s00106-003-0860-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report on two patients with ossifying fibroma of the anterior skull base with intracranial extension. A psammomatoid ossifying fibroma was removed from a 29 year old female patient, and in a 37 year old female patient a cemento ossifying fibroma was removed. The main clinical symptom in both cases was headache. Surgery took place after diagnosis and therapy in an interdisciplinary operation with ENT colleagues. The ossifying fibroma is a benign neoplasm mainly affecting the maxilla and mandible. Complete removal is better than a curettage of the tumor.
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Affiliation(s)
- H Barth
- Klinik für Neurochirurgie, Universitätsklinikum Kiel, Christian-Albrechts-Universität, Weimarer Strasse 8, 24106 Kiel.
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Gelabert-González M, Fernández-Villa J, García-Allut A, Pintos-Martínez E. Fibroma cemento osificante del cráneo. Neurocirugia (Astur) 2002. [DOI: 10.1016/s1130-1473(02)70581-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
The benign fibro-osseous lesions (BFOL) represent a clinically diverse group of disorders of bone that share similar histopathologic features. As a group, they are relatively common in the craniofacial complex, especially the jaws. Although the general concept of BFOL is relatively well known, specific diagnostic interpretation of individual cases is often challenging. New concepts and controversies have arisen over the past 10 to 15 years regarding classification and diagnostic criteria. However, among the new theories and contentions, there is now essential agreement that the osseous dysplasias represent a single disease process, while the so-called "juvenile active ossifying fibroma" and other "aggressive," "active," "psammomatoid" ossifying/cementifying fibromas remain controversial. This review is presented to update the surgical pathologist on the various entities comprising the spectrum of BFOL and to examine the criteria for their diagnosis.
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Affiliation(s)
- R B Brannon
- Department of Oral and Maxillofacial Pathology, Louisiana State University Health Sciences Center, Dental School, New Orleans 70119, USA.
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