Osteoblastoma of the mandible: Clinicopathologic study of four cases and literature review

Osteoblastoma and Osteoid Osteoma of the Mandible: Review of the Literature and Report of Two Cases

Osteoblastoma and osteoid osteoma are rare benign neoplasms of the jaws. We reviewed current literature surrounding the ongoing debate over similarities and differences of osteoblastoma and osteoid osteoma and present two cases. Both cases are well-demarcated mixed radiodensity mandibular lesions with histological features of osteoblastoma. They exhibit, however, distinctly unique and contrasting clinical and imaging characteristics suggesting that the first case is osteoblastoma and the second is osteoid osteoma. The first case of a 37-year-old male presents with a large, expansile lesion at posterior mandible, surrounded by a thick sclerotic band. Unusual features include significant buccal/lingual expansion, extensive new bone apposition, and soft tissue edema in the masseter muscle. This is in contrast to the second case of a much smaller lesion in a 17-year-old male with history of recent third molar extraction in the left posterior mandible. In this case, CT imaging revealed a circular, nonexpansile lesion with a sclerotic border surrounded by a radiolucent rim. Both patients underwent surgical excision of the lesion with extraction of the adjacent tooth. We discuss herein the distinct clinical and imaging features.

Benign osteoblastoma of the mandible in a 12-year-old female: A case report

Benign osteoblastoma refers to a benign tumor of the bone. Osteoblastoma most commonly affects the vertebrae and long tubular bones, however, in rare cases is observed in the facial bones. The current study presents the case of a 12-year-old female patient with a tumor in the mandibular body. Radiological imaging revealed a lesion with regular contours. The lesion was radically resected and histological analysis of the specimen demonstrated features that are typical of a benign osteoblastoma. The consequential defects of the jaw were reconstructed using titanium implants and autologous bone transplantation. The patient remains disease free subsequent to a five-month follow-up period. The aim of the present report is to present a rare case of benign osteoblastoma of the mandible. This study demonstrated that correct diagnosis and complete surgical excision are important to reduce the risk of recurrence of a benign osteoblastoma.

Two cases of multiple ossifying fibromas in the jaws

BACKGROUND

The clinicopathologic characteristics of multiple ossifying fibroma (OF) are unclear due to the condition's rarity, making diagnosis challenging. Sporadic multiple OFs must be distinguished from hyperparathyroidism-jaw tumour syndrome (HPT-JT) related OF and other fibro-osseous lesions.

METHODS

Multiple OF cases were identified from ossifying fibroma cases. Clinical data including age, sex, anatomic site, radiographic features, clinical impression, treatment and available follow-up data as well as serum calcium, phosphorus, and parathyroid hormone (PTH) were recorded. GNAS and HRPT2 genetic mutations were examined in the two present cases. Case reports of sporadic multiple ossifying fibroma and HPT-JT-related OF were also reviewed.

RESULTS

The two present cases were confirmed as sporadic multiple OF, with no genetic GNAS and HRPT2 mutations found. The incidence of sporadic multiple ossifying fibroma was 2.0% (2/102). The total 18 sporadic multiform OF cases were characterized as followed: 13 (72.2%) female; 5 (27.8%) male; mean age 28.6 years; 2/16 (11.1%) cases only in the mandible; 4/18 (22.2%) cases only in the maxilla; and 12/18 (66.7%) cases in both the maxilla and mandible. Radiographically, the lesions were radiolucent in 5/18 (27.8%) cases and mixed density in 13/18 (72.2%) cases. Along with 24 cases of HPT-JT related OF were reviewed, sixteen (66.7%) patients were diagnosed with a single lesion, and 8 patients (33.3%) were diagnosed with multiple jaw lesions.

CONCLUSIONS

Sporadic multiple OFs are very rare, but must be distinguished from HPT-JT related OF. We strongly recommend that patients diagnosed with multiple ossifying fibromas receive serum PTH testing and mutation screening of HRPT2.

VIRTUAL SLIDES

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Osteoblastoma of the mandible mimicking osteosarcoma in FDG PET/CT imaging. Clin Nucl Med. 2013;38:143-144. [PMID: 23334133 DOI: 10.1097/rlu.0b013e318279f131]

Osteoblastomas are rare tumors accounting for approximately 1% of all primary bone tumors. We report a case of osteoblastoma of the mandible with high FDG uptake. Initially, this lesion was judged as an osteosarcoma. Osteoblastomas are benign slow-growing tumors. High-resolution thin-slice CT images of the lesion as part of the PET/CT study help to characterize its morphology and extension, thus facilitating biopsy planning and resection. Approximately 25% of osteoblastomas initially have the imaging appearance of a malignant tumor. In our case, complete resection of the lesion followed by reconstruction with a bone graft was performed.

Fibro-osseous lesions of the maxillofacial bones

Fibro-osseous lesions of the maxillofacial bones should be classified based on their radiographic growth pattern. This method can simplify this category of lesions, which have considerable overlapping histologic features. These neoplasms can be grouped into three categories: (a) fibrous dysplasia; (b) ossifying fibroma; (c) and osseous dysplasia. Important lesions in the differential diagnosis are osteoblastoma and giant cell reparative granuloma.

Benign osteoblastoma of the ethmoid sinus

Osteoblastoma is categorized as a benign bone-forming tumor, which occurs rarely in the craniofacial region. We report a case of osteoblastoma developed in the nasal cavity and ethmoid sinus in a 14-year-old girl whose chief symptom was nasal obstruction and exophthalmos on the right side. CT revealed the lesion having the same density as bone and a ground-glass border, expanding to the nasal and paranasal cavities. Complete removal was accomplished under endoscopic view, although the tumor was removed piece by piece. Histologic inspection showed exuberant osteoid trabeculae and immature bone formation by osteoblasts with vascularized connective tissue. We diagnosed the tumor as osteoblastoma based on the clinical presentation and the size of the tumor. No recurrence was evident at the 1-year follow-up visit.

Benign osteoblastoma involving maxilla: a case report and review of the literature

Background. Osteoblastoma is a rare benign tumor. This tumor is characterized by osteoid and bone formation with the presence of numerous osteoblasts. The lesion is more frequently seen in long bones and rarely involves maxilla and mandible. Due to its clinical and histological similarity with other bone tumors such as osteoid osteoma and fibro-osseous lesions, osteoblastoma presents a diagnostic dilemma. Case Report. Very few cases of osteoblastomas involving maxillofacial region have been reported in the literature. This case report involves osteoblastoma involving right maxilla in an 18-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, surgical excision was performed. The patient was followed up for a period of 3 years and was disease free. Summary and Conclusion. Benign osteoblastoma involving jaw bones is a rare tumor. There is a close resemblance of this tumor with other lesions such as fibro-osseous lesions and odontogenic tumors and thus faces a diagnostic challenge. Surgical excision with a long-term follow-up gives good prognosis to this lesion—Benign Osteoblastoma.

Osteoblastoma of the jaws: report of a case and review of literature

Benign osteoblastoma (OB) is a rare tumor of bone representing less than 1% of all tumors of the maxillofacial region. Vertebral column, sacrum, long bones, and calvarium are more frequent sites of this tumor. Clinically, patients present with pain and swelling. Histologically, contain a well vascularized, osteoblastic connective tissue stroma and occasionally, osteoclasts along with osteoid and varying degrees of calcification, as well as immature bone may also be noted. The main aim of this report is present a case of OB occurring in the mandible and a brief review of English Medical Literature of this tumor. Many bone-producing lesions possess some overlapping clinical, radiographic or histopathological findings similar to osteoblastoma. Understanding and correlating all features helps in correct diagnosis and adequate management of this rare entity. Hence, osteoblastoma has to be differentiated from other bone lesions for correct diagnosis.

Osteoblastoma of the jaws: report of a case and review of literature

Benign osteoblastoma (OB) is a rare tumor of bone representing less than 1% of all tumors of the maxillofacial region. Vertebral column, sacrum, long bones, and calvarium are more frequent sites of this tumor. Clinically, patients present with pain and swelling. Histologically, contain a well vascularized, osteoblastic connective tissue stroma and occasionally, osteoclasts along with osteoid and varying degrees of calcification, as well as immature bone may also be noted. The main aim of this report is present a case of OB occurring in the mandible and a brief review of English Medical Literature of this tumor. Many bone-producing lesions possess some overlapping clinical, radiographic or histopathological findings similar to osteoblastoma. Understanding and correlating all features helps in correct diagnosis and adequate management of this rare entity. Hence, osteoblastoma has to be differentiated from other bone lesions for correct diagnosis.

Osteoblastoma of the hyoid bone

Osteoblastoma is a rare bone tumor that usually affects the vertebrae. We present the first known case of osteoblastoma arising in the hyoid bone, in a patient who presented with a neck mass and dysphagia. The radiographic appearance of the tumor is similar to that of low-grade chondrosarcoma, with well-defined expansion of the bone and central chondroid matrix.