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Bone Reports Dec 2023Non-ossifying fibroma (NOF) is one of the most commonly seen benign bone tumours. Although renowned for their benign behaviour and tendency for spontaneous healing,...
BACKGROUND AND PURPOSE
Non-ossifying fibroma (NOF) is one of the most commonly seen benign bone tumours. Although renowned for their benign behaviour and tendency for spontaneous healing, these tumours can occasionally exhibit an aggressive course. Few published papers have focused on the treatment options of symptomatic NOFs.The aim of this case report is to discuss the clinical presentation of a painful and unusually aggressive multiple NOF of the distal tibia in a female adolescent patient.
CASE PRESENTATION
The case of a 17-year-old female patient who was complaining of a painful swollen right lower leg for the past few months. The symptoms became gradually worse, preventing her from sporting activities and becoming more and more debilitating. The patient was diagnosed with a particularly aggressive multiple non-ossifying fibroma of the distal tibia and fibula. She was treated with lesion curettage, bone grafting and external fixation with good clinical and radiological outcomes.
CONCLUSION
Non-ossifying fibroma is a benign lesion that only requires observation in most of the cases. However, symptomatic lesions with aggressive behaviour or complicated with pathologic fracture may warrant surgical intervention.
PubMed: 37859796
DOI: 10.1016/j.bonr.2023.101721 -
Dental Clinics of North America Apr 2024This review directs the focus on the imaging features of various fibro-osseous lesions and other bone lesions that can be of similar presentation. Broad diagnosis of... (Review)
Review
This review directs the focus on the imaging features of various fibro-osseous lesions and other bone lesions that can be of similar presentation. Broad diagnosis of "fibrous osseous lesion" may culminate in improper treatment and management. Radiographic discriminating factors between these entities are highlighted and summarized to improve the diagnostic process when encountering these lesions.
Topics: Humans; Diagnostic Imaging; Jaw; Fibroma, Ossifying; Fibrous Dysplasia of Bone
PubMed: 38417992
DOI: 10.1016/j.cden.2023.09.005 -
Indian Journal of Pathology &... Jul 2023Hybrid tumors are rare lesions having features of multiple diseases in one lesion. A hybrid tumor of central giant cell granuloma (CGCG) and central ossifying fibroma...
Hybrid tumors are rare lesions having features of multiple diseases in one lesion. A hybrid tumor of central giant cell granuloma (CGCG) and central ossifying fibroma (COF) shows the presence of microscopically large areas with CGCG character and large areas with COF features inside a single clinical lesion, separated by a transition zone. A rare type of COF is juvenile ossifying fibroma (JOF)-trabecular variant in the mandible. We present a unique and rare case of a hybrid tumor of the CGCG-JOF-trabecular variant in the mandible of a 14-year-old female which initially diagnosed with CGCG. The ambiguous pathogenesis of hybrid tumors and giant cells is reviewed. The goal of this article is to highlight the importance of careful clinical, radiological, and histopathological examination of each case to prevent misdiagnoses and recurrences. Similar and other cases must be reported in order to better understand the interrelationship between these hybrid lesions and their biological behavior.
PubMed: 38391302
DOI: 10.4103/ijpm.ijpm_623_22 -
International Journal of Surgery Case... Oct 2023Juvenile trabecular ossifying fibroma is a rare benign tumor of childhood affecting the facial bones rarely described in literature. Its aggressive growth and high...
INTRODUCTION AND IMPORTANCE
Juvenile trabecular ossifying fibroma is a rare benign tumor of childhood affecting the facial bones rarely described in literature. Its aggressive growth and high tendency of recurrence make it a real challenge for diagnosis and care.
CASE PRESENTATION
This article presents a case of an extensive juvenile trabecular ossifying fibroma of the maxilla in a 14-year-old boy, which required surgical intervention with immediate bone reconstruction using an autogenous graft (iliac crest). No recurrence has been found after two and a half years of follow-up.
CLINICAL DISCUSSION
Common symptoms of juvenile trabecular ossifying fibroma include painless swelling, facial asymmetry, jaw deformity and teeth displacement. Differential diagnosis should consider other forms like psammomatoid ossifying fibroma, osteofibrous dysplasia, fibrous dysplasia, ameloblastoma, odontoma, or even poorly differentiated carcinoma.
CONCLUSION
Currently, there is no recommendation or consensus for the treatment of juvenile trabecular ossifying fibroma. The objective of treatment is also to preserve growth and development and conserve the nervous structure and the function, as mastication, vision. Early diagnosis and appropriate care are essential to prevent morphological and functional defects in young patients. Regular and long-term follow-up is essential due to the high recurrence rate.
PubMed: 37703694
DOI: 10.1016/j.ijscr.2023.108620 -
Trauma Case Reports Oct 2023Non-ossifying fibromas are extremely rare in the upper extremity, such as those in the radius and humerus. The treatment of completely displaced fractures following...
Non-ossifying fibromas are extremely rare in the upper extremity, such as those in the radius and humerus. The treatment of completely displaced fractures following non-ossifying fibromas in the radius has not been reported. We present the case of a pathological fracture caused by a non-ossifying fibroma in the radius treated using external fixation. The patient was a 10-year-old girl who presented to our hospital with right forearm pain after an accidental fall. She had no remarkable medical history. Radiographs and computed tomography showed a pathological fracture through osteolytic lesions with sclerotic rims in the diaphysis of the radius, suggesting a pathological fracture through a non-ossifying fibroma in the radius. We performed tumor curettage and external fixation due to marked fracture displacement. Histological findings were compatible with those of non-ossifying fibroma. Six months post-surgery, there were no limitations in the range of motion of supination and pronation of the forearm, and radiographs confirmed a bone union. Although non-ossifying fibromas in the radius are rare, cases with large lesions can cause pathological fractures after minor trauma. This case suggests that curettage and external fixation are beneficial, especially if early surgery is required due to unacceptable displacement and when there is no time for a biopsy to rule out malignancy.
PubMed: 37592955
DOI: 10.1016/j.tcr.2023.100895 -
Oral Diseases May 2024In this study, our aim was to develop and validate the effectiveness of diverse radiomic models for distinguishing between gnathic fibrous dysplasia (FD) and ossifying...
OBJECTIVE
In this study, our aim was to develop and validate the effectiveness of diverse radiomic models for distinguishing between gnathic fibrous dysplasia (FD) and ossifying fibroma (OF) before surgery.
MATERIALS AND METHODS
We enrolled 220 patients with confirmed FD or OF. We extracted radiomic features from nonenhanced CT images. Following dimensionality reduction and feature selection, we constructed radiomic models using logistic regression, support vector machine, random forest, light gradient boosting machine, and eXtreme gradient boosting. We then identified the best radiomic model using receiver operating characteristic (ROC) curve analysis. After combining radiomics features with clinical features, we developed a comprehensive model. ROC curve and decision curve analysis (DCA) demonstrated the models' robustness and clinical value.
RESULTS
We extracted 1834 radiomic features from CT images, reduced them to eight valuable features, and achieved high predictive efficiency, with area under curves (AUC) exceeding 0.95 for all the models. Ultimately, our combined model, which integrates radiomic and clinical data, displayed superior discriminatory ability (AUC: training cohort 0.970; test cohort 0.967). DCA highlighted its optimal clinical efficacy.
CONCLUSION
Our combined model effectively differentiates between FD and OF, offering a noninvasive and efficient approach to clinical decision-making.
PubMed: 38813877
DOI: 10.1111/odi.14984 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Dec 2023Cemento-ossifying fibroma (COF) is a mesenchymal benign odontogenic tumor, which may lead to impacted or ectopic permanent teeth. Autotransplantation of teeth is a...
Cemento-ossifying fibroma (COF) is a mesenchymal benign odontogenic tumor, which may lead to impacted or ectopic permanent teeth. Autotransplantation of teeth is a surgical process, in which a tooth is transplanted from one position to another in the same individual. This method can effectively restore the patient's mastication and aesthetics and is feasible in replacing missing teeth. This study reports a case of simultaneous COF resection combined with heterotopic canine autotransplantation to repair dentition defect, which effectively promotes the restoration of bone continuity and stability and achieves immediate and long-term aesthetic function requirements.
Topics: Humans; Cementoma; Transplantation, Autologous; Esthetics, Dental; Fibroma, Ossifying; Odontogenic Tumors
PubMed: 38597041
DOI: 10.7518/hxkq.2023.2023103 -
Indian Journal of Pathology &... Feb 2024Indistinct and analogous histopathological features of various fibro-osseous lesions make establishing a definitive diagnosis a challenge. There is a need for additional...
BACKGROUND
Indistinct and analogous histopathological features of various fibro-osseous lesions make establishing a definitive diagnosis a challenge. There is a need for additional molecular and histochemical tools to support and differentiate these lesions in order to establish a concrete diagnosis.
MATERIALS AND METHODS
A retrospective analysis of biopsied lesions in formalin-fixed paraffin-embedded sections (10 cases each of fibrous dysplasia, ossifying fibroma, and cement-osseous dysplasia) retrieved from the archives was studied for immunoexpression of osteocalcin (quantitative analysis in osteocytes), collagen characterization using Azan, Picrosirus, and Toluidine blue stain for evaluating intensity and localization of collagen fibers, and morphometric analysis of vasculature (for evaluating mean vessel density as square microns).
RESULTS
Positive immunostaining of osteocalcin suggested mutations of the GNAS-1 gene found in fibrous dysplasia indirectly, as it is a negative regulator of bone formation. Osteocalcin immunopositivity was quantitatively measured in the fibro-osseous lesions, with fibrous dysplasia measuring 14.47 ± 3.628 as compared to ossifying fibroma measuring 5.23 ± 1.33, followed by cemento-osseous dysplasia measuring 2.30 ± 1.409. Toluidine blue suggests the presence of oxytalan fibers (resistant to acid hydrolysis) in ossifying fibroma and cemento-osseous dysplasia, pointing toward the pathogenesis of the lesion. Azan stain and Picrosirus (under a polarizing microscope) helped in distinguishing hard tissue characteristics (70% of cases of fibrous dysplasia showed only a magenta component followed by intermixed magenta with a blue component in 20% of cases and only 10% of cases showed magenta with blue borders whereas for ossifying fibroma, 40% of cases depicted magenta with blue borders along with the other 40% with intermixed magenta with blue component). The mean vessel density was also highest in fibrous dysplasia measuring 7.90 ± 1.079 (in Sq. micron area), followed by ossifying fibroma and cemento-osseous dysplasia.
CONCLUSION
The diagnosis of fibro-osseous lesions by hematoxylin and eosin alone is confusing and thus should be supported by relatively simple histomorphometric analysis for better treatment outcomes. At the diagnostic stage of fibro-osseous lesions, evaluation of intralesional vessel size, reliable molecular marker, and histochemical nature can aid in differentiating fibrous dysplasia from central ossifying fibroma and cemento-osseous dysplasia alongside, other clinical, radiographic and pathological criteria. These parameters help in the diagnostic decision-making of fibro-osseous lesions.
PubMed: 38391368
DOI: 10.4103/ijpm.ijpm_918_22 -
Head and Neck Pathology Dec 2023
Topics: Humans; Fibroma, Ossifying; Mandible; Mandibular Neoplasms; Soft Tissue Neoplasms; Skull Neoplasms
PubMed: 37943466
DOI: 10.1007/s12105-023-01599-x -
Surgical Neurology International 2024Fibro-osseous lesions include a variety of bone lesions with different clinical and histopathological features.
BACKGROUND
Fibro-osseous lesions include a variety of bone lesions with different clinical and histopathological features.
CASE DESCRIPTION
We report a case of cemento-ossifying lesion involving the left ethmoid and sphenoid sinus in a 17-year-old male patient. Computed tomography showed an expansile hyperdense lesion with sclerosed peripheral mantle epicentered on the left ethmoid and sphenoid sinus and extending into the left nasal cavity. Magnetic resonance imaging was done for preoperative planning. Transnasal endoscopic resection was performed and histopathological examination confirmed the diagnosis of ossifying fibroma (OF).
CONCLUSION
Involvement of the ethmoid sinus with OF is a rare condition; therefore, we examined the literature for similar cases to highlight the possible clinical presentation and management. Endoscopic management is a safe, effective approach with a low rate of complications.
PubMed: 38468684
DOI: 10.25259/SNI_182_2023