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Cureus Feb 2024This case report describes a 67-year-old woman who developed an extensive, slow-growing lesion occupying the whole of the palate in 10 years. Considering clinical and...
This case report describes a 67-year-old woman who developed an extensive, slow-growing lesion occupying the whole of the palate in 10 years. Considering clinical and radiographic features, calcifying neoplasms were considered. Correlating microscopic features with clinical features, the lesion was diagnosed as peripheral ossifying fibroma, which seldom presents as an extensive lesion on the palate amongst the elderly age group. This case report will highlight clinicians and pathologists about a rare presentation of a commonly encountered lesion with a comprehensive view of the differential diagnosis of other comparable lesions.
PubMed: 38558750
DOI: 10.7759/cureus.55287 -
Journal of Cancer Research and... Jan 2024Fibro-osseous lesions (FOLs) of the craniomaxillofacial region comprise a group of developmental, dysplastic, and neoplastic alterations. FOLs include ossifying fibromas...
Fibro-osseous lesions (FOLs) of the craniomaxillofacial region comprise a group of developmental, dysplastic, and neoplastic alterations. FOLs include ossifying fibromas (OF), cemento-ossifying fibroma (COF), familial gigantiform cementoma (FGC), fibrous dysplasia (FD), and cemento-osseous dysplasia (COD). Evidence suggests that some FOL, especially FD and OF may have a risk of spontaneous malignant transformation. This report documents a rare case of malignant transformation of ossifying fibromas of the jaw and the probable cause for same. Although it is rare, the clinician should have a complete follow up to observe such changes among the patients having FOLs.
Topics: Humans; Fibroma, Ossifying; Cementoma; Jaw Neoplasms; Odontogenic Tumors; Fibrous Dysplasia of Bone
PubMed: 38554359
DOI: 10.4103/jcrt.jcrt_1757_22 -
Cureus Feb 2024Benign osseous tumors of mesodermal origin that are included within the group of fibro-osseous lesions include cemento-ossifying fibromas (COFs). The fibrocellular...
Benign osseous tumors of mesodermal origin that are included within the group of fibro-osseous lesions include cemento-ossifying fibromas (COFs). The fibrocellular component of these diseases originates from the periodontal ligament, which deposits bone and cementum encased in fibrous tissue. It typically appears in the mandible and presents as a solitary, nonaggressive, slowly developing, asymptomatic, expansile lesion, rarely occurring in the maxilla. The only intervention that proved to be successful in producing excellent outcomes and that may be regarded as a final therapeutic option is the complete surgical removal of COFs. Presenting herein is a case report describing a painless and expansile mass in the left mandibular region, histopathologically diagnosed as COF.
PubMed: 38550404
DOI: 10.7759/cureus.55063 -
Journal of Dentistry (Shiraz, Iran) Mar 2024Fibro-osseous lesions (FLs), may rarely exhibit malignant features likewise undergo malignant transformation. Awareness of these features can assist in screening for...
STATEMENT OF THE PROBLEM
Fibro-osseous lesions (FLs), may rarely exhibit malignant features likewise undergo malignant transformation. Awareness of these features can assist in screening for potentially malignant cases and identifying low-grade central osteogenic sarcoma (LGCOS) that may mimic FLs.
PURPOSE
The objective of this study was to determine the usability of an index in predicting malignant changes in jaw FLs.
MATERIALS AND METHOD
This was a retrospective study where hematoxylin and eosin (H&E) slides and archival records of fibrous dysplasia (FD) and ossifying fibroma (OF) cases were reviewed. The sections were assessed for permeation of marrow spaces, stromal growth pattern, cytologic atypia, mitotic activity, and pattern of bone growth, which are parameters for diagnosing LGCOS. The predictive histologic index of malignancy (PHIM) was determined by a sum of the scores and graded as 0=nil, 1=low, 2 & 3=moderate, and 4 & 5=high. Data were presented using descriptive analysis.
RESULTS
Ninety-three cases of FLs met the inclusion criteria, consisting of 40(43%) cases of FD and 53(57%) cases of OF. The peak age of presentation for FD and OF was 2 and 3 decade. There was a female preponderance of 1:1.6. The maxilla was the most common site affected by FD, while the mandible was most commonly affected by OF. For FD cases, the PHIM was moderate in 10(25%) cases and low in 21(52.5%) cases. Similarly, for OF cases, 30(56.6%) cases had low grade PHIM while 10(17%) cases had moderate grade PHIM.
CONCLUSION
The PHIM depicted low to moderate malignancy grade in some of the cases studied. Follow up studies would be necessary to assess the PHIM.
PubMed: 38544774
DOI: 10.30476/dentjods.2023.96389.1935 -
World Neurosurgery: X Jul 2024The aesthetic reconstruction of disfiguring cranio-facial defects after tumour excision can be quite challenging to the neurosurgeon with limited resources. The choice...
BACKGROUND
The aesthetic reconstruction of disfiguring cranio-facial defects after tumour excision can be quite challenging to the neurosurgeon with limited resources. The choice of cranioplasty implant, intraoperative technicalities and the patients' postoperative appearance are critical considerations in management. There are a number of synthetic materials available for cranioplasty, however, the customised implants are not readily available in our practice setup. They are also mostly constructed and contoured after the bony defect has been created or require sophisticated software construction pre-operatively.
METHODS
Eight patients with cranio-facial tumour pathologies who presented to our neurosurgical service, and had titanium mesh cranioplasty for the correction of cosmetically disfiguring cranio-facial tumours.
RESULTS
There were 6 females, and 2 male patients respectively, with an age range between 28 and 74years. The histological diagnoses were meningioma, frontal squamous cell carcinoma, fibrous dysplasia, frontal mucocoele, cemeto-ossifying fibroma, osteoma, and naso-ethmoidal squamous cell carcinoma. The patient with naso-ethmoidal squamous cell carcinoma had post-operative subgaleal empyema which was amenable to incision and drainage procedure. The patient with a frontal cemento-ossifyng fibroma had a transient immediate post-operative mechanical ptosis, which resolved completely in 3months. All of the total eight patients (100%) had satisfactory cosmetic outlook at a minimum follow up period of 1month post-operatively (Numeric Rating Scale of at least 7/10). One of the patients required a revision surgery on account of implant displacement.
CONCLUSION
Cranioplasty is a common reconstructive neurosurgical procedure. It is important to the neurosurgeon for its neuro-protective function, and in the restoration of intra-cranial CSF dynamics. However, the cosmetic outlook appears to be more important to patients in the absence of pain and/or neurological deficits. Titanium mesh reconstruction is commonly used globally, and is becoming the preferred choice in low resource settings.
PubMed: 38533234
DOI: 10.1016/j.wnsx.2024.100362 -
Case Reports in Dentistry 2024Peripheral ossifying fibroma (POF) is a benign swelling of the gingival connective tissue commonly associated with dental biofilm and biofilm-retentive dental...
Peripheral ossifying fibroma (POF) is a benign swelling of the gingival connective tissue commonly associated with dental biofilm and biofilm-retentive dental appliances. In the present case report, we described three cases of POF with different clinical presentations and treatment approaches. The treatment consisted of the removal of supra- and subgingival calculus, followed by a flap surgery with excision of the entire lesion ensuring the inclusion of the periosteal bed. The first patient developed POF during her pregnancy that remained clinically noticeable postpartum. The second case represented a rare case of POF appearing on the palatal aspect of the anterior maxilla of an African American male. The third case represented POF that developed on the mandible, and contrary to the first two cases, it was excised using a diode laser and not a scalpel blade. All patients showed uneventful healing during follow-up appointments; however, poor patient compliance did not allow for evaluation of long-term healing responses and possible recurrence of the lesion. Within the limitations of this clinical report, it is evident that the periodontal surgical approach was effective in managing POF with stable short-term clinical outcomes.
PubMed: 38501031
DOI: 10.1155/2024/3683561 -
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 -
Cureus Feb 2024Osteosarcoma is primarily a long-bone disease that rarely affects the facial bones. Chondroblastic osteosarcoma is a subvariant of osteosarcoma. Its defining...
Osteosarcoma is primarily a long-bone disease that rarely affects the facial bones. Chondroblastic osteosarcoma is a subvariant of osteosarcoma. Its defining characteristics include the presence of malignant spindle and polygonal cells, as well as a thick layer of chondroid matrix and interwoven neoplastic tissue deposition. Mandibular chondroblastic osteosarcoma, in particular, is often overlooked and disregarded as a presumptive diagnosis at the time of initial presentation. This is mainly because of its rarity or inadequate lesion evaluation. Here, we present the case of a 47-year-old female patient with a rapidly growing swelling at the anterior mandible that was initially misdiagnosed as an ossifying fibroma of the mandible. The subsequent histopathological examination confirmed the diagnosis of chondroblastic osteosarcoma of the mandible. The patient requested a more extensive and aggressive excision, with the possibility of adjuvant radiation or chemotherapy. This article illustrates a rare case of mandibular chondroblastic osteosarcoma, with a focus on the clinical and pathological features of the tumor that should be taken into account when making a differential diagnosis for oral bone lesions.
PubMed: 38455794
DOI: 10.7759/cureus.53713 -
Indian Journal of Otolaryngology and... Feb 2024Non-ossifying fibroma (NOF) of jaw bones are rare. While NOF is the most common benign bone tumor of long bones with pathognomonic radiological features and bear a...
Non-ossifying fibroma (NOF) of jaw bones are rare. While NOF is the most common benign bone tumor of long bones with pathognomonic radiological features and bear a tendency for self-regression, gnathic NOF appears to be comparatively larger in size and behave more aggressively. A 16 years old female patient reported with painless swelling of the right side of the face of 4 months duration. Radiographic analysis showed a unilocular radiolucent lesion of right angle of the mandible with ill-defined margins, cortical perforation and thinning of inferior border. The lesion was provisionally diagnosed as odontogenic keratocyst/unicystic ameloblastoma and incisional biopsy was performed. The histopathological features and immunohistochemical characteristics favored a diagnosis of NOF. The lesion was excised and reconstructed. The excised specimen confirmed the diagnosis. There are no signs of recurrence at 18 months follow-up. NOF should be considered in the differential diagnosis of uni-/multilocular radiolucencies of jaws particularly the posterior mandible.
PubMed: 38440574
DOI: 10.1007/s12070-023-04110-8 -
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