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Journal of Medical Case Reports May 2024Peripheral ossifying fibroma is a nonneoplastic inflammatory hyperplasia that originates in the periodontal ligament or periosteum in response to chronic mechanical... (Review)
Review
BACKGROUND
Peripheral ossifying fibroma is a nonneoplastic inflammatory hyperplasia that originates in the periodontal ligament or periosteum in response to chronic mechanical irritation. Peripheral ossifying fibroma develops more commonly in young females as a solitary, slow-growing, exophytic nodular mass of the gingiva, no more than 2 cm in diameter. While various synonyms have been used to refer to peripheral ossifying fibroma, very similar names have also been applied to neoplastic diseases that are pathologically distinct from peripheral ossifying fibroma, causing considerable nomenclatural confusion. Herein, we report our experience with an unusual giant peripheral ossifying fibroma with a differential diagnostic challenge in distinguishing it from a malignancy.
CASE PRESENTATION
A 68-year-old Japanese male was referred to our department with a suspected gingival malignancy presenting with an elastic hard, pedunculated, exophytic mass 60 mm in diameter in the right maxillary gingiva. In addition to computed tomography showing extensive bone destruction in the right maxillary alveolus, positron emission tomography with computed tomography revealed fluorodeoxyglucose hyperaccumulation in the gingival lesion. Although these clinical findings were highly suggestive of malignancy, repeated preoperative biopsies showed no evidence of malignancy. Since even intraoperative frozen histological examination revealed no malignancy, surgical resection was performed in the form of partial maxillectomy for benign disease, followed by thorough curettage of the surrounding granulation tissue and alveolar bone. Histologically, the excised mass consisted primarily of a fibrous component with sparse proliferation of atypical fibroblast-like cells, partly comprising ossification, leading to a final diagnosis of peripheral ossifying fibroma. No relapse was observed at the 10-month follow-up.
CONCLUSIONS
The clinical presentation of giant peripheral ossifying fibromas can make the differential diagnosis from malignancy difficult. Proper diagnosis relies on recognition of the characteristic histopathology and identification of the underlying chronic mechanical stimuli, while successful treatment mandates complete excision of the lesion and optimization of oral hygiene. Complicated terminological issues associated with peripheral ossifying fibroma require appropriate interpretation and sufficient awareness of the disease names to avoid diagnostic confusion and provide optimal management.
Topics: Humans; Fibroma, Ossifying; Male; Aged; Diagnosis, Differential; Gingival Neoplasms; Maxillary Neoplasms; Tomography, X-Ray Computed; Maxilla
PubMed: 38702820
DOI: 10.1186/s13256-024-04529-9 -
Pathology, Research and Practice May 2024Adenomatoid Odontogenic Tumor (AOT) accounts for 3% of all odontogenic tumors. It has been classified by WHO as an odontogenic tumor of purely epithelial origin. The...
BACKGROUND
Adenomatoid Odontogenic Tumor (AOT) accounts for 3% of all odontogenic tumors. It has been classified by WHO as an odontogenic tumor of purely epithelial origin. The current study attempts to establish the origin of the tumor along with detailed histopathological and clinicoradiographic analysis of 43 cases of AOT.
MATERIAL AND METHODS
Forty-three cases were reviewed from the departmental archives for demographic data, radiographic features and histological features. Further, histopathological slides were stained with Picrosirius Red (PSR) and observed under polarised light.
RESULTS
A majority of the cases were seen in the anterior jaws (76.7%), and were less than 3 cms (76.7%) in greatest dimension. Equal number of cases were of follicular and extra-follicular location while one was peripheral. Predominantly solid histological pattern was noted in 53.5%. Varied sub-patterns were observed with most cases exhibiting solid nodules and strands of tumor cells. Few cases showed melanin pigmentation. Over a third of cases (37.2%) showed dentigerous cyst like areas and one case each showed features of ossifying fibroma and focal cemento-osseous dysplasia. Tumor droplets, hyaline rings within duct-like structures, dentinoid material and osteodentin showed reddish yellow birefringence when observed under polarised microscopy post PSR staining.
CONCLUSION
This study highlights the diverse histopathological variation of AOT with evidence to reclassify it as a mixed odontogenic tumor based on the polarising microscopic findings with PSR staining.
Topics: Humans; Female; Male; Adult; Middle Aged; Adolescent; Young Adult; Child; Ameloblastoma; Odontogenic Tumors; Jaw Neoplasms; Aged
PubMed: 38688202
DOI: 10.1016/j.prp.2024.155322 -
Heliyon Apr 2024Sturge-Weber syndrome (SWS) is a neurocutaneous syndrome with vascular lesions of the cerebral meninges, port wine spots on the face, and glaucoma of the eyes; it is a...
Sturge-Weber syndrome (SWS) is a neurocutaneous syndrome with vascular lesions of the cerebral meninges, port wine spots on the face, and glaucoma of the eyes; it is a congenital, non-genetic disease whose etiology and mechanisms are unknown. In this report, we describe a rare case of SWS with unilateral large odontogenic tumors in the maxilla and mandible. The histopathological diagnosis of the maxillary bone lesion on biopsy was juvenile psammomatoid ossifying fibroma, which is considered a type of ossifying fibroma of craniofacial bone origin. However, the final pathological diagnosis of the excision was cemento-ossifying fibroma derived from periodontal ligament cells, and we discuss the histopathology in detail. In addition, the mandibular lesion was one of the largest odontomas reported to date. Furthermore, in this case, we suggest the possibility that the maxillary and mandibular bone lesions are not separate lesions, but a series of lesions related to SWS.
PubMed: 38660248
DOI: 10.1016/j.heliyon.2024.e29445 -
Journal of Surgical Case Reports Apr 2024Juvenile ossifying fibroma (JOF) and its variants, including juvenile psammomatoid ossifying fibroma (JPOF), represent rare yet clinically significant benign...
Juvenile ossifying fibroma (JOF) and its variants, including juvenile psammomatoid ossifying fibroma (JPOF), represent rare yet clinically significant benign fibro-osseous lesions that primarily occur in children and young adolescents. They can be found in diverse anatomical sites such as the jaw, nasal cavity, paranasal sinuses, and orbit. JOF exhibits an aggressive nature, necessitating early radiological detection and surgical intervention. Similarly, JPOF, with a locally malignant potential, requires surgical removal, typically conducted through endoscopic approaches. We report a case of a 5-year-old girl with JPOF arising in the ethmoid, revealed by recurrent epistaxis and proptosis. The text emphasizes the importance of early diagnosis through histopathology as a diagnostic tool and underscores the need for appropriate management.
PubMed: 38650975
DOI: 10.1093/jscr/rjae242 -
Cancer Reports (Hoboken, N.J.) Apr 2024Psammomatoid ossifying fibroma (POF) is a rare craniofacial neoplasm, primarily affecting the maxillofacial region, and typically observed in adolescents and young...
BACKGROUND
Psammomatoid ossifying fibroma (POF) is a rare craniofacial neoplasm, primarily affecting the maxillofacial region, and typically observed in adolescents and young adults. This case report presents a unique occurrence of POF in a 50-year-old male, defying the conventional age range and exhibiting an unusual anatomical location within the frontal sinus.
CASE
A 50-year-old male with a prior history of cecal adenocarcinoma and colectomy presented with left eye proptosis and new-onset headaches. Imaging revealed a well-defined calcified mass in the left frontal sinus, leading to a diagnosis of POF. Open surgical resection was performed to remove the tumor, and histopathological evaluation confirmed its diagnosis as psammomatoid ossifying fibroma. The patient exhibited no postoperative complications or signs of recurrence.
CONCLUSION
This case underscores the diverse clinical presentations and diagnostic challenges associated with POF, emphasizing the importance of accurate diagnosis and multidisciplinary collaboration. Further research is needed to explore the genetic underpinnings and optimal management strategies for this intriguing condition.
Topics: Male; Adolescent; Humans; Middle Aged; Fibroma, Ossifying; Frontal Sinus; Tomography, X-Ray Computed; Soft Tissue Neoplasms
PubMed: 38627899
DOI: 10.1002/cnr2.2063 -
BMJ Case Reports Apr 2024Nasal obstruction is a commonly reported issue in the Otorhinolaryngology Outpatient Department. In this case, an early adolescent boy with a long-standing problem of...
Nasal obstruction is a commonly reported issue in the Otorhinolaryngology Outpatient Department. In this case, an early adolescent boy with a long-standing problem of right-sided nasal obstruction since childhood sought consultation. Diagnostic nasal endoscopy revealed a deviation of the nasal septum to the left, coupled with right inferior turbinate hypertrophy, all overlying healthy mucosa. A CT scan of the nose and paranasal sinuses further identified a bony hyperdense lesion with ground glass attenuation, confined to the right inferior turbinate. Subsequent biopsy confirmed juvenile trabecular ossifying fibroma (JTOF). The patient underwent endoscopic right medial maxillectomy, and the final histology affirmed the diagnosis of JTOF.
Topics: Male; Adolescent; Humans; Child; Turbinates; Fibroma, Ossifying; Nasal Obstruction; Bone Neoplasms; Paranasal Sinuses; Cartilage Diseases
PubMed: 38627043
DOI: 10.1136/bcr-2023-259397 -
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 -
Journal of Pharmacy & Bioallied Sciences Feb 2024Peripheral ossifying fibroma is presented as an exophytic growth with a smooth surface. It is located mostly on the gingiva, and it is an unusual growth of gingiva that...
Peripheral ossifying fibroma is presented as an exophytic growth with a smooth surface. It is located mostly on the gingiva, and it is an unusual growth of gingiva that occurs after irritational trauma. It is seen in the later decade of life, with the calcifications in the lesion in advanced stages seen on radiographic images. In the present case, a 50-year-old male reported with a huge gingival growth in the left maxillary posterior gingival region; when radiograph was taken, it showed calcifications. The patient was treated by surgical excision of the growth.
PubMed: 38595507
DOI: 10.4103/jpbs.jpbs_690_23 -
Journal of Surgical Case Reports Apr 2024Ossifying fibroma (OF) is a slow-growing benign fibro-osseous neoplasm. It is mostly odontogenic in origin, and it arises in the jaws, particularly the mandible. OF is...
Ossifying fibroma (OF) is a slow-growing benign fibro-osseous neoplasm. It is mostly odontogenic in origin, and it arises in the jaws, particularly the mandible. OF is characterized by the production of bone and cementum-like calcifications in a fibrous stroma. OF reports of the bone of the maxilla are uncommon. Diagnosing OF can be challenging due to the considerable overlap of clinico-pathological characteristics with those of other neoplasms. Herein, the authors describe a case report OF in a 26-year-old male who presented with a huge fibro-osseous tumor of the maxilla. Histopathology established the diagnosis of maxillary OF. The tumor was surgically removed via a Weber-erguson approach with satisfactory functional and cosmetic results. No recurrence has been found after one year of follow-up. Clinical, radiological, and pathological characteristics, as well as surgical treatment approaches, are further discussed. This is one of a few documented cases of maxillary OF in our setting.
PubMed: 38572287
DOI: 10.1093/jscr/rjae198 -
Journal of Orthopaedic Case Reports Mar 2024Non-ossifying fibroma (NOF) is a common benign fibrogenic bone lesion commonly found in the metaphysis of long bones. While small NOFs are typically asymptomatic and...
INTRODUCTION
Non-ossifying fibroma (NOF) is a common benign fibrogenic bone lesion commonly found in the metaphysis of long bones. While small NOFs are typically asymptomatic and left untreated, large NOFs are often associated with pathologic fractures that can be treated conservatively or operatively. To our knowledge, the NOF presented in this case report is one of the largest reported in the literature.
CASE REPORT
We present a case of a 12-year-old Hispanic female who presented to our institution after falling off a horse and landing on her right leg and wrist. Radiographs revealed a right distal femur fracture through an unusually large lytic bone lesion. The patient was treated with curettage, grafting, open reduction, and internal fixation, given the unstable and pathological nature of the fracture.
CONCLUSION
This case substantiates the literature that large fractures through a NOF can be appropriately managed operatively. However, orthopedic surgeons should be aware of the risks of surgery, including infection, when considering operative management of patients who present with large unstable pathologic fractures through a NOF.
PubMed: 38560297
DOI: 10.13107/jocr.2024.v14.i03.4282