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BMJ Case Reports May 2013Peripheral ossifying fibroma is a gingival growth, usually arising from interdental papilla and occurring frequently in the anterior maxilla. It represents upto 2% of...
Peripheral ossifying fibroma is a gingival growth, usually arising from interdental papilla and occurring frequently in the anterior maxilla. It represents upto 2% of all lesions that are biopsied. Other terms used to describe this lesion include peripheral ossifying fibroma, peripheral cementifying fibroma and calcified or ossified fibrous epulis. Paediatric patients with such a lesion have special management considerations as it requires early recognition and treatment. It requires proper treatment protocol with close postoperative follow-up. This case report presents a 12-year-old boy with an unusually large lesion in relation to the palatal aspect of the maxillary anterior teeth and its management.
Topics: Child; Fibroma, Ossifying; Gingival Neoplasms; Humans; Male; Maxillary Neoplasms
PubMed: 23696140
DOI: 10.1136/bcr-2013-009010 -
Head and Neck Pathology Dec 2018Benign fibro-osseous lesions within the maxillofacial region represent a heterogeneous group of benign entities with overlapping histologic features. Ossifying fibroma,...
Benign fibro-osseous lesions within the maxillofacial region represent a heterogeneous group of benign entities with overlapping histologic features. Ossifying fibroma, the rarest of these entities, represents a true neoplasm. Juvenile ossifying fibroma (JOF) is considered an aggressive rapidly growing sub-type. It tends to occur in the first or second decades of life. Based on histological and clinical features it can further be classified into two variants, namely juvenile trabecular ossifying fibroma (JTOF) and juvenile psammomatoid ossifying fibroma (JPOF). JTOF features a proliferation of cellular fibroblastic tissue admixed with woven bone trabeculae with varying histologic presentations. Correlation with clinical and radiographic features is essential to differentiate it from other fibro-osseous lesions. A case of JTOF of the mandible is exemplified in this Sine Qua Non Radiology-Pathology article.
Topics: Cementoma; Child; Cone-Beam Computed Tomography; Humans; Male; Mandibular Neoplasms
PubMed: 29027609
DOI: 10.1007/s12105-017-0862-6 -
Medicina Oral, Patologia Oral Y Cirugia... Sep 2022Peripheral Ossifying Fibroma (POF) is a reactive hyperplastic lesion that exclusively occurs in the gingiva and is characterized by the deposition of dystrophic...
BACKGROUND
Peripheral Ossifying Fibroma (POF) is a reactive hyperplastic lesion that exclusively occurs in the gingiva and is characterized by the deposition of dystrophic calcification, cementum-like tissue, and immature and mature bone within the connective tissue. The objective of the present study was to perform a retrospective analysis of clinicopathologic features of POF.
MATERIAL AND METHODS
Clinical and histopathological data were obtained from biopsy records and histopathological reports from a Brazilian reference service in Oral Pathology (1999 - 2020). Morphological analysis was performed to evaluate features related to the mesenchymal component, inflammatory infiltrate, ulceration, and mineralized tissue.
RESULTS
A total of 270 POFs were diagnosed during the study period. A higher frequency was observed in females (71.9%) between the third (22.9%) and fourth (23.3%) decades of life. The anterior upper gingiva (29.1%) was the most affected region. Mature (86.7%) and immature (52.6%) bone tissue were the most frequent. There was a significant association between immature bone deposition and lesions with size ≤ 1.7 cm (p = 0.041); immature bone and cement-like tissue deposition with an evolution time ≤ 16 months (p < 0.001); deposition of immature bone and mesenchymal hypercellularization (p < 0.001); deposition of dystrophic calcification and the presence of ulceration (p < 0.001).
CONCLUSIONS
The clinical characteristics corroborate the findings in the literature. The heterogeneous distribution and quantity of mineralized tissues found in the analyzed cases support the theory that the different mineralized tissues constitute a spectrum of clinical maturation of POF.
Topics: Female; Fibroma, Ossifying; Gingiva; Gingival Neoplasms; Humans; Hyperplasia; Retrospective Studies
PubMed: 35717619
DOI: 10.4317/medoral.25454 -
Archives of Pathology & Laboratory... Apr 2016Ossifying fibromyxoid tumor (OFMT) is a rare soft tissue neoplasm of uncertain differentiation, initially described by Enzinger and colleagues. Until now, nearly 300... (Review)
Review
Ossifying fibromyxoid tumor (OFMT) is a rare soft tissue neoplasm of uncertain differentiation, initially described by Enzinger and colleagues. Until now, nearly 300 such cases have been reported worldwide. The histogenesis of these tumors remains controversial. These tumors show characteristic imaging findings and exhibit a spectrum of histopathologic features, including classical and atypical subtypes. Local recurrences and, occasionally, distant metastases have also been reported. A complete tumor resection forms the preferred treatment modality for these tumors, along with follow-up, as these tumors have an uncertain malignant potential. Lately, certain "molecular signatures" underlying OFMTs have been described that can further aid in reaching an accurate diagnosis for these tumors and unraveling their pathogenesis. This article is a review of the clinical, radiologic, histopathologic, and molecular features of OFMTs.
Topics: Chromosome Aberrations; Diagnosis, Differential; Fibroma, Ossifying; Humans; Soft Tissue Neoplasms
PubMed: 27028395
DOI: 10.5858/arpa.2014-0590-RS -
Asian Journal of Surgery Aug 2023
Topics: Humans; Fibroma, Ossifying; Radius; Upper Extremity; Osteochondroma; Soft Tissue Neoplasms
PubMed: 36878781
DOI: 10.1016/j.asjsur.2023.02.074 -
Indian Journal of Otolaryngology and... Oct 2022The ossifying fibroma is a rare fibro-osseous benign lesion of bone in the head and neck region. The mandible is the most common site reported followed by maxilla and...
The ossifying fibroma is a rare fibro-osseous benign lesion of bone in the head and neck region. The mandible is the most common site reported followed by maxilla and other bones of the skull. A paediatric male presented with protrusion of the right eyeball for one-month duration. Further evaluation by diagnostic nasal endoscopy revealed a smooth mass confined to the superior and middle meatus on the right side. Computed tomography of paranasal sinus showed a large heterogenous bony lesion involving the ethmoid and sphenoid sinus and extending laterally into the orbit and superiorly into anterior skull base. Endoscopic biopsy was suggestive of ossifying fibroma. Transnasal endoscopic excision of the lesion was done and the patient is currently on follow-up. This case is reported for the rarity of presentation and the difficulties in management.
PubMed: 36452801
DOI: 10.1007/s12070-021-02607-8 -
Case Reports in Dentistry 2013Intraoral ossifying fibromas have been described in the literature since the late 1940s. Peripheral ossifying fibroma (POF) is usually a fibroma of the gingival which...
Intraoral ossifying fibromas have been described in the literature since the late 1940s. Peripheral ossifying fibroma (POF) is usually a fibroma of the gingival which shows areas of calcification or ossification. It is a nonneoplastic enlargement of gingiva. Due to its clinical and histopathological similarities, some POFs are believed to develop initially as a pyogenic granuloma that undergoes fibrous maturation and subsequent calcification. It has been suggested that POF represents a separate clinical entity rather than a transitional form of pyogenic granuloma or irritation fibroma. This paper describes a case report of a 60-year-old female patient reported with growth on gingiva in the upper left front region of mouth three years ago.
PubMed: 23878748
DOI: 10.1155/2013/497234 -
Head and Neck Pathology Jun 2023Gingival fibromas (GFs) are fibrous lesions of the gingiva that are not well defined in the literature. They are histologically similar to peripheral ossifying fibromas...
PURPOSE
Gingival fibromas (GFs) are fibrous lesions of the gingiva that are not well defined in the literature. They are histologically similar to peripheral ossifying fibromas (POFs), both being characterized as cellular proliferations of dense fibrous tissue, with POFs differing in that they demonstrate foci of calcification. This study aims to expand upon the immunohistochemical characterization of GFs, and to confirm their osteoblastic phenotype.
METHODS
Formalin fixed, paraffin embedded GFs, POFs and fibroepithelial polyps (FEPs) of the gingiva were examined. Immunohistochemical staining was performed for special AT-rich sequence binding protein 2 (SATB2), runt-related transcription factor 2 (RUNX2), osteocalcin and alpha-smooth muscle actin (αSMA). Sections were evaluated by light microscopy and the immunohistochemical staining patterns were assigned immunoreactive scores (IRS) based on percentage of stained cells and intensity of staining.
RESULTS
GFs, POFs, and FEPs of the gingiva expressed osteoblastic markers SATB2, RUNX2 and osteocalcin. GFs and POFs expressed αSMA while FEPs of the gingiva did not. GFs and POFs had similar staining patterns of SATB2, RUNX2 and αSMA.
DISCUSSION
These findings demonstrate that GFs and POFs exhibit a similar immunohistochemical profile, and supports a theory that GFs are osteoblastic lesions possibly related to POFs.
Topics: Humans; Core Binding Factor Alpha 1 Subunit; Osteocalcin; Immunohistochemistry; Fibroma, Ossifying; Gingival Neoplasms; Calcinosis
PubMed: 36472794
DOI: 10.1007/s12105-022-01493-y -
Journal of Maxillofacial and Oral... Jun 2021Cemento-ossifying fibroma is considered as a benign osseous tumour, closely related to other lesions such as fibrous dysplasia and cementifying periapical dysplasia....
INTRODUCTION
Cemento-ossifying fibroma is considered as a benign osseous tumour, closely related to other lesions such as fibrous dysplasia and cementifying periapical dysplasia. These lesions occur in the second to the fourth decade of life. It is a bony tumour of maxilla and mandible of possibly odontogenic origin with aggressive behaviour and high tendency for recurrence. Radiologically, the lesion appearances varied ranging from radiolucent cyst-like appearance to mixed and/or radiopaque areas.
AIMS AND OBJECTIVES
The article attempts to highlight the importance of clinical, imaging aspects and histopathology in diagnosis of cemento-ossifying fibroma along with management and long-term follow-up.
MATERIALS AND METHODS
This retrospective study was done on histologically diagnosed 16 fibro-osseous lesions. These patients were treated under general anaesthesia at our institute. The demographic data, radiographic features, and histopathologic findings were analysed and compared. The treatment and follow-up data were also recorded.
RESULTS
Cemento-ossifying fibroma showed higher predilection for female than for male patients and with an equal number of cases reported in maxilla and mandible with no signs of recurrence in long-term follow-up of 15 years.
CONCLUSION
Complete surgical excision of cemento-ossifying fibroma comes out to be only effective treatment that gave satisfactory results and can be considered as a definitive treatment modality.
PubMed: 33927492
DOI: 10.1007/s12663-019-01304-y -
Journal of Clinical and Experimental... Jan 2022Juvenile ossifying fibroma (JOF) is an uncommon benign fibro-osseous lesion of the craniofacial skeleton; compared to conventional ossifying fibroma (OF), JOF is...
BACKGROUND
Juvenile ossifying fibroma (JOF) is an uncommon benign fibro-osseous lesion of the craniofacial skeleton; compared to conventional ossifying fibroma (OF), JOF is characterized by local aggressiveness and propensity for recurrence. The biologic basis for this different biologic behavior between JOF and OF remains elusive. The aim of this study was to evaluate the immunohistochemical expression of MDM2, CDK4 and p53, molecules associated with bone oncogenesis, in the trabecular variant of JOF.
MATERIAL AND METHODS
The study material consisted of five cases of trabecular JOF, affecting three male and two female patients with a mean age of 11.8 years. Three cases arose in the maxilla and two in the mandible. All cases were initially treated by enucleation; two cases recurred necessitating more aggressive treatment. Immunohistochemical study of MDM2, CDK4 and p53 was performed in all cases, as well as in five control cases of conventional OF.
RESULTS
CDK4 positivity was noted in all JOF cases; the staining pattern was diffuse and strong in 4 cases and focal and weak in one case. In contrast, 4 out of 5 cases of OF were weakly and focally CDK4 positive, the remaining one being negative. Immunostaining for MDM2 was observed in 3 JOF cases; all OF were MDM2 negative. All cases of OF and JOF were negative for p53, except for one focally positive JOF case.
CONCLUSIONS
CDK4 and MDM2 expression in the trabecular variant of JOF is higher compared to conventional OF. In contrast, p53 expression is almost universally negative in JOF and OF. Despite some overlapping features, differential expression patterns of proteins involved in bone oncogenesis can elucidate the pathogenesis and may facilitate accurate diagnosis and prediction of behavior of bone tumors in the craniofacial region. Juvenile ossifying fibroma, trabecular variant, conventional ossifying fibroma, MDM2, CDK4, p53.
PubMed: 35070121
DOI: 10.4317/jced.59116