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Journal of Cancer 2017: Ossifying fibroma in the jaws is a benign tumor and easily recurs in children, of which the treatment methods and prognosis still remain controversial. In this study,...
: Ossifying fibroma in the jaws is a benign tumor and easily recurs in children, of which the treatment methods and prognosis still remain controversial. In this study, we aimed to review the clinicopathological characteristics, treatment, and prognosis of ossifying fibroma in the jaws of children, and offer recommendations for clinical decision-making. A retrospective study was carried out on patients below the age of 18 years with ossifying fibroma in the jaws. Patients with complete clinical, pathological, and radiological records were included and followed-up. Sixty-three cases were collected with a preliminary search. After screening, fifty patients were included for general information analysis, of which forty-two patients were included in the recurrence analysis. Twelve patients showed a relapse, with a recurrence rate of 28.6% (12/42). The recurrence rates in cases with different surgical approaches and different X-ray boundaries were statistically different. Besides, twenty-three patients underwent reconstruction by free tissue grafting and the success rate was 96% (22/23). There was significant difference in the recurrence rates among different X-ray manifestations and surgical methods. An extended resection and reconstruction with free tissue grafting was a reliable method with a 96% success rate.
PubMed: 29151945
DOI: 10.7150/jca.21556 -
BMJ Case Reports Dec 2020Ossifying fibroma (OF) is a rare, benign, fibro-osseous lesion of the jawbone characterised by replacement of the normal bone with fibrous tissue. The fibrous tissue...
Ossifying fibroma (OF) is a rare, benign, fibro-osseous lesion of the jawbone characterised by replacement of the normal bone with fibrous tissue. The fibrous tissue shows varying amount of calcified structures resembling bone and/or cementum. The central variant of OF is rare, and shows predilection for mandible among the jawbone. Although it is classified as fibro-osseous lesion, it clinically behaves as a benign tumour and can grow to large size, causing bony swelling and facial asymmetry. This paper reports a case of large central OF of mandible in a 40-year-old male patient. The lesion was treated by segmental resection of mandible. Reconstruction of the surgical defect was done using avascular fibula bone graft. Role of three-dimensional printing of jaw and its benefits in surgical planning and reconstruction are also highlighted.
Topics: Adult; Facial Asymmetry; Fibroma, Ossifying; Fibula; Humans; Imaging, Three-Dimensional; Jaw; Male; Mandibular Neoplasms; Orthognathic Surgical Procedures; Printing, Three-Dimensional; Tomography, X-Ray Computed
PubMed: 33372024
DOI: 10.1136/bcr-2020-239286 -
Surgical Neurology International 2020Ossifying fibroma (OF) is benign bone lesions, most frequent in young children, more common in the maxillary sinus and mandible (75-89%), the pathogenesis of the tumor...
BACKGROUND
Ossifying fibroma (OF) is benign bone lesions, most frequent in young children, more common in the maxillary sinus and mandible (75-89%), the pathogenesis of the tumor is not clear, there are many subtypes of OF. This paper aims to report an OF a case and literature review.
CASE DESCRIPTION
Male, 19 years old, with a progressive history proptosis since 2012, diagnosed as a right supraorbital lesion at an external service and assigned to conservative management. Then, he evolved with double vision, which worsened in February of 2018, associated with a moderate headache. On admission: proptosis and downward deviation of the right orbit was noticed on the physical exam and with exception of limited right upgaze, external ocular movements were maintained. Head computed tomography showed a multiloculate expansive osteolytic lesion at the right orbital roof. On magnetic resonance imaging, the lesion had an inner content with septations, T1-weighted imaging heterogeneous signal, T2-weighted imaging high signal intensity, and peripheral contrast enhancement. The patient underwent a right frontal craniotomy with a gross total resection and the postoperative follow-up was uneventful. Menzel reported the first case in 1782. The clinical findings depend on localization. There are five subtypes. In general, the lesions have a radiological appearance with hyperdense boundary and cause deformity and destruction in bones with high recurrence risk. Radical resection is curative.
CONCLUSION
As a result, the correlation of clinical, radiologic, and pathologic data is significant while going for a specific diagnosis in cases of craniofacial fibrous lesions. Total excision is the best treatment, but it can recur.
PubMed: 32257561
DOI: 10.25259/SNI_492_2019 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Apr 2020To analyze the clinical features and discuss the treatment of ossifying fibroma in the nasal cavity and sinuses. The patients were performed surgical treatment after...
To analyze the clinical features and discuss the treatment of ossifying fibroma in the nasal cavity and sinuses. The patients were performed surgical treatment after admission. 6 cases were treated by endoscopic transnasal approach with image guidance system to resect the mass, 8 cases were operated by simple endoscopic approach, tumor resection was performed via endoscopic surgery with external approach in 2 cases, and endoscopic surgery combined with modified Caldwell-Luc procedure in 1 case. 1 patient was operated through labiolingual groove approach. The intraoperative blood loss of ossified fibroma patients was large, with an average blood loss of 550ml. All the patients were followed up for 6 months to 8 years, 15 patients with complete resection had no recurrence after surgery, and 3 patients with partial resection survived with tumor. Ossifying fibroma in the nasal cavity and sinuses can be completely resected by nasal endoscopic surgery with less trauma and good effect. Transnasal endoscopic surgery assisted by image navigation system can protect important structures in lesions involving orbital cardboard and anterior skull base. Nasal endoscopic surgery combined with small eyebrow incision approach is feasible for ossifying fibroma invading frontal sinus. Ossifying fibroma, which requires adequate preoperative evaluation and blood preparation is prone to bleeding, and lesions with rich blood supply need preoperative interventional therapy.
Topics: Endoscopy; Fibroma; Fibroma, Ossifying; Humans; Neoplasm Recurrence, Local; Paranasal Sinus Neoplasms
PubMed: 32842232
DOI: 10.13201/j.issn.2096-7993.2020.04.016 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Aug 2021To analyze the clinical features of juvenile ossifying fibroma in nasal root and to compare different surgical methods. Seven cases of juvenile ossifying fibroma...
To analyze the clinical features of juvenile ossifying fibroma in nasal root and to compare different surgical methods. Seven cases of juvenile ossifying fibroma occurring in the nasal root were treated via surgery, 5 cases were resected under nasal endoscopy guided by Image Guidance System-based electromagnetic navigation, and 2 cases were resected by lateral nasal butterfly incision. Postoperative follow-up included endoscopy and CT scan of the sinuses. The pathological results of 7 patients were consistent with juvenile ossifying fibroma. Follow-up period ranged from 6 to 45 months, and there were no recurrence or surgical complications. Surgery is the only effective treatment. Endoscopic sinus surgery with image navigation and lateral nasal butterfly incision resection has been deemed available. The external nasal butterfly incision has less bleeding and shorter operation time, but with mild nasal face swelling after surgery, and nasal endoscopy is a surgical method with less damage.
Topics: Endoscopy; Fibroma, Ossifying; Humans; Neoplasm Recurrence, Local; Paranasal Sinus Neoplasms; Paranasal Sinuses
PubMed: 34304524
DOI: 10.13201/j.issn.2096-7993.2021.08.001 -
Journal of Oral and Maxillofacial... Jan 2011Here, we present a case report of peripheral ossifying fibroma (POF) in an adult lady in her fourth decade of life. This case report comprises the growth that occurred...
Here, we present a case report of peripheral ossifying fibroma (POF) in an adult lady in her fourth decade of life. This case report comprises the growth that occurred in the mandibular anterior region with displacement of anterior teeth, its satisfactory management and literature review. POF represents a reactive benign lesion of connective tissue and is not the soft tissue counterpart of ossifying fibroma and is also not related anyhow to peripheral odontogenic fibroma. POF in the age of 45 years, arising in the mandibular anterior region, is an occasional entity. Careful clinical examination and histopathology findings should be correlated to conclude the final diagnosis.
PubMed: 21731281
DOI: 10.4103/0973-029X.80023 -
International Journal of Surgery Case... Jan 2022Cemento ossifying fibroma (COF) is an encapsulated lesion that is often found in the mandible of middle-aged females. Cystic degeneration may be associated to several...
INTRODUCTION AND IMPORTANCE
Cemento ossifying fibroma (COF) is an encapsulated lesion that is often found in the mandible of middle-aged females. Cystic degeneration may be associated to several osseous lesion. This particular presentation is not well documented in the jaws.
CASE PRESENTATION
Patient presented was referred to oral surgery department for abnormal radiolucency in the right mandible on panoramic X-ray. The patient did not have any specific medical history and reported painful areas in right mandibular region. During diagnosis assessment, ameloblastoma was first considered due to the presence of cystic lesion clusters. But the mixed image in previous X-ray pointed to a fibro-osseous with a change in pathogenesis pathway. Diagnosis buildup was based on previous radiographs, incisional biopsy was proposed to identify the histopathological feature of the lesion before proceeding to further investigation (CBCT) or treatments (decompression or enucleation). COF of the jaws associated to non-specific cystic changes was the histopathological diagnosis. Delay in treatment showed an unexpected outcome with good clinical and bone healing.
CLINICAL DISCUSSION AND CONCLUSION
This case shows the importance of previous radiographs, when available, in diagnosis buildup. The fibro-osseous lesion with cystic change may show a good biological response with conservative management. A clinical and radiological surveillance after a conservative treatment may be a better option in treatment of these lesions.
PubMed: 34954627
DOI: 10.1016/j.ijscr.2021.106676 -
Cureus Jan 2023Fibro-osseous lesions in the jaw bones include fibrous dysplasia, ossifying fibroma (OF), cemento-ossifying fibroma, florid osseous dysplasia, and focal osseous...
Fibro-osseous lesions in the jaw bones include fibrous dysplasia, ossifying fibroma (OF), cemento-ossifying fibroma, florid osseous dysplasia, and focal osseous dysplasia. OF is the most common fibro-osseous tumor that presents as a slow-growing well-encapsulated benign neoplasm composed of varying amounts of bone or cement-like tissue in a fibrous stroma well-demarcated from the adjacent normal bone. OF is most common in the jaw bones, with a predilection for the mandible. OF usually occur as solitary lesions and rarely as multiple lesions in a patient. We present clinical and radiologic features, histopathology, and surgical management of a rare case with large synchronous OFs in the mandible and maxilla and a brief review of the literature.
PubMed: 36843790
DOI: 10.7759/cureus.34257 -
Annals of Medicine and Surgery (2012) Aug 2023A significant percentage of lesions of endodontic origin require surgical management due to the possible diagnosis of odontogenic cysts and tumors in the maxilla and...
UNLABELLED
A significant percentage of lesions of endodontic origin require surgical management due to the possible diagnosis of odontogenic cysts and tumors in the maxilla and mandible. Ossifying fibroma is a benign fibro-osseous lesion that typically presents as a painless, slow-growing, and expansile lesion that appears as a well-demarcated lesion with a variable degree of internal calcification on radiography. Treatment results in a large osseous defect, utilization of a graft to fill the void accelerates healing and prevents complications that may result from failure to fill by the host response.
CASE PRESENTATION
Following endodontic surgery placement of osseous graft material via Guided Tissue Regeneration to fill the defect aids to accelerate fill of the defect on a healthy 26-year-old female patient. A case discussing the one-step treatment of an ossifying fibroma of the anterior part of the mandible following endodontic microsurgery with associated retrograde fill of the apex, then site grating with biphasic calcium sulfate (Bond Apatite) used in regeneration of the osseous defect related to the lesion and resulting surgery.
CLINICAL DISCUSSION
Histologically, the ossifying fibroma is dominated by connective tissue containing cell rich areas with a few fragments of fibrosis. Moreover, in the connective tissue numerous small fragments of spongy and compact bone with areas of partial necrosis present and a significant number of inflammatory cells are observed. Surgical removal of the cyst with thorough curettage of the osseous walls and grafting of the defect provides predictable healing and the desired clinical results sought. Utilization of the biphasic calcium sulfate graft material allows the elimination of the need to overlay the area with a membrane before the flap due to its hard set and the prevention of soft tissue ingrowth into the graft material during the healing phase. Additionally, the hard set of the material allows tenting of the area to maintain the desired volume and ridge contour. Conversion of the graft material depending on the volume placed to host bone occurs over a 3-6 month period.
CONCLUSION
The case report presented, as well as the authors experience mimics the literature on biphasic calcium sulfate in its use as an osseous graft material and is an effective method for the repair of osseous defects that result from the removal of tumors and cysts of the maxilla and mandible. Treatment of an ossifying fibroma is an ideal application of the use of this biphasic calcium sulfate material allowing tenting of the surgical site over the defect created after cyst removal without the need for resorbable collagen membranes. This simplifies its use and decreases material costs that may hamper patient acceptance of treatment without a decrease in expected clinical results.
PubMed: 37554914
DOI: 10.1097/MS9.0000000000001068 -
Medicina Oral, Patologia Oral Y Cirugia... Sep 2021The diagnosis and management of juvenile ossifying fibroma (JOF) remains a highly debated topic with paucity of studies with long-term follow-up, hence the aim of this...
BACKGROUND
The diagnosis and management of juvenile ossifying fibroma (JOF) remains a highly debated topic with paucity of studies with long-term follow-up, hence the aim of this study was to report on the clinico-pathological features and management of these neoplasms.
MATERIAL AND METHODS
A retrospective analysis was performed on all histopathologically confirmed JOF presenting at two tertiary hospitals in Cape Town, South Africa over a period of 39 years. Clinical, demographic, histopathological and radiological features were analyzed. Surgical methods were documented and a minimum post-operative follow-up of 12 months was a prerequisite.
RESULTS
Seventeen patients met the inclusion criteria and were included in this study. Overall, the ages of patients ranged from 3-31 years (mean= 13 years) with male to female ratio of 1.8:1. The ages of patients diagnosed with Trabecular JOF were significantly younger than patients with Psammomatoid JOF (P = 0.01). The majority of patients presented with marked swelling (88.2%). Interestingly, most neoplasms occurred in the mandible (76.5%) with all Psammomatoid JOF uncharacteristically occurring in the mandible. There was only one case of Trabecular JOF occurring in the sinonasal area. Most neoplasms appeared as unilocular (76.5%) and well-defined (82.4%) with mixed radio-density (70.6%) on radiographs and computed tomography. Curettage with peripheral ostectomy was shown to be the least invasive method with an acceptable recurrence rate (10%). Six lesions underwent resection without any recurrences however caused high morbidity to these young patients.
CONCLUSIONS
The high number of lesions occurring in the mandible for both variants of JOF demonstrates that site should not be a major determining factor in the diagnosis of JOF. Moreover, curettage with peripheral ostectomy should be used as the first line of management to minimize morbidity to the patient and that resection should be reserved for large and recurrent lesions.
Topics: Adolescent; Adult; Bone Neoplasms; Child; Child, Preschool; Female; Fibroma, Ossifying; Humans; Male; Neoplasm Recurrence, Local; Retrospective Studies; South Africa; Young Adult
PubMed: 34162821
DOI: 10.4317/medoral.24592