Benign Fibro-osseous Lesion Research Articles

Monostotic fibrous dysplasia of jaw bones: a case series

Abstract Background Fibrous dysplasia (FD) is a benign fibro-osseous lesion, a skeletal developmental anomaly of the bone-forming mesenchyme. The diagnosis of fibro-osseous lesions, particularly those of the jaw bones, poses significant challenges to clinicians and pathologists since it requires a correlation of clinical, radiological, histological, and surgical findings. Accurate and specific diagnosis is crucial as treatment modalities differ with different fibro-osseous lesions. Methods This retrospective analysis presents a case series of a rare condition of monostotic FD in the maxillofacial region affecting jaw bones diagnosed and/or treated over period of 10 years. Results Five cases of monostotic FD were diagnosed and treated between a period of 2013 and 2023. The cases from the 2nd to 8th decade were included in the analysis with equal involvement of males and females. Out of five cases, four cases were involving maxilla and 1 showed involvement of mandible. Conclusion FD is a rare entity affecting the jaw bones which often lead to disfigurement of face. Early detection is warranted to decrease potential complications. In addition, genetic analysis could help in understanding the occurrence in certain population.

Benign fibro-osseous lesions: A retrospective study of sixty-four cases from a single institute, Riyadh, Saudi Arabia

ObjectiveBenign fibroosseous lesions (BFOLs) encompass a heterogenous collection of bone conditions characterized by replacing normal bone with fibro-collagenous tissue with osteoid or woven bone, and cementicles. Despite their clinical significance, the frequency of BFOLs in Saudi Arabia still needs to be assessed. MethodsThis retrospective study investigated the frequency and demographics of BFOLs in Riyadh, Saudi Arabia, by retrieving all cases recorded between January 1984 and January 2013 from a single Oral Pathology Laboratory archive. ResultsA total of 64 cases were classified as BFOLs, with a predominance in females (67.2 %) and a median age of 21.5 years. The most prevalent condition identified was fibrous dysplasia (45.31 %), followed by cemento-ossifying fibroma (26.56 %). There were significant sex differences between BFOLs, with a p-value of 0.03. FD was predominantly located in the maxilla (65.5 %), whereas COF was predominantly found in the mandible (82.3 %). Recurrence was observed in 17.2 % of patients with FD, in contrast to no reported recurrence in patients with COF. ConclusionThis study represents the first exploration of BFOL frequency and demographics in Riyadh, Saudi Arabia, highlighting the need for further investigations to comprehensively understand the nature of these lesions in our population.

A rare case of fibrous dysplasia in the mandible: a case report

Background: Fibrous dysplasia (FD) is a benign fibro-osseous lesion of the bone which can be monostotic FD and the polyostotic form. Polyostotic FD with café-au-lait spots of the skin and hormonal imbalances is called McCune–Albright syndrome. Besides, Mazabraud syndrome is characterized by polyostotic FD and intramuscular myxomas. FD has its onset during childhood or early adolescence and usually occurs within the first or second decade of life.
 The mode of presentation of the FD of the jaw ranges from asymptomatic to dental anomalies, pain, and facial asymmetry. Given the clinical history and radiological assessment, cystic lesions have some important differential diagnoses which range from cystic ameloblastoma, fibrous dysplasia, aneurysmal bone cyst, and odontogenic keratocyst.
 Case report: This presents a 19-year-old female who presented to the maxillofacial surgeons’ clinic with a referral from a peripheral hospital. Her major complaint was right-sided facial swelling which was noticed 4 years before the presentation. A plain radiograph revealed an expansile lesion of the mid-right mandible appearing as a well-outlined, fairly oval multiloculated cystic radiolucent mass with multiple internal septations. A preliminary diagnosis of a complex cystic right jaw mass with benign features was made with possible differential diagnoses such as ameloblastoma, fibrous dysplasia, aneurysmal bone cyst, and odontogenic keratocyst were suggested as possible differential diagnoses. Finally, she had an excision biopsy with a histological diagnosis of fibrous dysplasia. The outcome of the surgery was satisfactory at one year review.
 

Evaluation of anatomical variants and pathological findings of the maxillary sinus prior to sinus floor elevation: A Cone Beam CT retrospective study in 660 patients.

Maxillary sinuses may present a wide spectrum of anatomical variations and pathological lesions whose recognition is mandatory for the clinician, especially prior to any surgical intervention in the area, such as in cases of sinus floor elevation. The goal of this study was the evaluation, mapping and prevalence of sinus anatomical variants and pathoses in Cone Beam Computed Tomography (CBCT) scans of dental patients. 660 CBCT examinations of adult patients involving both sinuses were obtained (between 2017 and 2023) and analyzed. The following anatomic variants and pathologic findings were evaluated: antral septa (AS), posterior superior alveolar artery (PSAA), sinus hypoplasia, sinusitis, odontogenic cysts, retention cysts, antroliths, and various less common lesions (e.g.: benign fibro-osseous dysplastic lesions, neoplasms etc.). Investigation of the association of the findings with patients' age and gender was performed using the Chi-square test (X2), Fisher's exact test, t-test, and ANOVA (P<0.05). Differences in prevalence between findings, based on their location (right and/or left sinus), were investigated using z-test and t-test. AS were found in 38.6%, and PSAA was identifiable in 90.2% (mean distance from the sinus floor=6.44 mm) of the patients respectively. 3% of patients had hypoplasia, 15.6% sinusitis, 2.7% odontogenic cysts, 16.1% retention cysts, 8.6% antroliths, and 1.7% uncommon lesions (e.g. malignant neoplasms and fibrous dysplasia). A statistically significant association was found between gender and PSAA diameter, PSAA distance from the sinus floor, hypoplasia, sinusitis, and retention cysts, as well as a statistically significant association between age and PSSA diameter and sinusitis. The prevalence of various anatomical variants and pathologic findings of the maxillary sinus did not differ based on their location. However, some of these findings appear to be related to either gender or age. CBCT is a valuable diagnostic tool to identify various anatomical variants and pathological findings of the maxillary sinus. Key words:Sinus, anatomy, pathology, CBCT.

Surgical and Prosthetic Management of a Juvenile Ossifying Fibroma In a 5-Year-Old Child: A Clinical Report

Juvenile ossifying fibroma (JOF) is a rare and benign fibro-osseous lesion of the craniofacial skeleton commonly seen in children under 15 years of age. Despite being classified as benign, JOF lesions are aggressive in nature and reach large dimensions in a short period of time. Thus, their resections may cause large orofacial defects which have serious detrimental effects on the functional and nutritional requirements of pediatric patients being in the pe-riod of growth. Therefore, its early diagnosis and proper surgical and prost-hetic management are of vital importance for the survival of patients. However, no detailed reports in the literature describe the prosthetic mana-gement of large intraoral defects in pediatric patients under 10 years old.

Retrospective Evaluation of Periradicular Biopsies: An 18-Year Study

IntroductionRadiographic findings in periradicular areas are repeatedly associated with infected root canal systems. Although non-odontogenic lesions in teeth are reported to be low, they often mimic periapical pathoses, and consequently, histopathologic examinations after surgical revisions are nurtured. MethodsBiopsies submitted to the College of Dentistry between 2003 and 2021 were reviewed. Clinicopathologic characteristics were collected, including age, sex, medical history, location, sensibility tests, and clinic impressions from each specimen. Histopathologic diagnosis and gross description were also part of our database. ResultsA total of 72,055 pathology reports were reviewed, of which 10,031 lesions (13.9%) met the criterion of being intraosseous lesions at the periradicular area. Among those 10,031 lesions, 7.94% (n = 796) were of non-endodontic origin, 7153 were documented as non-vital, and 2.36% (n = 169) of these non-vital teeth were diagnosed with a non-endodontic origin. A total of 5707 lesions were obtained from surgeries within the periapical tissues, primarily performed by endodontists (94.02%). Non-endodontic lesions were reported in 1.09% of the cases. Odontogenic keratocyst was the most common non-endodontic diagnosis, followed by nasopalatine duct cyst and benign fibro-osseous lesion, respectively. ConclusionsPathologic findings of the periradicular tissues are not always from endodontic origin. The probability of encountering non-endodontic lesions is almost 8%. Even in clinically reported teeth with pulp necrosis, 1%–3% of biopsies were confirmed as non-endodontic lesions.

Juvenile psammomatoid ossifying fibroma: A case report and a review of the literature

Abstract Juvenile psammomatoid ossifying fibroma (OF) is a rare histological variant of OF with aggressive behavior. It is a benign fibro-osseous lesion with a high rate of recurrence. It occurs mainly in male children with paranasal sinuses and orbits the most common sites. The diagnosis depends on clinical, radiologic, and pathologic correlation. This study aims to present a case report of juvenile psammomatoid OF (JPOF) in a 9-year-old boy and to also review the relevant literature. A case of a 9-year-old boy who presented with a 1-year history of the left maxillary swelling was presented. There was no associated history of pain, ulceration, bleeding, or teeth mobility. There was no history of previous trauma to the site or teeth extraction. The patient had no difficulty in chewing, speaking, nasal blockage, or discharge. Examination revealed an ovoid left maxillary buccal mass measuring about 4 cm × 3 cm, which was hard, nontender with no teeth mobility. The diagnosis of JPOF made was confirmed through a combination of clinical, radiological, and histopathological findings. The patient had enucleation of the lesion under general anesthesia. Follow-up was satisfactory with no recurrence. JPOF is a rare histological variant of OF that is known to exhibit a high rate of recurrence. Although clinical and radiological features contribute to its diagnosis, histopathological examination has been the main diagnostic modality. Early detection and treatment are essential.

An obturator prosthesis for a 4-year-old child following treatment of a juvenile trabecular ossifying fibroma with a maxillary resection

Juvenile trabecular ossifying fibroma (JTOF) is a benign fibro-osseous lesion that usually occurs in the maxilla or mandible. Individuals with JTOF of the maxilla will most commonly require a resection that can result in a significant palatal defect. Appearance and articulatory, masticatory, and deglutitory functions can be restored with a clasp-retained obturator. Providing a prosthetic obturator with adequate retention in situations where the teeth cannot accommodate clasps because of insufficient eruption can be challenging. This article describes a technique that has been developed for such instances—in this situation, a 4-year-old child who had undergone a maxillary resection because of a JTOF.

Endoscopic Excision of Rare Large Maxillary Sinus Osteoma: A Case Report and Literature Review

Paranasal sinus osteomas are the most common benign fibro-osseous lesions that occur in the paranasal sinuses, having potential serious complications. With a prevalence ratio of 2:1 towards males, in 95% of the cases, the osteomas are situated most commonly in the frontoethmoidal region. However, osteomas of the maxillary sinus account for less than 5% of cases. The management of symptomatic paranasal sinus osteomas is surgical and is decided based on tumor size and location, patient symptoms, and experience of the surgeon. The Caldwell–Luc procedure, lateral rhinotomy, or craniotomy as external standard procedures remain mandatory if endonasal endoscopic surgery fails. In most reported cases, large tumors are excised by an external approach or in conjunction with an endoscopic technique. Endoscopic treatment of such tumors is a huge challenge for the operator. We report on a 42-year-old male patient presenting with a giant calcified mass in the right maxillary sinus. In this case, an endonasal approach was the most appropriate management even with the large size of the tumor. No recurrence at 24 months follow-up was reported.

Focal Cemento- Osseous Dysplasia - A Case Report

Cemento- osseous dysplasia is a reactive benign fibro-osseous lesion with the most commonly occurring type being Focal cemento-osseous dysplasia (FCOD). It is categorized by the replacement of normal bone with fibrous tissue along with calcification resembling cementum like structures. Most of the lesions were asymptomatic and no treatment was required. When the lesion is infected with any secondary local or systemic agent, it becomes symptomatic and intervention is required. Here, we report a case of asymptomatic FCOD of the mandible in a 29-year-old female patient. Histopathological evaluation of the biopsy specimen by decalcified sections aided in the final diagnosis of the case.

EPIDEMIOLOGICAL ASPECTS OF BENIGN FIBRO-OSSEOUS LESIONS IN A SOUTHEAST BRAZILIAN POPULATION

This work aimed to describe the epidemiological aspects of Benign Fibro-Osseous Lesions (BFOL) in a Southeast Brazilian population. Sociodemographic and clinical-pathological data were gathered from the archives of two Oral Pathology Services. A total of 182 cases were diagnosed as BFOL (0.93% of all records). Of these, 86 (47.3%) were classified as osseous dysplasia (OD), 57 (31.3%) as fibrous dysplasia (FD), and 39 (21.4%) as central ossifying fibromas. These lesions mostly affected afro-descendant women, with a mean age of 39.1 ±17.30. The mandible was the main affected site (67.6%), except for FD, which commonly appeared in the maxilla. Asymptomatic swelling was the generally cited complaint. The mixed radiographic appearance was most frequently described. In all studies regarding Brazilian patients, OD was the most common BFOL. In this sample, BFOL depicted similar clinical-pathological features, when compared with most of the previously published studies. (Support: PAPE-UNIUBE). This work aimed to describe the epidemiological aspects of Benign Fibro-Osseous Lesions (BFOL) in a Southeast Brazilian population. Sociodemographic and clinical-pathological data were gathered from the archives of two Oral Pathology Services. A total of 182 cases were diagnosed as BFOL (0.93% of all records). Of these, 86 (47.3%) were classified as osseous dysplasia (OD), 57 (31.3%) as fibrous dysplasia (FD), and 39 (21.4%) as central ossifying fibromas. These lesions mostly affected afro-descendant women, with a mean age of 39.1 ±17.30. The mandible was the main affected site (67.6%), except for FD, which commonly appeared in the maxilla. Asymptomatic swelling was the generally cited complaint. The mixed radiographic appearance was most frequently described. In all studies regarding Brazilian patients, OD was the most common BFOL. In this sample, BFOL depicted similar clinical-pathological features, when compared with most of the previously published studies. (Support: PAPE-UNIUBE).

Periapical Cemento-Osseous Dysplasia in a Medically Compromised Patient: A Case Report

A fibro-osseous lesion is a condition where the regular bone is changed with a fibrous connective tissue matrix that includes an abnormal bone or cementum. These lesions are divided into three groups: ossifying fibroma, cemento-osseous dysplasia (COD), and fibrous dysplasia. COD is the most recurring benign fibro-osseous lesion. These lesions are usually not detected unless infected and are commonly noted accidentally on an X-ray. In this report, we demonstrate a case of periapical cemento-osseous dysplasia in a medically compromised patient with multiple systemic diseases.

Cemento-Osseous Dysplasia of the Jaw: Demographic and Clinical Analysis of 191 New Cases

Cemento-osseous dysplasia (COD) is a form of benign fibro-osseous lesion of the jaw. We sought to evaluate the demographic and clinical presentations of COD by collecting and analyzing the demographic, clinical, radiographic, and pathologic data of COD diagnosed in our institution from 2017 to 2022. Over this six-year period, the records of 191 patients with COD were reviewed. Most patients were African American and female. Eighty-five patients were diagnosed with florid COD (FLCOD), 63 with periapical COD (PCOD), and 43 with focal COD (FCOD). Twenty-eight (14.7%) patients presented symptoms. The most common symptom was pain. All the symptomatic cases of COD that were histopathologically diagnosed were osteomyelitis in the setting of COD. Symptomatic patients were older (mean of 61.3 years) than the asymptomatic patients (mean of 51.2 years). Due to the radiographic appearance of a radiolucency or a mixture of radiolucency and radiopacity, forty-five asymptomatic patients were biopsied. Most of the asymptomatic patients biopsied were patients with FCOD (n = 19, 54.3%), followed by PCOD (n = 16, 25.8%), and FLCOD (n = 10, 15.2%). FLCOD is the most common form of COD to present with symptoms. Due to the significant overlap in clinical and radiographic presentation with other entities, FCOD and PCOD remain a diagnostic challenge to dentists. In conclusion, we analyzed the demographic and clinical features of 191 new cases of COD, which reaffirms that cemento-osseous dysplasia is a condition that primarily affects middle-aged females of African descent and occurs more frequently in the mandible.

Fibrous dysplasia mimicking skeletal involvement in Lymphoma.

We present the case of a 19-year-old male with nodular sclerosing classical Hodgkin lymphoma, who had an incidental finding of fibrous dysplasia of the bone. This caused 18-F-fluorodeoxyglucose (18-F-FDG) avidity on positron emission tomography-computed tomography (PET-CT) scan leading to incorrect initial staging. This patient presented with a 4-month history of enlarging cervical lymph nodes, without B symptoms. He had no prior medical history. His initial diagnostic 18-F-FDG PET-CT demonstrated moderately avid left cervical and superior mediastinal lymphadenopathy and two partially sclerotic, partially lytic bone lesions. These were moderately avid, one in the proximal right humerus (SUV 6.1) and the second in the posterior distal humerus (SUV 8.1). There was no other avid lymphadenopathy (see Figure 1). He had a magnetic resonance imaging (MRI) scan and an orthopaedic opinion was sought; the lesions were felt likely to be skeletal involvement of his Hodgkin lymphoma. Therefore, his staging was 4A, with an international prognostic score of 2, and treatment was commenced following a RATHL approach starting with ABVD chemotherapy. The interim PET-CT scan following cycle 2 of ABVD demonstrated a complete metabolic response within the cervical and mediastinal lymphadenopathy, but persistent avidity within the right humeral shaft lesions which were essentially unchanged in size with a mild reduction in 18-F-FDG avidity (see Figure 2). He did report some aching in the right arm. This discrepant radiological response prompted further investigation. The bone lesions were evaluated with a CT and MRI scan, and his case was discussed again with the orthopaedic team who at that point felt the radiological appearances were suggestive of fibrous dysplasia. He had a biopsy of the bone lesion and histological examination confirmed the diagnosis of fibrous dysplasia with no evidence of Hodgkin lymphoma or other primary bone malignancy. The patient's staging was therefore amended to stage 2A early favourable (ESR 4 mm/h at diagnosis), and treatment was changed to combined modality chemo-radiotherapy. He had already completed 2 cycles of ABVD and so proceeded to receive 20 Gy in 10 fractions of consolidation radiotherapy. His end-of-treatment PET-CT scan is awaited but clinically he remains in complete remission. He will require surveillance imaging of the bony lesions. Fibrous dysplasia of the bone (FD) is an uncommon genetic disorder causing benign fibroosseous bone lesions. It is diagnosed predominantly in children and young adults. It has a wide spectrum of presentations but is often asymptomatic and can be found incidentally. Malignant transformation can rarely occur. Radiological features can vary from classical ground glass lesions to cystic or sclerotic lesions. FD lesions can show a large variability in 18-F-FDG uptake on PET-CT, and avidity in FD may change over time. There are several other case reports of FD mimicking skeletal involvement in lymphoma. In conclusion, discrepant responses to treatment should be further investigated. Careful interpretation of 18-F-FDG avid bone lesions is required to avoid misdiagnosis or overtreatment. FD should be considered within the differential diagnosis, especially in younger patients. Orla Gildea: conception, literature review and writing—original draft preparation Claire Burney: supervision and writing—review and editing Julian Kabala: resources, visualisation The authors declare no conflict of interest. Self. N/A. Uploaded. N/A. Not applicable to this article as no new data were created or analysed.

Cemento-osseous dysplasia is caused by RAS-MAPK activation

Cemento-osseous dysplasia (COD) belongs to the spectrum of benign fibro-osseous lesions occurring exclusively in the tooth-bearing areas of the jaws. Depending on site and extent of involvement, periapical, focal and florid subtypes can be distinguished that share an identical histomorphology. Most cases are asymptomatic and follow a self-limited course requiring no specific treatment. Over time, lesions progressively mineralise while the cellularity decreases. However, the molecular pathogenesis of COD, has not yet been explored. We analysed a series of 31 COD samples by targeted sequencing and detected pathogenic hotspot mutations involving the RAS-MAPK signalling pathway in 5/18 evaluable cases (28%). The mutations were found in the BRAF, HRAS, KRAS, NRAS, and FGFR3 genes. Our findings suggest that COD is driven by RAS-MAPK activation; however, the mechanism underlying the spontaneous growth arrest typically occuring in most of the lesions remains elusive.

Maxillary Parosteal Osteosarcoma: Additional case Report and Literature Review of Surface Osteosarcomas.

Introduction: Surface osteosarcomas represent around 3-6% of all osteosarcomas, which include the parosteal (low-grade), periosteal (intermediate-grade) and high-grade surface osteosarcomas. The classical location is the femur, followed by tibia and humerus. Parosteal osteosarcoma is the most common type of surface osteosarcoma. To date, 26 cases of parosteal osteosarcoma affecting the jaws have been reported, with most cases following an evolution time of several months to years, clinically favoring a benign osseous or fibro-osseous lesion. Methods: Here, we report a 39-year-old female who was referred presenting a maxillary tumoral mass 5 years ago, clinically diagnosed as osteoma. After clinical, imaginological and histopathological analysis, a diagnosis of parosteal osteosarcoma was made. Conclusion: Thus, parosteal osteosarcoma should also be considered in the differential diagnosis of benign-appearance, bone-forming nodular lesions affecting the jaws.

Low-grade central osteosarcoma of the hallux with a 7-year undiagnosed course: Case report

Low-grade central osteosarcoma usually exhibits a long course with nonspecific symptoms, while the imaging and histological findings may be easily confused with a variety of benign fibroosseous lesions. A 15-year-old boy was referred for a painless swelling of the proximal phalanx associated with shortening of the right hallux. A benign cystic bone lesion complicated by a pathological fracture had been diagnosed on the radiographs at 8 and 10 years of age after sport injuries. He was referred for evaluation and treatment of the bone lesion. Magnetic resonance imaging and computed tomography were performed. A referral centre was contacted, since there was a strong evidence of malignancy. An open biopsy was suggested, which indicated bone malignancy. The patient was then referred to the specialized tumor centre. A new biopsy was performed there, since the previous sampling was considered insufficient or inadequate to secure a differentiation from fibrous dysplasia. It ensured the diagnosis of low-grade central osteosarcoma. Radical excision of the proximal phalanx and reconstruction of the defect with an iliac graft associated with arthrodesis of both the hallux metatarsophalangeal and interphalangeal joints was the treatment of choice. Disturbed wound healing necessitated hardware removal 4 months postoperatively. No further interventions were required in the follow-up. Clinical and radiographic evaluation at 12 years confirmed no evidence of local recurrence or distant metastasis. The patient was satisfied with the final outcome and reported unrestricted participation to physical activities and sports. • The rarity and the highly variable presentation of the foot and ankle malignancies may explain why they are often not considered in the differential diagnosis and the increased likelihood of delayed or incorrect diagnosis. • A low-grade central osteosarcoma localized in the proximal phalanx of the great toe of a 15-year-old boy is presented. The imaging appearance of the lesion was not correctly assessed to suggest a potentially malignant pathology and to require an early bone biopsy leading to a 7-year delayed diagnosis. • All available clinical and imaging features should be carefully considered in decision making, during the diagnostic steps in a patient with a potentially malignant bone tumor of the foot or ankle, to ensure that the diagnosis will not be delayed or missed and that proper treatment by a specialized tumor surgeon in a designated tumor centre will be offered.

Clinic and Radiographic Evaluation of Cemento-osseous Dysplasia: Case Series

Aim: Cemento-osseous dysplasia (COD) is usually asymptomatic and slowly progressive benign fibro-osseous lesion characterized by the replacement of normal bone with fibrous tissue. The aim of this presentation is to evaluate the clinical and radiographical findings of six COD cases that were detected incidentally during radiographic examination.&#x0D; Case Report: Six female patients who four (%66) of them with different dental complaints and two (%33) of them for routine control examination of the previously diagnosed COD with a mean age of 38 applied to our clinic. It was learned that the patients did not have any systemic disorders in their medical anamnesis. There is not any finding on extraoral examination. In intraoral examination, teeth associated with COD lesions were vital as a result of the electric pulp test, and there is no other finding related to the lesion. In the radiography examination, different sizes radiolucent, mixed, and radiopaque lesions were detected in the mandible on control panoramic radiographs. The lesions were examined in detail with cone-beam computed tomography. Local thinning and resorption were observed in the buccal and lingual cortical bone in the relevant region. Histopathological examination revealed that the lesions were definitively diagnosed as SOD in four patients. Based on clinical, radiographic, and histopathological examinations, three (%50) of the lesions were diagnosed as periapical COD and the others (%50) were diagnosed with fluoride COD. All patients were followed up periodically for six months.&#x0D; Conclusion: The findings of this case series showed that all lesions examined were clinically asymptomatic and mixed on radiography. Due to insufficient vascular support of the bone in the COD area, there is a risk of infection and osteomyelitis may occur. Therefore, dentists should be aware of the clinical and radiographic features of COD in clinical practice and follow the patients periodically.

Pediatric Benign Fibro-Osseous Lesions of the Nose and Paranasal Sinuses: A Tertiary Hospital Experience.

Pediatric benign fibro-osseous lesions of the nose and paranasal sinuses are considered rare neoplastic entities. These fibro-osseous lesions are difficult to accomplish owing to the multifaceted anatomy of the skull base in addition to the closeness to neurovascular configurations. The study aimed to study different clinical presentations, radiological manifestations, surgical management, and consequences of different benign fibro-osseous lesions in the pediatric age groups. Methods and Settings. This is a case series study of a single-center experience. Four different cases were presented and discussed (osteoma, fibrous dysplasia, and ossifying fibroma. We reported four different cases of osteoma, ossifying fibroma, and fibrous dysplasia. All of these cases were managed endoscopically with no postoperative complications. Endoscopic management is considered highly effective with reduced morbidity. Preoperative radiographic studies are highly essential for diagnosis and operative planning.

JUVENILE AGGRESSIVE OSSIFYING FIBROMA WITH ANEURISMATIC BONE CYST AREAS: REPORT OF TWO CASES

Juvenile ossifying fibroma (JOF) is a benign fibro-osseous lesion that commonly affects gnathic bones. It has a predilection for the maxilla of young individuals. Occasionally, it may be associated with other pathologic entities such as aneurysmal bone cyst (ABC), which may lead to a more aggressive behavior of the lesion. Here, we report 2 cases of expansive, rapidly growing intraosseous lesions, located in the maxilla region, both affecting young males aged 11 and 12 years. Computed tomography showed well-defined osteolytic lesions, with hypodense/hyperdense areas and cortical bone expansion. Enucleation and complete curettage of the lesions were performed. In both cases, the anatomopathologic diagnosis of aggressive JOF associated with ABC was rendered. After follow-up of about 3 and 6 years, no relapse has been observed. Juvenile ossifying fibroma (JOF) is a benign fibro-osseous lesion that commonly affects gnathic bones. It has a predilection for the maxilla of young individuals. Occasionally, it may be associated with other pathologic entities such as aneurysmal bone cyst (ABC), which may lead to a more aggressive behavior of the lesion. Here, we report 2 cases of expansive, rapidly growing intraosseous lesions, located in the maxilla region, both affecting young males aged 11 and 12 years. Computed tomography showed well-defined osteolytic lesions, with hypodense/hyperdense areas and cortical bone expansion. Enucleation and complete curettage of the lesions were performed. In both cases, the anatomopathologic diagnosis of aggressive JOF associated with ABC was rendered. After follow-up of about 3 and 6 years, no relapse has been observed.