Trabecular Juvenile Ossifying Fibroma Research Articles

Immunohistochemical analysis of osteoclastic and osteoblastic activity in ossifying fibroma and juvenile ossifying fibroma: A comparative study.

Cemento-ossifying fibroma (COF) and juvenile ossifying fibroma (JOF) have been considered distinct entities within the category of fibro-osseous lesions. This study aimed to assess osteoblast and osteoclast activity in COF and JOF by investigating bone resorption markers, specifically receptor activator of nuclear factor-kB (RANK), RANK ligand (RANKL), and its inhibitor osteoprotegerin (OPG). A comparative analysis of these markers was performed on all lesions. Immunohistochemistry was employed to evaluate and quantify the expression of these biomarkers in a sample of 20 cases of cemento-ossifying fibroma (COF), 15 cases of psammomatoid juvenile ossifying fibroma (PsJOF), and 10 cases of trabecular juvenile ossifying fibroma (TrJOF). The expression of osteoprotegerin was significantly higher in cemento-ossifying fibroma (33.9±13.0) compared to trabecular juvenile ossifying fibroma (27.3±9.2) and psammatoid ossifying fibroma (25.2±14.9), with the COF showing the highest expression followed by the latter two (p=0.037). There was a higher percentage (80%) of stromal fibroblast cells that showed positive expression of RANKL in cemento-ossifying fibroma (COF) compared to psammomatoid juvenile ossifying fibroma (PsJOF) (33.3%) and trabecular juvenile ossifying fibroma (TrJOF) (30.0%) when considering a positive expression score of 3 (p=0.024). Cemento-ossifying fibroma demonstrated the highest expression of osteoprotegerin and RANKL-positive stromal fibroblast cells, followed by psammomatoid juvenile ossifying fibroma and trabecular juvenile ossifying fibroma. These findings provide valuable insights into the pathogenesis of these lesions.

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.

Ossifying Fibromas of the Head and Neck Region: A Clinicopathological Study of 45 Cases.

Ossifying fibromas of the head and neck region are classified as cemento-ossifying fibroma (COF) (odontogenic origin), and two types of juvenile ossifying fibromas: juvenile trabecular ossifying fibroma (JTOF), and juvenile psammomatous ossifying fibroma (JPOF). The potential for recurrence in JTOF and JPOF and the discovery of newer molecular signatures necessitates accurate histological classification. Over 12years (2005-2017), a total of 45 patients with 51 tumours were retrieved and reviewed for clinic-pathological features from the archives of a tertiary care oncology centre. Of 45 cases, COF, JTOF and JPOF comprised 13 (28.9%), 11 (24.4%) and 18 (40%) cases respectively. Three cases were unclassifiable. M: F ratio was 1:3.3, 1.1:1, 2:1 for COF, JTOF and JPOF respectively with an age range of 6-66years (mean: 24.6, median; 18.1years). The most common site for COF was mandible, for JTOF was maxilla, and for JPOF was ethmoid sinus. One case of mixed JTOF and JPOF histology was seen. Aneurysmal bone cyst-like areas were seen in 26.6% of cases, most commonly in JPOF. Follow up was available in 23 cases, and ranged from 4 to 207months. Three cases of JPOF had a recurrence and one patient with JTOF had residual disease after surgery. One case of COF demonstrated increased parathyroid hormone levels. COF, JTOF, and JPOF are clinically, radiologically and histologically distinct entities. Surgical resection is the mainstay of treatment. JPOF has a higher incidence of recurrence as compared to JTOF and COF and hence needs a more aggressive follow-up.

Spheno-orbital juvenile psammomatoid ossifying fibroma: a case report and literature review

Ossifying fibroma (OF) is an uncommon benign fibro-osseous lesion. Based on its clinical, morphological, and radiological features, OF is further divided into cemento-ossifying fibroma (COF), juvenile psammomatoid ossifying fibroma (JPOF), and juvenile trabecular ossifying fibroma (JTOF). JPOF rarely involves the cranial base, with limited reports published on spheno-orbital JPOF. In this paper, we report a case of JPOF of the greater wing of the sphenoid bone and lateral orbital wall in an 11-year-old child and show a surgical video. Although rare, JPOF should be considered in the differential diagnosis of fibro-osseous lesions of the spheno-orbital region.

Juvenile Trabecular Ossifying Fibroma (TrJOF) Orginating from Lateral Fronto-Orbital Bone with Secondary Aneurysmal Bone Cyst (ABC) Formation: Report of an Unusual Case and Literature Review

Juvenile Trabecular Ossifying Fibroma (TrJOF) Orginating from Lateral Fronto-Orbital Bone with Secondary Aneurysmal Bone Cyst (ABC) Formation: Report of an Unusual Case and Literature Review

Juvenile Trabecular Ossifying Fibroma (TrJOF) Orginating from Lateral Fronto-Orbital Bone with Secondary Aneurysmal Bone Cyst (ABC) Formation: Report of an Unusual Case and Literature Review

Juvenile trabeculated Ossifying Fibroma (JTrOF) is commonly arising from the maxilla and the mandibular bones, while Psammomatoid Juvenile Ossifying Fibroma (PsJOF) commonly arises in the sinonasal and calvarial bones. In our paper, we described a 12-year-old pediatric female who presented with a right fronto-orbital disfiguring swelling. She underwent total resection, peripheral osteotomy, and reconstruction. Pathology reported a TrJOF associated with Aneurysmal Bone Cyst (ABC) formation. TrJOF rarely originates from superolateral wall orbital bone, and it is exceedingly rare when it is associated with ABC formation. Pathologically, it is difficult to distinguish TrJOF from other FOLs due to similarities and overlap. The ideal treatment is total surgical excision and reconstruction. The Surgical resection is challenging as regards functional and cosmetic outcomes.

Juvenile ossifying fibroma of the maxillofacial region: analysis of clinico-pathological features and management.

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. Key words:Juvenile ossifying fibroma, juvenile trabecular ossifying fibroma, juvenile psammomatoid ossifying fibroma, fibro-osseous lesions, maxillofacial region, multi-centre study.

Trabecular Juvenile Ossifying Fibroma Management by Virtual Surgical Planning, Piezoelectric Surgery, and Simultaneous Patient Specific Implant (PSI) Reconstruction

Trabecular juvenile ossifying fibroma is a rare fibro-osseous lesion affecting the craniofacial skeleton occurring commonly in children and young adults. Tumor clinical behavior is highly aggressive with invasion of adjacent anatomic structures. Because of its high recurrence rate complete excision is necessary, but this one could be facial mutilating. This case report presents a 23-year-old female patient with a trabecular juvenile ossifying fibroma of the right maxilla, expanding into the orbit and zygomatic bone. The report also shows the multidisciplinary surgical management of this lesion with successful preservation of optic nerve function and facial aesthetics.

Comparison radical surgery versus conservative surgery to decrease post-operative recurrence in ossifying fibroma: systematic review

Background:Ossifying fibroma in craniofacial is a rare disease, benign, locally aggressive fibro-osseous tumor. In the recent 2017 WHO classifications, ossifying fibroma divided into 2 type, ossifying fibroma of odontogenic origin and juvenile ossifying fibroma. Choosing the right treatment that can reduce the recurrence rate are particularly challenging. In this systematic review we try to analyse related study to determine the best treatment for ossifying fibroma.Aim:The aim of this review to evaluate best treatment option and analysed level of recurrence in each type of treatment.Method:Collected Juvenile Ossifying Fibroma (JOF) and Ossifying Fibroma (OF) related Article from four different database (PubMed, Scopus, Cochrane Library, and Proquest). Study selection was done by using PRISMA strategy.Result:Eight retrospective case series studies were analyzed. Recurrence rate after surgery was 15.3%, most frequent recurrence occurs in conservative surgery. Recurrence rate after conservative surgery was 19.7%, compared with radical surgery which relatively lower in percentage, with recurrence rate after surgery was 10.6%.Conclusion:Juvenile Ossifying Fibroma, especially Trabecular Juvenile Ossifying Fibroma (TrJOF), show high recurrence percentage comparing other type. The first-choice management for treating OF was surgical approach. Types of surgery choose to depend on the aggressiveness and morbidity of the disease. Radical surgery was proven better to decrease level of recurrence compared with conservative surgery.

Juvenile trabecular ossifying fibroma of the mandible

Fibro-osseous lesions are bony lesions where the bone is replaced by fibrous connective tissue and include fibrous dysplasia (FD), cemento-osseous dysplasia, and ossifying fibroma (OF). OF is a benign osteogenic mesenchymal tumor and clinicopathologically divided into juvenile and conventional subtypes. Juvenile OF (JOF) is a rare rapidly growing tumor of the craniofacial bones having aggressive clinical behavior with high recurrence rate. Pathologically, JOF is classified into juvenile trabecular OF (JTOF) and juvenile psammomatoid OF. JTOF microscopically shows proliferation of fibrocellular connective tissue stroma along with immature and woven bony trabeculae with varied histologic features. We report a case of JTOF of the mandible in a 12-year-old male with the initial presentation of painless swelling on the right side lower jaw. Clinicoradiologically, the case was suspected as central giant cell granuloma and odontogenic tumors. He was successfully treated with wide local excision and reconstruction and was on follow-up for 8 months without any recurrence of the disease.

CT and MR imaging characteristics of histological subtypes of head and neck ossifying fibroma.

The current study aimed to assess CT and MRI characteristics of histological subtypes of head and neck ossifying fibroma (OF). 12 patients with histopathologically-proven head and neck OF were included in this study. Lesions were pathologically classified into three histological subtypes: eight cement-OFs (COFs), three juvenile psammomatoid OFs (JPOFs), and one juvenile trabecular OF (JTOF). All patients underwent CT examination, while seven also underwent MRI. Imaging characteristics were retrospectively assessed. On CT images, the lesion margins were well-defined in nine patients (75%) (seven COFs and two JPOFs), partially ill-defined in two (17%) (one COF and one JTOF), and ill-defined in one (8%) (one JPOF). The continuity of the eroded overlying bone cortex was maintained in nine patients (75%) (seven COFs and two JPOFs) but disrupted in three (25%) (one COF, one JPOF, one JTOF). With respect to lesion density, homogeneous ground-glass opacity was observed in five patients (42%) (five COFs), target-like appearance in three (25%) (two COFs, one JPOF), and mixture of hyper- and hypodense areas were observed in four (33%) (one COF, two JPOFs, one JTOF). MR signal intensity was homogeneous in two patients (29%) (two COFs) and heterogeneous in five (71%) (two COFs, two JPOFs, one JTOF). COFs tended to exhibit well-defined margins and preserved continuity of the overlying bone cortex. COFs were usually homogeneous, whereas JPOFs and JTOF were always heterogeneous. Target-like appearance was one of the characteristics of OFs, but it was observed in both COF and JPOF.

Trabecular Juvenile Ossifying Fibroma: Updated Review of the Literature and Report of an Interesting Case

Trabecular Juvenile Ossifying Fibroma: Updated Review of the Literature and Report of an Interesting Case

Juvenile ossifying fibroma: an analysis of clinico-pathological features in a case series with a literature review

Juvenile Aggressive Ossifying Fibroma (JAOF) is divided into two entities namely Juvenile Psammomatoid Ossifying Fibroma (JPOF) and Juvenile Trabecular Ossifying Fibroma (JTOF). JAOFs are aggressive but benign tumours that require clinico-pathological correlation to arrive at the definitive diagnosis. We report nine new cases of JPOF and 6 cases of JTOF with a brief review of the literature to aid correct diagnosis of these two different entities. According to the clinico-pathological analysis both JPOF and JTOF had occurred in children and adults, with a mean age of 28.6 years and 21 years at presentation respectively. JPOF showed a male predilection while equal gender distribution was observed in JTOF. Both tumours occurred most often in the mandible. Regarding the histopathological features all tumours were unencapsulated. All cases of JPOF showed presence of psammoma bodies which can be considered as a main diagnostic feature. JTOF showed osteoid and immature woven bone trabeculae. Osteoblastic rimming was commonly observed among JTOF but absent in JPOF. Other histopathological features did not show any striking difference between the two lesions. In conclusion, the term “Juvenile aggressive ossifying fibroma” is a misnomer as it can occur in adults as well. Therefore, the word “Juvenile” should be excluded when renaming the tumour which is a “need of the hour”. Further, the study demonstrates the use of demographic, radiological and histopathological features with clinico-pathological correlation to diagnose and exclude mimics of JPOF and JTOF.

A rare cause of maxillary mass: juvenile ossifying fibroma

<p class="abstract">Juvenile ossifying fibroma (JOF) is a unique fibro-osseous neoplasm. It has 2 histopathological variants. Psammomatoid juvenile ossifying fibroma (PsJOF) and Trabecular juvenile ossifying fibroma (TrJOF) affecting the jaws of children. Only 20% of the patients are over 15 years of age. JOF is more common in maxilla than mandible. It presents as an asymptomatic progressive, rapid expansion of jaws. It has a recurrence rate of 30-58%. Surgery is the only cure for this kind of lesion and total excision should be the goal of the treatment. We present a case report of 12 year-old female patient with clinical, radiographic and histopathological features of Psammomatoid JOF which clinically admitted to our clinic as maxillary sinus mass.</p>

Juvenile ossifying fibroma of the jaw: a retrospective study of 15 cases

The management of patients with juvenile ossifying fibroma (JOF) remains controversial. To explore the correlations between different treatments and the patient prognosis, 15 cases of JOF of the jaw were reviewed. Five patients were male and 10 were female. Patient age at the time of disease onset ranged from 7 to 18 years (mean 10.9 years). Nine tumours were located in mandible and six in the maxilla. These cases typically manifested clinically as painless swelling of the jaw (9/15, 60%); 40% (6/15) of the cases were associated with pain, diplopia, stuffy nose, and/or rapid growth. Images of JOF can show a radiolucent, mixed, or ground glass-like appearance. Pathological examinations revealed 10 cases of juvenile trabecular ossifying fibroma (JTOF) and five cases of juvenile psammomatoid ossifying fibroma (JPOF). In terms of the treatment plan, six patients initially received radical surgery; nine patients underwent conservative treatment, among whom six (6/9, 66.7%) had one or more recurrence. At the end of the follow-up period, 12 patients had no evidence of tumour recurrence and three cases were alive with a tumour. In summary, surgeons should develop the surgical plan according to the extent of the lesion, relapse status, growth rate, and family choice, and these patients should be followed up closely.

Ablation of Extensive Trabecular Juvenile Ossifying Fibroma of the Mandible: A Rare Case Report

Ablation of Extensive Trabecular Juvenile Ossifying Fibroma of the Mandible: A Rare Case Report

Trabecular Juvenile Ossifying Fibroma of the Craniofacial Skeleton: Etiopathogenesis and a Case Report of the Rare Entity

ABSTRACTThe term, fibro-osseous lesions, is used for a group of pathological disturbances encompassing developmental, reactive or dysplastic lesions and neoplasms characterized by replacement of normal bone architecture by tissue composed of collagen fibers and fibroblasts containing various amount of calcified tissue. The groups of the fibro-osseous lesions are best considered as a spectrum of processes arising from cells in the periodontal ligament. Juvenile ossifying fibroma (JOF) is a benign, but potentially aggressive, fibro-osseous tumor of the craniofacial bones. This uncommon neoplasm is distinguished from other fibro-osseous lesions primarily by its age of onset, clinical presentation, potential behavior and the high tendency to recur. Clinically presenting as an actively growing lesion. Histopathologically consists cell rich fibrous stroma containing bands of cellular osteoid without osteoblastic lining together with trabeculae of more typical woven bone. Pathogenesis of JOF may be related to mutations of HRPT2 gene which may arises due to haploinsufficiency of the HRPT2 gene.Here, we reported a case of trabecular JOF (TJOF) which had variations in clinical, radiographic features and histopathological characteristics and it's etiopathogenesis in detail.How to cite this articleKadam R, Patel S, Pathak J, Swain N, Kumar S. Trabecular Juvenile Ossifying Fibroma of the Craniofacial Skeleton: Etiopathogenesis and a Case Report of the Rare Entity. J Contemp Dent 2014;4(1):51-55.

Fibroma osificante juvenil trabecular mandibular: presentación de un caso con reconstrucción inmediata mediante un injerto libre de la cresta ilíaca y costocondral

Juvenile ossifying fibroma (JOF) is a benign fibro-osseous lesion with an aggressive biological behavior in most cases. The clinical course is fast, manifesting mainly as a facial asymmetry. Radiographically it presents as a well-defined, uni- or multi-locular radiolucent lesion with variable radiopaque areas. Treatment may vary depending on the clinical, imaging and histopathological specific pattern, but generally an aggressive treatment with resection is the most appropriate. We report a case of a child with an extensive trabecular JOF (TFOJ) of the mandible. We performed a complete resection of the lesion with a security margin and immediate reconstruction with a costochondral-iliac crest bone graft. Postoperative controls were performed for seven years, during which there were no signs of recurrence, demonstrating a successful functional and anesthetic reconstruction.

A massive sinonasal psammomatoid variant of juvenile ossifying fibroma: Report of a rare entity

Juvenile ossifying fibroma (JOF) is an uncommon, benign, bone-forming neoplasm with an aggressive local growth that is distinguished from other fibro-osseous lesions primarily by its age of onset, clinical presentation and aggressive behaviour. JOF is considered as a variant of the ossifying fibroma (OF) and the former includes psammomatoid JOF (PsJOF) and Trabecular JOF (TrJOF). Both variants involve the craniofacial bones with the trabecular variant being more common in the jaws and the psammomatoid variant being more common in the craniofacial skeleton. PsJOF is an unique variant of JOF that has a predilection for the sinonasal tract and the orbit particularly centered on the periorbital, frontal, and ethmoid bones. We report a rare case of massive PsJOF involving the maxillary sinus in a 20-year-old female.

Case Report: Trabecular Juvenile Ossifying Fibroma Presenting as a Sellar Mass

A 15-year-old girl presented with left occulomotor nerve palsy and was found to have a space occupying lesion of the sellar region with invasion of the left cavernous sinus. A transsphenoidal approach lead to subtotal removal of a solid tumor with some remnants in the cavernous sinus and revealed the diagnosis of trabecular juvenile ossifying fibroma (JOF). A repeat magnetic resonance imaging was obtained within 1 month that showed intrasellar recurrence and growing tumor in the cavernous sinus. Therefore, a combined transsphenoidal and transcranial approach was performed to more aggressively remove the tumor. Subsequently, adjuvant proton radiotherapy was performed. JOF of the trabecular type is a rare fibro-osseous lesion of the craniofacial skeleton almost exclusively occurring in the maxilla or the mandible. To our knowledge, this is the first case of this tumor entity presenting as a sellar mass.