Ossifying Fibroma Research Articles

Osteocalcin, Azan and Toluidine blue staining in fibrous dysplasia and ossifying fibroma of the jaws

BackgroundFibrous dysplasia (FD) and ossifying fibroma (OF) are fibro-osseous lesions (FOLs) having several overlaps that may make final diagnosis difficult by hematoxylin and eosin (H/E) alone. AimThis study seeks to detect any association between Azan and Toluidine blue staining as compared with osteocalcin in FD and OF diagnosis. MethodsForty formalin fixed paraffin embedded (FFPE) blocks of FD and OF were prepared for Azan, Toluidine blue and osteocalcin staining. Brown staining of calcified structures was considered as positive for osteocalcin. Scoring for Azan and Toluidine blue was evaluated based on intensity and localization. Level of agreement of original and revised diagnosis was determined. ResultsSix (40%) of 15 FD were corroborated by osteocalcin. Eight cases initially diagnosed as OF were revised to FD. There were 25 OF according to H/E, and 17 (68%) were validated by osteocalcin. Measure of agreement between histology and immunohistochemistry was 0.081; p = .608. Eleven (42.3%) OF expressed strong toluidine blue staining of the intervening fibrous connective tissue stroma while only 2 (14.2%) FD showed similar staining, this difference was statistically significant [p = .001]. ConclusionsHistomorphometric analysis with Toluidine blue may reduce diagnostic errors of OF and FD.

Peripheral ossifying fibroma: An unusual presentation

Peripheral ossifying fibroma (POF) is a focal, reactive, non-neoplastic tumor-like growth of the soft tissue occurring frequently in the maxillary anterior region, mainly affects females, predominating in the second decade of life. POF typically presented as a solitary, slow growing nodular mass that is either pedunculated or sessile. POF is commonly associated with poor oral hygiene, trauma, microorganisms etc and majority of cases showing no marked underlying bone involvement radiographically. The definitive diagnosis is based on histology, with identification of cellular connective tissue and focal presence of osseous component or other calcifications. Surgery is the treatment of choice, though it has a recurrence rate of 8-20%. We report an unusual case of a large POF in the posterior mandible region of a male child patient with histopathological correlations and also highlights the differential diagnosis and management.

Osteofibrous dysplasia arising in the humerus: A case report.

Osteofibrous dysplasia is a benign fibro-osseous lesion of bone which is most commonly occurred in cortical bone of anterior mid-shaft of the tibia of infancy and childhood. This study reported a case of osteofibrous dysplasia arising in the humerus of adult, resulting in good prognosis after a surgical treatment. A 34-year-old male had felt left upper arm pain and was suspected as having a bone tumor at the humeral shaft by X-ray pictures. The tumor was suspected as the osteofibrous dysplasia of the humerus by a core needle biopsy. Intralesional curettage, intraoperative anhydrous ethanol therapy, and artificial bone graft were performed. Surgical specimens showed fibro-osseous lesion, which strongly indicated osteofibrous dysplasia. Seven years after the surgery, he has lived without any local recurrence and complaints. It is important to recognize that osteofibrous dysplasia can arise in the humerus of an older patient for appropriate diagnosis.

A novel approach for the treatment of peripheral ossifying fibroma: A case report with 1-Year follow-up

Peripheral ossifying fibroma (POF) is a nonneoplastic enlargement of the gingiva precipitated by local irritation and minor trauma. POF represents 9.6% of all gingival tumors and 3.1% of the oral lesions which are biopsied. Dental calculus, plaque, microorganisms, dental appliances, and restorations are considered to be examples of etiological factors. A 38-year-old female patient presented with a chief complaint of swelling in her upper front teeth region for 6 months. Examination revealed a nontender oval, sessile growth with respect to tooth number 21, 22 region, measuring approximately 2 cm × 1.5 cm × 1.5 cm in size with a pinkish red overlying mucosa without any ulcerations. Palpation revealed a sessile base with firm consistency. Based on these clinical, radiological, and histopathological findings a final diagnosis of POF with respect to 21, 22 region was made. The treatment consisted of scaling and root planning followed by complete excision of the lesion using a combination technique of using both surgical scalpel and diode laser. The patient was followed up for 1 year and there were no signs of recurrence. This case of excision with the combination of scalpel and laser and the absence of recurrence over a period of 1 year makes this novel approach a promising treatment option.

Ossifying fibroma of maxilla: A rare case report

A 32-year-old male patient reported with a painless swelling over right cheek and is slowly growing in size for the past 2 years. Incisional biopsy revealed the lesion as Ossifying fibroma (OF), which is not very common in the maxilla. Surgical excision and primary closure was successfully carried out with no postoperative complications. The case was followed for a period of 3 years with no evidence of recurrence.

A Case of Maxillary Ossifying Fibroma Treated by Navigation Surgery

A Case of Maxillary Ossifying Fibroma Treated by Navigation Surgery

Osteofibrous Dysplasia of the Tibia in Children: Outcome Without Resection.

The proposed association between osteofibrous dysplasia and adamantinoma has led some to advocate resection of the entire lesion, which can require major subsequent reconstruction. However, this link remains unproven and there is some support in more recent literature for a less aggressive approach. This study aims to describe our experience managing pediatric tibial osteofibrous dysplasia with such an approach and to report functional outcomes in children treated thus. A total of 28 cases of osteofibrous dysplasia in 25 patients were managed at a referral center for pediatric bone tumors with observation in the first instance, then limited surgical intervention if required to address pain and deformity. Surgery aimed to restore stability and alignment without excising the lesion. Clinical records provided basic clinical outcome measures involving walking, recreation, orthoses and school/work participation and patients provided a Musculoskeletal Tumour Society score (MSTS) where contactable. Mean age at presentation was 6.0 years and mean follow-up was 8.3 years. Only 8 patients required surgery. According to basic outcome measures, 13 patients were symptom-free. About 15 patients (17 cases) provided a MSTS and the mean score was 24 of 30. No transformation to adamantinoma was observed. Those who presented at a younger age and with bilateral disease more often required surgery and remained symptomatic. A less aggressive approach to pediatric tibial osteofibrous dysplasia achieves good functional outcomes and patient satisfaction in most cases. Surgery is required in the minority of cases. Transformation to adamantinoma was not observed in this series. We recommend patient education, clinical observation and reactive intervention if required, rather than proactive resection and reconstruction. Level IV-case series.

Postoperative care and long-term follow-up after a rostral mandibulectomy to treat an ossifying fibroma in a horse

ABSTRACT: Ossifying fibroma is a disfiguring benign neoplasia of the jaw that affects young animals of several species, including horses. The present report described the postoperative care and long-term follow-up after a rostral mandibulectomy (RM) that was performed to treat an ossifying fibroma in a horse. A 3-year-old crossbred horse presented a hard, well-defined, 14.5×10.0×9.5cm ulcerated mass attached to the rostral mandible. Radiographic findings were compatible with a nonaggressive mandibular bone deformity (benign neoplasia). Histological features confirmed the diagnosis of the ossifying fibroma. After the RM, the horse slowly adapted to the new feeding conditions and was discharged when it fully recovered and was capable of feeding on the paddock and drinking water on its own on day 60. This slow adaptation was crucial for post-surgical recovery and required hard labor to manage the feeding and hydration by nasogastric tube during the hospital stay.

Conservative management of an atypical intra-sinusal ossifying fibroma associated to an aneurysmal bone cyst.

Ossifying fibroma (OF) is a benign fibro-osseous lesion mainly occurring in young adults and seems to originate from the periodontal ligament. Aneurysmal bone cyst (ABC) is a benign intraosseous lesion characterized by blood-filled spaces of various sizes. These two lesions can specifically affect the jaws and are commonly described in the literature. However, few cases describing an association of OF and ABC have been reported in the literature, especially in the maxillary sinus. We report the case of a 40-year-old male patient affected with an asymptomatic lesion with a dual component of OF and ABC laying in the maxillary sinus. Our aim is to discuss its clinical and morphological features as well as treatment results.

Deletion of Menin in craniofacial osteogenic cells in mice elicits development of mandibular ossifying fibroma.

Ossifying fibroma (OF) is a rare benign tumor of the craniofacial bones that can reach considerable and disfiguring dimensions if left untreated. Although the clinicopathological characteristics of OF are well established, the underlying etiology has remained largely unknown. Our work indicates that Men1-a tumor suppressor gene responsible of Multiple endocrine neoplasia type 1-is critical for OF formation and shows that mice with targeted disruption of Men1 in osteoblasts (Men1Runx2Cre) develop multifocal OF in the mandible with a 100% penetrance. Using lineage-tracing analysis, we demonstrate that loss of Men1 arrests stromal osteoprogenitors in OF at the osterix-positive pre-osteoblastic differentiation stage. Analysis of Men1-lacking stromal spindle cells isolated from OF (OF-derived MSCs (OFMSCs)) revealed a downregulation of the cyclin-dependent kinase (CDK) inhibitor Cdkn1a, consistent with an increased proliferation rate. Intriguingly, the re-expression of Men1 in Men1-deficient OFMSCs restored Cdkn1a expression and abrogated cellular proliferation supporting the tumor-suppressive role of Men1 in OF. Although our work presents the first evidence of Men1 in OF development, it further provides the first genetic mouse model of OF that can be used to better understand the molecular pathogenesis of these benign tumors and to potentially develop novel treatment strategies.

Ossifying fibroma – diagnosis, treatment, and follow-up: case report and literature review

OBJECTIVE: This article presents a case of ossifying fibroma (OF), including its diagnosis, treatment, and 15-month clinical and radiographic follow-up as well as a review of the literature about this pathology.CASE REPORT: A routine panoramic radiograph of a 27-year-old, systemically healthy, white woman revealed a radiolucent lesion with well-defined sclerotic margins of approximately 3 × 2 cm in the mandible. The histopathological diagnosis revealed it was an OF. Lower Right Canine and Lower Right First Premolar teeth were endodontically treated for later surgical removal of the tumor. There was no history of trauma in the region.CONCLUSION: OF is a benign fibro-osseous tumor of the craniofacial bones commonly involving the jaws, especially the mandible. The diagnosis is based on a combination of clinical, radiographic and histologic criteria. Conservative treatment is an effective option that reduces morbidity and simplifies postoperative rehabilitation. We emphasize the importance of properly documenting individual cases and interpreting postoperative radiographic images along with the patients in order to avoid possible confusion between areas of bone repair and of potentially suspicious lesions in the future.

Fibular osteocutaneous free flap reconstruction of the mandible after resection of ossifying fibroma in a seven-year old child

Ossifying fibromas (OSF) belong to a group of benign fibro-osseous neoplasms encountered almost exclusively in the craniofacial skeleton. The clinical course is typically asymptomatic. However, discomfort in the mouth begins to develop once the neoplasm progressively extends, causing an overgrowth of bone resulting in pain and facial asym­metry. The development of craniofacial bone tumors in children is quite a rare occurrence. In international medical literature, the described cases typically involve young adolescent patients, with very few case reports of craniofacial neoplasms in children under the age of seven [1, 2]. In the current case report, we present a seven-year-old patient with a biopsy-proven ossifying fibroma. The patient underwent a resection of the neoplasm with reconstruction. One of the major issues encountered in reconstruction of the mandible using a vascularized fibular flap in children is the growth potential of the fibula in comparison to the mandible, resulting in a symmetrical facial image. The use of a fibular osteocutaneous free flap in reconstruction of mandibular deficits in children is a favourable solution. The use of this type of flap permits functional restoration and significantly improved facial cosmesis. The union of the mandible with the integrated fibula is still a topic of ongoing discussion and one must be prepared for possible further orthognathic procedures after completing the growth of the craniofacial skeleton.

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

OSSIFYING FIBROMA: REPORT OF A CASE IN THE LEFT MAXILLA WITH A 10-YEAR FOLLOW-UP

Ossifying fibroma is a well-delineated lesion composed by fibrous tissue and mineralized matrix of odontogenic or periodontal origin. It occurs mostly in women between their 20th and 40th years, often in the posterior mandible. It is asymptomatic but detectable by routine radiographs. Standard care involves resection followed by bone grafting, presenting a favorable prognosis and low recurrence or malignant transformation rates. This report describes a case (female patient, 19 years old) of a radiolucent, well-delineated lesion between the teeth 23 and 26. This lesion was expanding, collapsing cortical bone and dislodging roots. Incisional biopsy revealed fibrous tissue presenting with mineralized areas resembling immature trabecular bone or cementum, with a diagnosis of central ossifying fibroma associated to an aneurysmal bone cyst. Surgical removal was performed, with deepening of the chin as a sequelae. This report validates the relevance of observing clinical, radiographic, and histopathologic changes, and the importance of the 10-year follow-up showing no recurrence.

OSSIFYING FIBROMA: REPORT OF A CASE IN THE MANDIBULAR SYMPHYSIS WITH A 9-YEAR FOLLOW-UP

Ossifying fibroma is a well-delineated lesion, composed by fibrous tissue and mineralized matrix of odontogenic or periodontal origin. It is commonly found in the posterior mandible of women between their 20th and 40th years. It is asymptomatic but detectable by routine radiographs. Standard care involves resection followed by bone graft, with good prognosis and unlikely recurrence or malignant transformation. This study reports a case (female patient, 40 years old) presenting with a radiolucent lesion with internal calcification between the teeth 34 and 43. Clinical and imaging findings also included expansion of the symphysis with collapsing cortical bone and root dislodgement. Biopsy revealed fibrous tissue with mineralized areas resembling immature trabecular bone or cementum, leading to the diagnosis of central ossifying fibroma. Treatment involved block resection and bone grafting. This report highlights the importance of observing clinical, radiographic, and histopathologic changes, as well as follow-up, which extend for 9 years in this case, without recurrence.

Management of Juvenile Ossifying Fibroma by Aggressive Curettage – A Case Report

Management of Juvenile Ossifying Fibroma by Aggressive Curettage – A Case Report

Ossifying Fibroma of the Maxilla: A Rare Case

Ossifying fibroma OF is primarily classified under Fibro osseous lesions FOL rsquo s of the jaw the rare benign non aggressive tumors This article presents a case of ossifying fibroma with minimal symptoms involving the left maxilla in a year old female patient The clinical and diagnostic features management and prognosis were discussed along with the review of literature

Does osteofibrous dysplasia progress to adamantinoma and how should they be treated?

The aim of this study was to identify any progression between benign osteofibrous dysplasia (OFD), OFD-like adamantinoma and malignant adamantinoma, and to investigate the rates of local recurrence, metastases and survival, in order to develop treatment algorithms for each. A single institution retrospective review of all patients presenting with OFD, OFD-like adamantinoma and adamantinoma between 1973 and 2012 was undertaken. Complete data were available for 73 patients (42 with OFD; ten with an OFD-like adamantinoma and 21 with an adamantinoma). The mean follow-up was 10.3 years (3 to 25) for OFD, 9.2 years (3.0 to 26.3) for OFD-like and 11.6 years (0.25 to 33) for adamantinoma. The mean age at diagnosis for OFD was 13.5 years (1 to 49), 10.5 years (6 to 28) for OFD-like and 34 years (14 to 86) for adamantinoma. A total of 24 of the 42 patients with OFD (57%) have not required any treatment and have been managed with observation. A total of 18 of the 42 patients with OFD underwent surgery, 13 with curettage and five with resection. In all, three patients developed recurrence following curettage (23%) but none following resection. All these patients were cured with further limited surgery. A total of six patients initially diagnosed with OFD were subsequently found to have OFD-like adamantinoma. Of the ten patients initially diagnosed with OFD-like adamantinoma, three (30%) were managed with observation alone and seven underwent surgery, two with curettage and five with resection. Local recurrence arose in two patients, one each after curettage and resection. No patients with either OFD or an OFD-like adamantinoma developed metastases or had progression to adamantinoma. All patients with an adamantinoma were treated by surgery, three with curettage, six with amputation and 12 with excision. In all, two of the three treated with curettage developed local recurrence, requiring further surgery. Late development of both local recurrence and metastases led to a ten year disease specific survival of 93% which had dropped to 39% by 20 years. We found no evidence of progression from OFD to adamantinoma. Conservative management with observation or curettage is often successful for patients with OFD and OFD-like adamantinoma. Resection with clear margins is required for patients with adamantinoma. Late tumour recurrence is not uncommon in adamantinoma and prolonged follow-up should be considered. Cite this article: Bone Joint J 2017;99-B:409-16.

Clinical research for treatment of ossifying fibroma in the jaws of children

Background: A high recurrence rate of ossifying fibroma (OF) in the jaws of children has been noticed by surgeons. It must be treated properly for children's physical and mental health. Objectives: To evaluate recurrence rate of different surgical methods of OF in the jaws of children. Methods: A retrospective study was carried out for patients below the age of 18 years with ossifying fibroma of the jaws treated in Department of Oral and Maxillofacial surgery, Peking University School and Hospital of Stomatology, China between 1991 and 2016. Patients with complete clinical, pathological, radiological and follow-up data were selected. Recurrence rates of different surgical methods were compared. Findings: 44 patients met the selection criteria comprising of 30 males and 14 females. The age ranged 3–18 years with a medium age of 11 years. 20 cases were located in the mandible and 23 in the maxilla. One was multiple OFs in both jaws. Forty patients were subjected to surgical treatment. Seven cases got curettage, 8 cases got local excision and 25 cases got extended resection. Ten of them relapsed with the recurrence rate of 25%. The recurrence rate of curettage was 71.4% (5/7), and 50% (4/8) for local excision. As for extended resection, it was 4% (1/25). Different jaws were also different, 33.3% (7/21) in maxilla and 15.8% (3/19) in mandible. Conclusions: The recurrence rate of extended resection for OF in the jaw of children was lower than local excision and curettage. OF occurred in maxilla was easier to relapse than in mandible.

Trabecular Variant of Juvenile Ossifying Fibroma (WHO Type) - A Rare Case Report and Review of the Literature

Trabecular Variant of Juvenile Ossifying Fibroma (WHO Type) - A Rare Case Report and Review of the Literature