This article reports a case of ossifying fibroma of the mandible. It is highly aggressive and has a high tendency to recur. This bone tumor consists of highly cellular, fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum, or both. Eversole fibro osseous lesions are a diverse group of processes that are characterized by replacement of. It originates from the proliferation of fibrous tissue and histocytes. They most often arise from the tooth bearing areas of these bones. Varying shapes of the lesion including cystic lesion. The swelling was bony hard, nontender with no fluctuation on manual palpation. Other terms used in reference to pof are peripheral cementifying fibroma, peripheral fibroma with cementogenesis, peripheral fibroma with osteogenesis, peripheral fibroma with calcification, calcified or ossified fibrous epulis, and calcified fibroblastic granuloma. This is a growth that appears inside the mouth as a small lump on the gum.
Extensive presentation of central ossifying fibroma treated. Pdf central ossifying fibroma cof is the most common benign fibroosseous lesion of the jaw. Two cases of multiple ossifying fibromas in the jaws. A nof is a result from failure of the bone to properly close at its outer shell. Therefore the present study is aimed to describe a rare case of ossifying odontogenic fibroma and discuss the histopathology and immunohistochemical features of this rare variant of of. Osteofibrous dysplasia is a rare, benign nonneoplastic condition with no known cause. Peripheral ossifying fibroma is a fairly common lesion, representing % of all oral biopsies in most series. Peripheral ossifying fibroma, also known as ossifying fibrous epulis, is a gingival nodule which is composed of a cellular fibroblastic connective tissue stroma which is associated with the formation of randomly dispersed foci of mineralised products, which consists of bone, cementumlike tissue, or a dystrophic calcification.
We use cookies to offer you a better experience, personalize content, tailor advertising, provide social media features, and better understand the use of our services. In the latest world health organization who classification of 2005, the term cementifying ossifying fibroma was replaced with ossifying fibroma. However, it is controversial whether it represents a true neoplasm or rather a developmental disorder of growing bone. Figure 1 plain radiographs of a non ossifying fibroma in the humerus of a 4yearold female.
Peripheral ossifying fibroma pof is a gingival nodule composed of a cellular fibroblastic connective tissue stroma associated with the formation of randomly dispersed foci of a mineralized product consisting of. Central ossifying fibroma, periapical cementoosseous. The signs of recurrence in spite of thorough excision. It originates in the cells of the periodontal ligament and is more common in children and young adults. A definitive surgical protocol has not yet been published.
Cementoossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cementossifying dysplasia. It has been reported from birth to old age, but peaks in the teenage years. Massive ossifying fibroma of mandible pubmed central pmc. The present article discusses the case of central ossifying fibroma in a 35yearold female patient who presented with a swelling in premolarmolar region of left mandible which was symptomfree. Radiographically, the tumor presents as a well marginated radiolucent lesion, with a distinct multilocular appearance.
Cementoossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous. They tend to persist or increase in size as the child grows but decrease in size or close once growth ends. Intraoral ossifying fibromas have been described in the literature since the late 1940s. Pdf central ossifying fibromas are benign fibro osseous neoplasms affecting the jaws and the craniofacial skeleton. Central cemento ossifying fibroma behaves like, a benign bone neoplasm. Trabecular type of juvenile ossifying fibroma a rare. A variant of ossifying fibroma of was first described in 1872 by menzel in a 35yearold woman who presented with a large tumor of the mandible. Children and adolescents are the most common group of age affected. We also had a nonossifying fibroma with aneurysmal bone cyst type changes. We report in this study, the clinical report of a 20yrold male patient with a peripheral ossifying fibroma i n the maxilla exhibiting significant size with the disease duration of 1 year. Juvenile ossifying fibromas two distinct clinicopathologic entities are known. Central ossifying fibroma is a rare, benign fibroosseous lesion that arises from the periodontal ligament. The lesion is considered part of an ossifying fibroma, but that. S, ravi david austin department of oral medicine and radiology, rajah muthiah dental college and hospital, annamalai university, chidambaram, tamil nadu, india 608002.
And tomorrow i get to gross in a humeral head osteosarcoma and a liposarcoma of the thigh as well as my 15 lung cancers and 15 femoral heads and probably 5 neck dissections. Radiographs taken after 7 mo b, 1 year c, 1 year and 7 mo d, and 2 years and 7 mo e together reveal the location of the lesion became more distal with growth of the child. Central ossifying fibroma is a benign neoplasm that may arise from the fibroblasts of the periodontal ligaments. Terminology in the 2005 who histological classification of odontogeni. In consequence, the fibroosseous lesions present different biological behavior 1, 2. Juvenile ossifying fibroma jof is a rare controversial fibroosseous lesion affecting the craniofacial skeleton and occurring commonly in childrens and young adults. Cemento ossifying fibroma cof are rare, benign neoplasms that usually arise from the mandible or maxilla. However, the marked cellularity of jofpo is in sharp contrast to the usually stromarich appearance of the latter group of lesions. This condition should be differentiated from nonossifying fibroma and fibrous dysplasia of. Ossifying fibroma of is one of the most frequent of the 3 fibroosseous lesions of the jaws and has had an inconstant recurrence rate.
Extensive presentation of central ossifying fibroma treated with. Central ossifying fibroma is a benign slowgrowing tumor of mesenchymal origin and it tends to occur in the second and third decades of life, with predilection for women and for the mandibular premolar and molar areas. The most common location are the distal femoral and distal tibial methaphyses. Traditionally, this type of lesion was subclassified. In the current article a case of peripheral ossifying fibroma pof in the anterior maxillary gingiva is highlighted, which histologically showed cellular, fibrous. A nonossifying fibroma is a common benign bone tumor in children and adolescents.
Peripheral ossifying fibroma pof is a lesion of the gingival tissues representing up to 2% of all oral lesions that are biopsied. Occasionally treated by curettage enucleation, this conservative. The clinicopathologic characteristics of multiple ossifying fibroma of are unclear due to the conditions rarity, making diagnosis challenging. In some cases it may be what is called a peripheral ossifying fibroma. It is distinguished from the adult variant of ossifying fibroma on the basis of age, site, cilinical behaviour and. A nonossifying fibroma nof is one of the most common benign bone tumors found in 30 to 40% of children between 820 years of age. We report a case of jpof involving the paranasal sinuses and orbit in a 15yearold boy that presented due to progressive proptosis and downward displacement of the left eye. It is more likely to affect women in their third and fourth decades. Central cementifying fibroma is a bony tumor, which is believed to be derived from the cells of the periodontal ligament. Extensive presentation of central ossifying fibroma. Central ossifying fibromas are more common in the mandible around premolars and molars. They do not become cancerous and they do not spread metastasize.
Trabecular type of juvenile ossifying fibroma a rare case. Non ossifying fibroma risks, symptoms and leading causes. Many names have been given to similar lesions, such as epulis,1 peripheral fibroma with calcification,1 peripheral ossifying fibroma,2,3 calcifying fibroblastic granuloma,4 peripheral cementifying fibroma, peripheral fibroma with cementogenesis5. Peripheral ossifying fibroma pof is a reactive gingival overgrowth which is relatively uncommon in nature. Cemento ossifying fibroma is a benign, non odontogenic tumour of the jaw, a subdivision of fibroosseous lesions. Nonossifying fibroma is one of the skeletal dont touch lesions. Ossifying fibroma is an uncommon benign osteogenic neoplasm, and it is derived from the multipotential mesenchymal cells of the periodontal ligament. The lesion rarely leads to aneurysmal bone cyst, which is characterized as a bloodfilled space. The peripheral ossifying fibroma pof is a reactive gingival overgrowth occurring frequently in the anterior maxilla. Due to its clinical and histopathological similarities, some pofs are believed to develop initially as a pyogenic granuloma that. Cementoossifying fibroma radiology reference article. Eversole fibro osseous lesions are a diverse group of processes that are characterized by.
This lesion occurs commonly in the long bones of young people, but may rarely occur in the mandible or. Fibroma, ossifying definition of fibroma, ossifying by. Ossifying fibromas of the craniofacial skeleton 127 6. Cemento ossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cement ossifying dysplasia. What is peripheral ossifying fibroma peripheral ossifying fibroma is a benign swelling of the gum, most commonly seen in teenagers and young adults. The cemento ossifying fibroma is a central neoplasm of bone as well as periodontium which has caused considerable controversy because of controversy regarding terminology and the criteria for its. These growths are most frequently seen in adolescents but they can occur at any age and they are not cancerous. Ossifying fibroma is a benign bone neoplasm often considered to be a type of fibroosseous lesion. Lowgrade osteosarcoma arising from cementoossifying fibroma. It is derived from cells of the periodontal ligament and is usually classified as a reactive hyperplasia but sometimes as a benign neoplasm. Pdf ossifying fibroma of is the most frequent of the three fibroosseous lesions of the jaws. Pdf central cemento ossifying fibroma researchgate. Histopathologic differential diagnoses thorakkal shamim department of dentistry, government taluk head quarters hospital, nilambur, india peripheral ossifying fibroma is a benign neoplasm that. Peripheral ossifying fibroma pof is a gingival nodule composed of a cellular fibroblastic connective tissue stroma associated with the formation of randomly dispersed foci of a mineralized product consisting of either bone woven and lamellar.
An ossifying fibroma can be one of two different types of tumor, or growth. Peripheral ossifying fibroma pof is usually a fibroma of the gingival which shows areas of calcification or ossification. Pdf central ossifying fibroma is a rare entity among fibroosseous lesions and is thought to originate from periodontal ligament. Central ossifying fibromas are more common in the mandible around premolars and molars references. If large involving more than 50% of the diameter of the parent bone then prophylactic curettage and bone grafting may be prudent to avoid a pathological fracture 1. Central ossifying fibroma is a benign slowgrowing tumor of mesenchymal origin and it tends to occur in the second and third decades of life, with predilection for. Histopathological examination showed the presence of a benign bone lesion suggestive of ossifying fibroma. More chandramani, thakkar krushna, mukesh asrani2011 cemento ossifying fibroma indian journal of dental research222 5. Nonossifying fibromas nofs are the most common benign bone tumor in children. Peripheral ossifying fibroma a clinical and histological. Nonossifying fibroma is a benign intracortical, multilocular and well circumscribed lesion that affects young patients. Hyperparathyroidism jaw tumor syndrome head neck pathol 2014. Central cementoossifying fibroma behaves like, a benign bone neoplasm.
Sporadic multiple ofs must be distinguished from hyperparathyroidismjaw tumour syndrome hptjt related of and other fibroosseous lesions. It is rare in children in relation to primary dentition milk teeth and incidence declines after the age of 30 years. They have a predilection for females between the third and. Nonossifying fibroma is a common fibrous bone lesion in children that occurs in the metaphysis of the long bones of the lower extremities. Nonossifying fibroma presenting as an aneurysmal bone cyst. A 29yearold male patient was attended at a hospital, after he had suffered a car accident. It was first described as relatively uncommon, solitary, nonneoplastic gingival growth by eversol and robin. The nonossifying fibroma nof is a benign, nonneoplastic lesion most commonly seen in the metaphyses of the long bones in children.
The varying clinical presentations of peripheral ossifying. Periapical cementoosseous dysplasia is another variant of fibroosseous lesion which occurs in the anterior region of the mandible of females. Cemento ossifying fibromas cofs are relatively rare, benign lesions affecting the jaws and other craniofacial bones and are included in the group of mesodermal odontogenic tumors by gorlin. This paper highlights the diverse clinical and histopathological presentations of peripheral ossifying fibroma through three cases encountered.
Central ossifying fibroma is a lesion in which diagnosis has proved intriguing and unclear for presenting clinical, radiographic, and even histopathological similarities to other types of lesions. Surgical management of ossifying fibroma in maxilla. We present the case of a yearold japanese boy with a complaint of discomfort in the thigh and a small, welldefined, osteolytic lesion with cortical. Peripheral ossifying fibroma is a focal, reactive, nonneoplastic tumorlike growth of the soft tissue that often arises from the interdental papilla 1. An osteolytic lesion is shown at the cortex in the proximal humerus a. Multiple of cases were identified from ossifying fibroma cases. Orthopaedic institute for children nonossifying fibroma. Central fibroma of the jaws of the literature suggests that.
All the cases had adequate radiographs and clinical information. While rare, the nof has been reported in the mandible. These are slow growing, painless lesions which are seen more commonly in women between the third and fourth decades of life. In most cases, no treatment is necessary because nofs typically go away on their own when a child is fully grown. Largely unknown for sporadic ossifying fibroma can rarely show syndromic inherited association. The ossifying fibroma of is a benign neoplasm that affects the jaws. Figure 1 plain radiographs of a nonossifying fibroma in the humerus of a 4yearold female.
Clinically, it is a large asymptomatic tumor of aggressive appearance, with possible tooth displacement. Conclusion juvenile ossifying fibroma is an aggressive lesion which. Central cemento ossifying fibroma of posterior maxilla uday shankar yaga, ashwini. Fibroosseous lesions refer to a collection of nonneoplastic intraosseous lesions that replace normal bone and consist of a cellular fibrous connective tissue within which nonfunctional osseous structures form. Central ossifying fibroma is a lesion in which diagnosis has proved intriguing and unclear for presenting clinical, radiographic, and even. Ossifying fibroma of is a benign, nonodontogenic tumor of the jaw, a type of fibroosseous lesion. The aim of the present study was to determine the clinical and radiologic features of of at a tertiary hospital in south africa, assess its management. First description of ossifying fibroma was given by menzel in 1872 while the term was given by montgomery in 1927. This condition should be differentiated from nonossifying fibroma and fibrous dysplasia of bone.
Juvenile psammomatoid ossifying fibroma jpof is an uncommon benign fibroosseous lesion predominantly arising in the paranasal sinuses and orbits of children and young adults. Pofs comprises of, one or more mineralized tissues, including bone, cementum like material or dystrophic calcification, within a matrix of cellular fibroblastic tissue 2. They are noncancerous and do not spread to other areas of the body. Radiographically, the tumor presents as a well marginated radiolucent lesion, with a. Mar 30, 2020 an ossifying fibroma can be one of two different types of tumor, or growth. The nof in the extragnathic skeleton has a characteristic radiographic appearance, is typically asymptomatic and has a variable histologic makeup. Its origin is believed to be from periodontal membrane, and it shows more predilection toward females. Osseous dysplasia and fibrous dysplasia are reactive lesions while ossifying fibroma is a true neoplasm. Campanacci described this condition in two leg bones, the tibia and fibula, and coined the term. Cementoossifying fibromas are benign tumors, and, although cases of an aggressive type have been. Central cementoossifying fibroma of posterior maxilla. The aim was to report on a case of ossifying fibroma, consisting of a benign fibroosseous lesion characterized by slow growth and proliferation of fibrous cellular tissue, bone, cement or a combination. Cemento ossifying fibroma of the jaw dental jounal424 3.
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