Fibrous dysplasia and ossifying fibroma of the paranasal sinuses

1998 ◽  
Vol 112 (10) ◽  
pp. 964-968 ◽  
Author(s):  
D. J. Commins ◽  
N. S. Tolley ◽  
C. A. Milford
Keyword(s):  
Fibrous Dysplasia ◽  
Surgical Approach ◽  
Paranasal Sinuses ◽  
Radical Surgery ◽  
Anterior Skull Base ◽  
Ossifying Fibroma ◽  
Clinical Classification ◽  
Osseous Lesion ◽  
Clinical Behaviour ◽  
Management Perspective

AbstractFibro-osseous lesions involving the paranasal sinuses, the mid-face and anterior skull base are uncommon. In addition, there appears to be no clear pathological or clinical classification that embraces the variety of lesions that exhibit such diverse pathological and clinical behaviour, yet may still be referred to as a fibro-osseous lesion. The diagnosis of fibrous dysplasia and ossifying fibroma is made on a combination of clinical, radiological and pathological criteria.This paper emphasizes the clinical and pathological differences between fibrous dysplasia and ossifying fibroma. The more aggressive clinical behaviour of the latter is highlighted and a more radical surgical approach i s recommended. In contradistinction, fibrous dysplasia can exhibit a more benign behaviour and radical surgery s i not always justified.A clinicopathological distinction between these two conditions is important from a management perspective despite the fact that they both may be encompassed under the ‘umbrella’ term fibro-osseous lesion.

scholarly journals Imaging in the Diagnosis of Cemento-Ossifying Fibroma: A Case Series

2012 ◽  
Vol 2 ◽  
pp. 52 ◽  
Author(s):  
R Mithra ◽  
Pavitra Baskaran ◽  
M Sathyakumar
Keyword(s):  
Treatment Planning ◽  
Fibrous Dysplasia ◽  
Case Series ◽  
Disease Process ◽  
Ossifying Fibroma ◽  
Imaging Findings ◽  
The Third ◽  
Osseous Lesion ◽  
Essential Tool ◽  
Slow Growing

Cemento-ossifying fibroma is a benign fibro-osseous lesion belonging to the same category as fibrous dysplasia and cementifying dysplasia. These are slow-growing lesions that are seen in the third and fourth decades of life. Both the ossifying fibroma and cemento-ossifying fibroma represent two extremes of the same disease process since histologically both contain bone and cementum. However, the term cemento-ossifying fibroma is justified on the basis of clinical and radiological correlation. Radiographs have become an essential tool in the diagnosis of lesions in the jaw, where the anatomy is complex. Nowadays, CT provides information for diagnosis as well as treatment planning. In this case series, we report three cases of cemento-ossifying fibroma that were histologically confirmed and discuss the imaging findings.

scholarly journals Fibro Osseous Lesions of The Craniofacial Structures – A Clinical Study

2018 ◽  
Vol 8 (1) ◽  
pp. 45-54
Author(s):  
Mohammad Asifur Rahman ◽  
Tarin Rahman ◽  
Ismat Ara Haider
Keyword(s):  
Clinical Study ◽  
Fibrous Dysplasia ◽  
Clinical Observation ◽  
Maxillofacial Surgery ◽  
Ossifying Fibroma ◽  
Osseous Lesion ◽  
The Mean ◽  
Maxilla And Mandible ◽  
Age Range ◽  
Tissue Matrix

Fibro osseous lesions area diverse group of disorders characterized by replacement of normal archi- tecture of bone by a benign connective tissue matrix that displays various amount ofmineralizationin the form of woven bone or cementum. It includes developmental, reactive and neoplastic lesions.  The different type of fibro-osseous lesions express a common clinical and radiological features. Soad- equate knowledge and clinical observationare necessary for proper interpretation and appropriate diagnosis of these lesions.becausemanagement of patients with fibro-osseous lesions are case specificandindividualized.The aim of this study was to analyse the clinical, radiological and histo- pathological characteristics of fibro osseous lesions andprovide a proper management system affect- ed by this type of lesions. Materials and methods:The retrospective study was performed in the Department of Oral & Maxillofacial surgery, Dhaka Dental College and Hospital, Dhaka, Bangladesh from a period of January 2015 to January 2018. Patients were selected for this study based on clinical, radiological and histopathological confirmation of fibro-osseous lesion. The management of each case were plannedand follow-up data were also documented. Results: A total number of 30 patients were selected for this study.The most common fibro-osseous lesionsin this study were fibrous dyspla- sia 10 (33%) and ossifying fibroma 20 (67%).The mean age offibrous dysplasia were 17.4 years with an age range 12 to 33 years and at ossifying fibroma the mean age were 30.35 years with an age range 12 to 57 years. Female17 (57%) represented the majority of the affected patients. Fibrous dysplasia were more common in maxilla(70%) and ossifying fibroma were more common in the man- dible(60%).Surgical recontouring and clinical observation were treatment of choice infibrous dysplasia and surgical resection, enucleation and curettage were treatment of choice in ossifying fibroma. Conclusion:The most common fibro-osseous lesion in our clinical study was fibrous dysplasia and ossifying fibroma which presents painless bony swelling and deformity in maxilla and mandible. Fibrous dysplasia presents as a homogenous, radioopacity,ill defined border and ossifying fibroma presents a mixed radioopacity and radiolucent lesion that is well demarcated from normal bone. Surgi- cal recontouring and clinical observation was done in treatment of fibrous dysplasiaand ossifying fibroma wastreated enucleation and curettage, segmental resection completelyenucleatefromsur- rounding bone.Update Dent. Coll. j: 2018; 8 (1): 45-54

Subacute cystic expansion of intracranial juvenile psammomatoid ossifying fibroma

2013 ◽  
Vol 11 (6) ◽  
pp. 687-691 ◽  
Author(s):  
Nathan C. Rowland ◽  
Walter J. Jermakowicz ◽  
Tarik Tihan ◽  
Ivan H. El-Sayed ◽  
Michael W. McDermott
Keyword(s):  
Aggressive Behavior ◽  
Skull Base ◽  
Surgical Approach ◽  
Neurological Deficit ◽  
Ossifying Fibroma ◽  
Distinct Population ◽  
Focal Neurological Deficit ◽  
Osseous Lesion ◽  
Psammomatoid Ossifying Fibroma ◽  
Active Processes

Juvenile psammomatoid ossifying fibroma (JPOF) is a benign fibro-osseous lesion typically associated with the jaw, paranasal region, or orbit. However, JPOF may also originate from the skull base and locally invade the cranium. In published reports, intracranial JPOFs constitute only a small percentage of cases, and therefore it is not known whether more aggressive behavior typifies this distinct population of JPOFs compared with those in other locations. Nevertheless, JPOF histopathology is characterized by a number of active processes, including cystic transformation, that may precipitate violation of skull base boundaries. In the following article, the authors present a case of skull base JPOF that underwent cystic expansion in a young girl, produced a focal neurological deficit, and was resolved using a staged surgical approach.

scholarly journals Fibro-osseous lesions of the paranasal sinuses and the skull base

2018 ◽  
Vol 4 (6) ◽  
pp. 1324
Author(s):  
Sajedh M. Alturaiki ◽  
Ali Almomen ◽  
Ghaleb Al Azzeh ◽  
Abdulrahman Al Khatib ◽  
Nada Alshaikh
Keyword(s):  
Skull Base ◽  
Fibrous Dysplasia ◽  
Paranasal Sinuses ◽  
Correct Diagnosis ◽  
Computer Assisted Surgery ◽  
Ossifying Fibroma ◽  
Computer Assisted ◽  
Open Approach ◽  
Diagnostic Dilemma ◽  
Treatment Prognosis

<p class="abstract"><strong>Background:</strong> Osteomas, ossifying fibromas, and fibrous dysplasia comprise a set of benign neoplasms known as fibro-osseous lesions (FO), which can arise in the paranasal sinuses. The vast majority of benign FO lesions (BFOL) are incidental findings on radiographs. They tend to be slow-growing tumors, and are infrequently symptomatic. The management strategy can vary significantly for theses lesions. This can range from serial, observations to aggressive surgical resection, based on symptomatology, size, and location of the lesion.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of all the data of different symptomatic FO of the paranasal sinuses and the skull base was performed at King Fahad specialist hospital, Dammam, KSA (2006 to 2017).  </p><p class="abstract"><strong>Results:</strong> A total of 21 patients were identified; 10 (46.7%) patients were diagnosed with osteoma, 8 (38.1%) with fibrous dysplasia, 2 (9.5%) with ossifying fibroma and one (4.8%) with juvenile active ossifying (JAOF), 17 were adults and 4 were children, the range of f/u (3-60) months. 19 patients were managed by the endonasal endoscopic approach. They continue to be followed with no evidence of recurrence. Two cases required the revision combined endoscopic open approach to ensure adequate removal of the disease (residual and recurrence).</p><p><strong>Conclusions:</strong> Diagnostic dilemma of BFOL can be overcome with a combination of clinical, radiological and pathological criteria. Correct diagnosis of fibro-osseous tumors is crucial for adequate therapy as their treatment, prognosis, clinical aggressiveness and long term complications of individual entities vary significantly. Endoscopic computer-assisted surgery is the treatment of choice. Endoscopic resection remains a technical challenge. </p>

scholarly journals The Spectrum of Ossifying Fibroma

2007 ◽  
Vol 22 (1-2) ◽  
pp. 35
Author(s):  
Johanna Patricia A. Cañal
Keyword(s):  
Fibrous Dysplasia ◽  
The Other ◽  
Ossifying Fibroma ◽  
X Rays ◽  
X Ray ◽  
Osseous Lesion ◽  
Simple Enucleation ◽  
Slow Growing ◽  
Growing Mass ◽  
Better Than

An ossifying fibroma is a monostotic lesion that occurs in craniofacial bones.  It usually presents as a painless well-circumscribed, slow-growing mass in the 3rd and 4th decade.  It is a benign fibro-osseous lesion that is part of the bigger spectrum of fibro-osseous lesions which includes fibrous dysplasia, juvenile active ossifying fibroma, psammomatous ossifying fibroma, and extragnathic ossifying fibroma of the skull.    An ossifying fibroma, because of its well-circumscribed nature, lends itself to surgery better than does fibrous dysplasia.  Simple enucleation is usually sufficient for ossifying fibromas whereas curettage is probably better suited for fibrous dysplasia.    Radiographically, it is seen as a well-demarcated radiolucency in the mandible or maxilla, more common in the former than the latter.  It typically measures anywhere from 1 to 5 cm.  There may or may not be a central opacity or calcification, depending on the maturity of the lesion.  An immature lesion may present as completely radiolucent whereas a mature lesion may be completely radiopaque, although most lesions demonstrate varying degrees of radiopacity.  The images above show 2 samples of the same lesion on opposite sides of the spectrum.  Both are well-circumscribed but one is relatively radiolucent while the other is floridly sclerotic.   Is there a pathognomonic finding on x-ray?  Unfortunately, there is not one single finding that will distinguish an ossifying fibroma from other fibro-osseous lesion.  Does it matter?  Yes.  X-rays will lead the clinician to one diagnosis or the other and help plan the intended surgery.        

Endonasal Endoscopic Approach to Anterior Skull Base Fibrous Dysplasia

2016 ◽  
Vol 77 (S 02) ◽  
Author(s):  
Suha Beton ◽  
Hazan Basak ◽  
Selcuk Mulazimoglu ◽  
Cem Meco
Keyword(s):  
Skull Base ◽  
Fibrous Dysplasia ◽  
Anterior Skull Base ◽  
Endoscopic Approach

Central ossifying fibroma of mandible

2020 ◽  
Vol 13 (12) ◽  
pp. e239286
Author(s):  
Kumar Nilesh ◽  
Prashant Punde ◽  
Nitin Shivajirao Patil ◽  
Amol Gautam
Keyword(s):  
Fibrous Tissue ◽  
Three Dimensional ◽  
Facial Asymmetry ◽  
Ossifying Fibroma ◽  
Mandible Reconstruction ◽  
Three Dimensional Printing ◽  
Osseous Lesion ◽  
Large Size ◽  
Dimensional Printing

Ossifying fibroma (OF) is a rare, benign, fibro-osseous lesion of the jawbone characterised by replacement of the normal bone with fibrous tissue. The fibrous tissue shows varying amount of calcified structures resembling bone and/or cementum. The central variant of OF is rare, and shows predilection for mandible among the jawbone. Although it is classified as fibro-osseous lesion, it clinically behaves as a benign tumour and can grow to large size, causing bony swelling and facial asymmetry. This paper reports a case of large central OF of mandible in a 40-year-old male patient. The lesion was treated by segmental resection of mandible. Reconstruction of the surgical defect was done using avascular fibula bone graft. Role of three-dimensional printing of jaw and its benefits in surgical planning and reconstruction are also highlighted.

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