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Ossifying fibroma: an uncommon differential diagnosis for T2-hypointense sinonasal masses. Radiol Case Rep 2017; 12:313-317. [PMID: 28491178 PMCID: PMC5417760 DOI: 10.1016/j.radcr.2017.03.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/07/2017] [Accepted: 03/11/2017] [Indexed: 11/21/2022] Open
Abstract
Ossifying fibroma is a benign fibro-osseous lesion that occurs most commonly in the mandible of female patients. In rare cases, it affects the nasal cavity. The magnetic resonance imaging features may vary depending on the amount of fibrous and bony tissue in its composition. In these tumors, T2-hypointensity is a feature described in the peripheral ossified areas of the lesion, but it may present diffusely, especially when the degree of ossification is extensive. In this scenario, this particular characteristic on T2-weighted imaging is superimposable to the commonly described appearance of other lesions, such as non-Hodgkin's lymphoma, melanoma, and other sinonasal neoplasms with high cellularity and high nucleocytoplasmic ratio. In the present study, we report a case of ossifying fibroma of the nasal cavity that presented as a diffusely and homogeneously T2-hypointense mass, a finding that may cause difficulty in the differential diagnosis with other expansive sinonasal lesions.
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Lv M, Li J, Shen Y, Wang L, Sun J. The "Drawer-Like" Resection and Reconstruction With Titanium Mesh: A Novel Surgical Technique for Treatment of Giant Ossifying Fibroma in the Maxilla. J Oral Maxillofac Surg 2017; 75:1752-1761. [PMID: 28111211 DOI: 10.1016/j.joms.2016.12.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 12/20/2016] [Accepted: 12/20/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of this article is to introduce a new surgical method for the treatment of ossifying fibroma (OF) in the maxilla with dislocation of the eyeball and to evaluate the postoperative outcomes and prognosis. PATIENTS AND METHODS Cases of maxillary OF treated with "drawer-like" resection from 2014 to 2015 were reviewed. The surgical procedure consisted of total removal of the orbital floor and most of the maxilla with preservation of the alveolar ridge immediately followed by reconstruction with titanium mesh. Postoperative appearance and function were assessed. In addition, the recurrence rate was statistically observed. RESULTS The study included 6 patients with maxillary OF who were treated with drawer-like resection. Good esthetics and decrease of the globe were successfully achieved in all patients. Long-term follow-up showed a low recurrence rate. The original occlusal relation and masticatory function were preserved. CONCLUSIONS With this new method, the original occlusal relation can be well preserved and bulging of the maxilla and eyeball displacement can be corrected.
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Affiliation(s)
- Mingming Lv
- Resident, Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jun Li
- Associate Professor, Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yi Shen
- Attending Surgeon, Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Liang Wang
- Resident, Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jian Sun
- Professor, Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
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Virtual Surgical Planning and Piezoelectric Surgery in Tumor Extirpative Surgery Aimed at Inferior Alveolar Nerve Preservation. Case Rep Surg 2017. [PMID: 29527383 PMCID: PMC5804290 DOI: 10.1155/2017/4397178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A myriad of extirpative surgical protocols for the management of benign tumors of the jaws have been presented in the literature. Through significant advancements in computer-aided design and computer-aided manufacturing (CAD/CAM) technology and surgical instrumentation, today surgeons have at their disposal robust technology-driven techniques that are aimed at improving surgical outcomes. Our goal is to investigate the benefits of implementing virtual surgical planning (VSP) in conjunction with piezoelectric surgery (PES) to ensure success while minimizing the risk of complications during extirpation of tumors of the mandible. This case report describes the successful extirpation of an ossifying fibroma of the mandible in an adult patient using both VSP and PES.
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Ossifying Fibroma: Analysis of Treatment Methods and Recurrence Patterns. J Oral Maxillofac Surg 2016; 74:2409-2419. [DOI: 10.1016/j.joms.2016.05.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/15/2016] [Accepted: 05/16/2016] [Indexed: 12/13/2022]
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Sasirekha B, Mathew P, Ganeshkumar M, Austin RD, Prabhu R. Large radiopaque lesion in the posterior mandible: A challenging case. J Pharm Bioallied Sci 2016; 8:S164-S167. [PMID: 27829771 PMCID: PMC5074023 DOI: 10.4103/0975-7406.191950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Radiopaque lesions of the jawbones are frequently encountered in dental radiographs. A variety of conditions such as chronic inflammation, soft tissue calcifications, fibrosseous lesions, odontogenic tumors, and bone neoplasms can manifest as radiopaque lesions on the jawbones. These radiopaque lesions are often difficult to distinguish from each other, hence making the formulation of differential diagnosis challenging. A thorough patient's history and clinical examination supplemented by appropriate investigations will enable the clinician in narrowing down the differential diagnosis and to identify the condition accurately. Presented here is a case of the large radiopaque lesion on posterior mandible surrounded by lytic areas in a 20-year-old male patient.
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Affiliation(s)
- B Sasirekha
- Department of Oral Medicine and Radiology, J.K.K. Nattraja Dental College and Hospital, Namakkal, Tamil Nadu, India
| | - Philips Mathew
- Department of Oral Medicine and Radiology, Annamalai University, Chidambaram, Tamil Nadu, India
| | - M Ganeshkumar
- Department of Oral Medicine and Radiology, J.K.K. Nattraja Dental College and Hospital, Namakkal, Tamil Nadu, India
| | - Ravi David Austin
- Rajah Muthaiah Dental College, Annamalai University, Chennai, Tamil Nadu, India
| | - Raj Prabhu
- Department of Oral and Maxillofacial Surgery, Madha Dental College, Chennai, Tamil Nadu, India
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56
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du Preez H, Adams A, Richards P, Whitley S. Hyperparathyroidism jaw tumour syndrome: a pictoral review. Insights Imaging 2016; 7:793-800. [PMID: 27651062 PMCID: PMC5110477 DOI: 10.1007/s13244-016-0519-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/24/2016] [Accepted: 08/29/2016] [Indexed: 11/28/2022] Open
Abstract
Hyperparathyroidism jaw tumour syndrome is a rare autosomal dominant inherited endocrine neoplasia syndrome, which predisposes carriers to develop a triad of multiple ossifying fibromas of the maxilla and mandible, parathyroid adenomas and carcinomas (with consequent hyperparathyroidism) as well as renal and uterine tumours. The prevalence of this condition is unknown. Patients typically present initially with symptoms and signs of a jaw tumour. A high index of suspicion is required for the underlying diagnosis to be recognised, enabling appropriate management of jaw lesions, treatment of hyperparathyroidism, if present, as well as early detection of malignant disease and screening of family members. TEACHING POINTS • HPT-JT is a rare autosomal dominant inherited endocrine neoplasia syndrome. • HPT-JT causes facial disfigurement, morbidity secondary to hyperparathyroidism and malignancy. • Patients can present with ossifying fibromas of the jaw, hypercalcaemia or malignancy. • A high index of suspicion is required for the underlying diagnosis to be recognised. • Management involves screening of family members.
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Affiliation(s)
- Hannah du Preez
- Department of Radiology, Barts and The Royal London Hospitals, Barts Health NHS, London, UK.
| | - Ashok Adams
- Department of Radiology, Barts and The Royal London Hospitals, Barts Health NHS, London, UK
| | - Polly Richards
- Department of Radiology, Barts and The Royal London Hospitals, Barts Health NHS, London, UK
| | - Simon Whitley
- Department of Oral and Maxillofacial surgery, Barts and The Royal London Hospitals, Barts Health NHS, London, UK
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Which Patients With Ossifying Fibroma of the Jaws Would Be Suitable for Radical Ablative Surgery? J Craniofac Surg 2016; 27:927-31. [PMID: 27192645 DOI: 10.1097/scs.0000000000002653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of authors' study was to present their 10-year experience in the treatment of giant ossifying fibroma (GOF), and to prove if GOF can be totally excised preventing recurrence. The authors' secondary goal was to study the aesthetic and functional outcomes after radical resection of GOF followed by immediate reconstruction. METHODS Eighteen patients who underwent radical ablative surgery of GOF of the jaw followed by immediate reconstruction with vascularized fibula flap or ilium flap between May 2003 and May 2013 were taken. Recurrence rate was statistically observed and 2-year postoperative aesthetic and functional outcomes were evaluated. RESULTS The average length of follow-up was 4.5 years. There was no residual tumor or tumor recurrence observed in any patient during the mean follow-up of 4.5 years, and good cosmesis and functional outcome was noted after ablative surgery of GOF followed by computer-assisted reconstruction. CONCLUSIONS For giant OF, if it is mainly located in the jaws without invasion of the skull base and/or pterygoid process, radical surgical treatment should be performed for prevention of tumor recurrence. And good aesthetic and functional results can be achieved by immediate computer-assisted reconstruction and dental rehabilitation.
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58
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Mohapatra M, Banushree CS, Nagarajan K, Pati D. Cemento-ossifying fibroma of mandible: An unusual case report and review of literature. J Oral Maxillofac Pathol 2016; 19:405. [PMID: 26980975 PMCID: PMC4774300 DOI: 10.4103/0973-029x.174646] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The term ossifying fibroma (OF) has recently been included under fibro-osseous lesions. Cemento-OF (COF) is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. These tumors occur in the third and fourth decades of life with a predilection for women. The mandible is more commonly involved than the maxilla. This lesion has caused considerable controversy regarding the use of terminology, origin and diagnostic criteria. This article describes an unusual case of COF presenting as unilocular lytic lesion of mandible in a 38-year-old male patient with review of literature.
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Affiliation(s)
- Mounabati Mohapatra
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - C S Banushree
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - K Nagarajan
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Debashish Pati
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Abstract
Fibrous growths in the gingiva with the histopathological presence of calcifications are a common occurrence in the oral cavity. These lesions can be neoplastic in nature with either odontogenic or non odontogenic origin or they can be reactive lesions. This is a case report of an unusual presentation of peripheral ossifying fibroma , unusual because of its abnormally large size with review of literature.
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Affiliation(s)
- Reena Rachel John
- Department of Oral and Maxillofacial Surgery, Vinayaka Mission's Sankarachariyar Dental College and Hospital, Salem, Tamil Nadu, India
| | - Saravanan Kandasamy
- Department of Oral and Maxillofacial Surgery, Vinayaka Mission's Sankarachariyar Dental College and Hospital, Salem, Tamil Nadu, India
| | - Narendran Achuthan
- Department of Oral and Maxillofacial Surgery, Vinayaka Mission's Sankarachariyar Dental College and Hospital, Salem, Tamil Nadu, India
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Kendall R, Kendall EJ, Macleod I, Gowland R, Beaumont J. An unusual exostotic lesion of the maxillary sinus from Roman Lincoln. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2015; 11:45-50. [PMID: 28802966 DOI: 10.1016/j.ijpp.2015.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 08/15/2015] [Accepted: 09/01/2015] [Indexed: 06/07/2023]
Abstract
This report provides a differential diagnosis of an exostotic bony lesion within the left maxillary sinus of a Romano-British (3rd to 4th century AD) adult male from Newport, Lincoln. Macroscopic, radiographic, and cone beam computed tomography (CBCT) analyses suggest that the lesion is likely of odontogenic origin. The overall size of the lesion and areas of sclerosis and radiolucency, together with its hypothesised odontogenic origin, suggest that the lesion represents a chronic exostotic osteomyelitic reaction to the presence of odontogenic bacteria. While modern case studies of odontogenic maxillary sinus osteomyelitis are noteworthy, published cases of this condition are extremely rare in an archaeological context and may be underreported due to the enclosed nature of the sinuses. Such infections may have serious implications for individual and population health, and non-destructive investigation should be considered in cases where significant maxillary caries are present.
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Affiliation(s)
- Ross Kendall
- Department of Archaeology, Durham University, Durham DH1 3LE, UK
| | - Ellen J Kendall
- Department of Archaeology, Durham University, Durham DH1 3LE, UK.
| | - Iain Macleod
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne NE2 4BW, UK
| | - Rebecca Gowland
- Department of Archaeology, Durham University, Durham DH1 3LE, UK
| | - Julia Beaumont
- Archaeological and Environmental Sciences, University of Bradford, Bradford, West Yorkshire BD7 1DP, UK
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61
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Vura NG, Gaddipati R, Ramisetti S, Kumara R, Reddy R, Kanchi U. Surgical Management of Ossifying Fibroma in Maxilla: Report of Two Cases. J Int Oral Health 2015; 7:115-8. [PMID: 26124613 PMCID: PMC4479764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 02/01/2015] [Indexed: 12/04/2022] Open
Abstract
Ossifying fibroma is a rare benign osteogenic neoplasm arising from undifferentiated cells of the periodontal ligament. Ossifying fibroma have a well-defined border that differentiates it from fibrous dysplasia clinically, these tumors manifest as a round or ovoid, expansile, painless, slow-growing mass may displace the roots of adjacent teeth and also cause root resorption. They occur at second to fourth decade of life. Radiologically the lesion appears as a dense radiopaque mass surrounded by a thin, well-defined regular radiolucent rim. Patient underwent thorough history taking and complete face, ear, nose, and throat examination. Computed tomography maxilla, orthopantomogram, paranasal sinus reveals entire maxillary sinus involved in one case. Nasal septum deviated to the opposite side, airway reduced on the side of swelling seen in one case. Root resorption seen in two cases and missing teeth in seen in case 1. In our study in case 1, the tumor involved maxillary sinus, medial wall of the nose. The tumors were excised by Weber-Fergusson and in case 2 the tumor was excised by maxillary vestibular approach. Overall recurrence rates after resection is reported to range from 30 to 56%.
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Affiliation(s)
- Nanda Gopal Vura
- Professor, Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Andhra Pradesh, India
| | - Rajasekhar Gaddipati
- Professor & Head, Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Andhra Pradesh, India
| | - Sudhir Ramisetti
- Associate Professor, Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Andhra Pradesh, India
| | - Ratna Kumara
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Andhra Pradesh, India
| | - Rajiv Reddy
- Associate Professor, Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Andhra Pradesh, India
| | - Ujwala Kanchi
- Post-graduate, Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Andhra Pradesh, India
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62
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Misra SR, Saigal A, Rastogi V, Priyadarshini SR, Pati AR. Giant central ossifying fibroma of the maxilla presenting with a pus discharging intra-oral sinus. J Clin Diagn Res 2015; 9:ZD08-11. [PMID: 25738089 DOI: 10.7860/jcdr/2015/11192.5417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/30/2014] [Indexed: 11/24/2022]
Abstract
Central ossifying fibroma (COF) is a rare benign fibro-osseous neoplasm which has a predilection for mandible and is encountered in middle aged women. It arises from mesenchymal blast cells of the periodontal ligament, and with a potential to form fibrous tissue, cementum and bone. It is a well circumscribed lesion mainly comprising of fibrous tissue with varying amounts of bone or cementum or osteo-cementum like tissue. We present an uncommon case of COF of the maxilla in a 35-year-old male who presented with a pus discharging sinus in the maxilla. Due to the bizarre size of the lesion we have termed as 'giant' COF. There is extensive facial asymmetry on the right side with obliteration of the maxillary antrum, deviation of the nose and upward displacement of the orbit.
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Affiliation(s)
- Satya Ranjan Misra
- Reader, Department of Oral Medicine & Radiology, Institute of Dental Sciences , Bhubaneswar, Odisha, India
| | - Anjali Saigal
- Reader, Department of Oral Medicine & Radiology, Dasmesh Institute of Research & Dental Sciences , Talwandi Road, Faridkot, Punjab, India
| | - Varun Rastogi
- Reader, Department of Oral Pathology & Microbiology, Kalka Dental College , Meerut, Uttar Pradesh, India
| | - Smita R Priyadarshini
- Senior Lecturer, Department of Oral Medicine & Radiology, Institute of Dental Sciences , Bhubaneswar, Odisha, India
| | - Abhishek Ranjan Pati
- Senior Lecturer, Department of Oral Medicine & Radiology, Institute of Dental Sciences , Bhubaneswar, Odisha, India
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63
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Abstract
Ossifying fibroma is a benign bone neoplasm often considered to be a type of fibro-osseous lesion. Its origin is believed to be from periodontal membrane, and it shows more predilection toward females. Mandible is more commonly affected than maxilla. This bone tumor consists of highly cellular, fibrous tissue that contains varying amounts of calcified tissue-resembling bone, cementum, or both. Radiographically, the lesions are either completely radiolucent or mixed, depending on the amount of calcification, or are completely radiopaque and surrounded by a radiolucent rim. Ossifying fibroma requires radical surgery, because of the tendency for recurrence and possibility of malignant transformation. Here, we have presented a case of massive ossifying fibroma of mandible in an 80-year-old female.
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Affiliation(s)
- D Saikrishna
- Department of Oral and Maxillofacial Surgery, J. S. S. Dental College and Hospital, A Constituent College of J. S. S. University, Bannimantap, Mysore, Karnataka, India
| | - Sujith Shetty
- Department of Oral and Maxillofacial Surgery, J. S. S. Dental College and Hospital, A Constituent College of J. S. S. University, Bannimantap, Mysore, Karnataka, India
| | - S Ramya
- Department of Oral and Maxillofacial Surgery, J. S. S. Dental College and Hospital, A Constituent College of J. S. S. University, Bannimantap, Mysore, Karnataka, India
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64
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Urs AB, Arora S, Singh H. Intra-osseous jaw lesions in paediatric patients: a retrospective study. J Clin Diagn Res 2014; 8:216-20. [PMID: 24783141 DOI: 10.7860/jcdr/2014/7318.4166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 01/12/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study was undertaken to comprehensively analyze the distribution of intra-osseous paediatric jaw lesions (0-16 years) and to correlate the same with the data which has been published in the literature. STUDY DESIGN A total of 171 hard tissue paediatric pathologies obtained from the archives of Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, India were retrospectively reviewed over a period of 6 years. All the cases were analyzed for gender, site, radiographic findings, histopathological diagnosis, treatment modality and recurrence rate. RESULTS The present study revealed 54/171 odontogenic cysts, 45/171 odontogenic tumours, 33/171 bone pathologies, 2 malignant tumours, 1 connective tissue pathology and 36/171 miscellaneous category cases. The highlights of this analysis showed a relatively higher incidence of odontogenic tumours (26.3%) as compared to those seen in other studies which have been published in literature. KCOT and ameloblastoma (solid and unicystic) were the most frequently diagnosed tumours. Also, one case of dentigerous cyst which was converted into calcifying ghost cell odontogenic tumour was a unique feature which was noted in the current study. CONCLUSION In the current study, a preponderance of odontogenic pathosis was seen in the paediatric age group which was studied.
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Affiliation(s)
- Aadithya B Urs
- Professor and Head, Department of Oral and Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences , New Delhi, India
| | - Shelly Arora
- Senior Research Associate, Department of Oral and Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences , New Delhi, India
| | - Hanspal Singh
- Senior Resident, Department of Oral and Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences , New Delhi, India
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65
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Muwazi LM, Kamulegeya A. The 5-year prevalence of maxillofacial fibro-osseous lesions in Uganda. Oral Dis 2014; 21:e79-85. [PMID: 24605931 DOI: 10.1111/odi.12233] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/24/2014] [Accepted: 02/27/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Fibro-osseous lesions of the jaws are a diagnostic challenge for the pathologist because histologically, they are not easily distinguishable. African data on the prevalence of these lesions are scarce. We present a 5-year report of benign fibro-osseous lesions at Mulago Hospital, Uganda, showing the frequency and distribution of these lesions. MATERIALS AND METHODS Confirmed fibro-osseous lesions reports at the pathology department (2007-2012) were retrieved. Patients' clinical data including age, gender, anatomic location, and diagnosis were recorded. Descriptive statistics and simple proportion tests were carried out. RESULTS We retrieved 155 confirmed benign fibro-osseous lesions over this period, 65% were females, 34% males, and the gender of one case was not specified. Fibrous dysplasia was the most prevalent lesion (n = 87, 56.1%) followed by ossifying fibroma (n = 50, 32.9%) and osseous dysplasia (n = 17, 10.9%). We neither found craniofacial nor polyostotic fibrous dysplasia. Fibrous dysplasia and ossifying fibroma peaked in the second decade at 40.2% and 40.0%, respectively. Florid osseous dysplasia was commonest in the fifth decade. CONCLUSION In this study, all the florid osseous dysplasia were seen among females. We need to carry out prospective studies to establish as to why and what kind of women get afflicted by this lesion.
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Affiliation(s)
- L M Muwazi
- Department of Dentistry, Makerere University College of Health Sciences, Kampala, Uganda
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66
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Naik RM, Guruprasad Y, Sujatha D, Gurudath S, Pai A, Suresh K. Giant cemento-ossifying fibroma of the mandible. J Nat Sci Biol Med 2014; 5:190-4. [PMID: 24678226 PMCID: PMC3961933 DOI: 10.4103/0976-9668.127326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Cemento-ossifying fibroma (COF) is classified as a fibro-osseous neoplasm and included among the non-odontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential for forming fibrous tissue, cementum and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women between the third and fourth decades of life. Case reports of massive expansile COF, measuring more than 10 cm are rarely reported in the literature. We report a case of giant cemento-ossifying fibroma of the mandible in a 34 year old female patient.
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Affiliation(s)
- Raghavendra Mahadev Naik
- Department of Oral Medicine and Radiology, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Yadavalli Guruprasad
- Department of Oral and Maxillofacial Surgery, AME's Dental College Hospital and Research Centre, Raichur, Karnataka, India
| | - D Sujatha
- Department of Oral Medicine and Radiology, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Shubha Gurudath
- Department of Oral Medicine and Radiology, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Anuradha Pai
- Department of Oral Medicine and Radiology, Oxford Dental College and Hospital, Bangalore, Karnataka, India
| | - Kv Suresh
- Department of Oral Medicine and Radiology, Krishna School of Dental Sciences, Karad, Maharashtra, India
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67
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Massive expansile ossifying fibroma of the mandible with osteomyelitis. Oral Radiol 2014. [DOI: 10.1007/s11282-013-0164-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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68
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Extensive Presentation of Central Ossifying Fibroma Treated with Conservative Surgical Excision. Case Rep Dent 2014; 2014:204258. [PMID: 25506435 PMCID: PMC4258925 DOI: 10.1155/2014/204258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 11/09/2014] [Indexed: 11/29/2022] Open
Abstract
Central ossifying fibroma is a benign slow-growing 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. Clinically, it is a large asymptomatic tumor of aggressive appearance, with possible tooth displacement. Occasionally treated by curettage enucleation, this conservative surgical excision is showing a recurrence rate extremely low. The objective of this study was to report a case of a 44-year-old woman, presenting a very large ossifying fibroma in the mandible, which was successfully treated with curettage, and to conduct a brief literature review of this lesion, focusing on the histology, clinical behavior, and management of these uncommon lesions.
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69
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Phattarataratip E, Pholjaroen C, Tiranon P. A Clinicopathologic Analysis of 207 Cases of Benign Fibro-Osseous Lesions of the Jaws. Int J Surg Pathol 2013; 22:326-33. [DOI: 10.1177/1066896913511985] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Benign fibro-osseous lesion (BFOL) is a distinct group of jaw entities composed of fibrocellular tissue and mineralized materials. In this study, we examined the epidemiological, clinical, and pathological features of patients with BFOL. Records and microslides of 207 BFOLs submitted to pathology service were retrospectively reviewed. Overall, fibrous dysplasia (FD) was the most prevalent (36.7%), followed by ossifying fibroma (OF; 32.4%), osseous dysplasia (OD; 24.6%), and juvenile ossifying fibroma (JOF; 6.3%). Female predilection was noted. FD and JOF were common in maxilla, whereas most OF and OD affected the mandible. Most patients with FD and OF presented with painless swelling, while patients with OD were symptomless. The majority of FD specimens showed woven bone, while a mixture of woven bone and cementum-like materials was often noted in OF and OD. Our data show variations in the clinicopathologic features of BFOLs. A thorough examination of all aspects of BFOL patients is imperative for accurate diagnosis.
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70
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Sheikhi M, Mosavat F, Jalalian F, Rashidipoor R. Central cementifying fibroma of maxilla. Dent Res J (Isfahan) 2013; 10:122-5. [PMID: 23878576 PMCID: PMC3714814 DOI: 10.4103/1735-3327.111814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Central cementifying fibroma is a bony tumor, which is believed to be derived from the cells of the periodontal ligament. Central cemento-ossifying fibroma behaves like, a benign bone neoplasm. This bone tumor consists of highly cellular, fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum, or both. Central cemento-ossifying fibromas of the mandible are common; however, they are rare in the maxilla region. This tumor is most frequent between 35 and 40 years of ages. In this report we have described a 37-year-old male with cemento-ossifying fibroma of the maxilla region with the mass that had been appeared 2-3 months prior to his first referral. Radiologic imaging such as intra-oral, panoramic, and Cone Beam CT had been performed. Histological analysis was done and finally diagnosis of central cementifying fibroma was made. The postoperative follow up at 12 months revealed no recurrence.
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Affiliation(s)
- Mahnaz Sheikhi
- Torabinejad Dental Research Center and Department of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Fusconi M, Conte M, Pagliarella M, De Vincentiis C, De Virgilio A, Benincasa AT, Alessi S, Gallo A. Fibrous dysplasia of the maxilla: diagnostic reliability of the study image. Literature review. J Neurol Surg B Skull Base 2013; 74:364-8. [PMID: 24436939 DOI: 10.1055/s-0033-1347374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 03/05/2013] [Indexed: 10/26/2022] Open
Abstract
Objective Fibrous dysplasia (FD) is a benign bone disorder in facial bones. This study evaluates the possibility of diagnosing fibrous dysplasia on imaging alone, without biopsy of the lesion, which is often burdensome for the patient. Materials and Methods The authors bring their experience of four cases of bone lesions of the maxillofacial region and present a review of published studies. The imaging techniques evaluated are computed tomography (CT) and magnetic resonance imaging (MRI) with and without contrast. Results The literature review demonstrates that it is impossible to make diagnosis of fibrous dysplasia exclusively by imaging. Radiographic images often show a ground-glass appearance, which is characteristic but not pathognomonic of fibrous dysplasia. Conclusion Although CT and MRI images may in many cases suggest a diagnosis of fibrous dysplasia, histological examination or follow-up imaging should follow.
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Affiliation(s)
- Massimo Fusconi
- Department of Sensory Organs, University "La Sapienza" of Roma, Rome, Italy
| | - Michela Conte
- Department of Sensory Organs, University "La Sapienza" of Roma, Rome, Italy
| | - Martina Pagliarella
- Department of Applied Clinical Sciences and Biotechnologies, Università dell'Aquila, Aquila, Italy
| | | | | | | | - Simone Alessi
- Department of Sensory Organs, University "La Sapienza" of Roma, Rome, Italy
| | - Andrea Gallo
- Department of Surgical Sciences, University of Rome "La Sapienza," Rome, Italy
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Urs AB, Kumar P, Arora S, Augustine J. Clinicopathologic and radiologic correlation of ossifying fibroma and juvenile ossifying fibroma—an institutional study of 22 cases. Ann Diagn Pathol 2013; 17:198-203. [DOI: 10.1016/j.anndiagpath.2012.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 06/12/2012] [Accepted: 06/25/2012] [Indexed: 11/29/2022]
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Wilson JRF, Kumar R, Goddard A, Liddington M, Carter L, Russell J, Chumas PD. Recurrent ossifying fibroma of the sphenoid bone 26 years after primary surgical excision; a case report and review of the literature. Acta Neurochir (Wien) 2013. [PMID: 23192835 DOI: 10.1007/s00701-012-1564-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ranganath K, Kamath SM, Munoyath SK, Nandini HV. Juvenile psammomatoid ossifying fibroma of maxillary sinus: case report with review of literature. J Maxillofac Oral Surg 2013; 13:109-14. [PMID: 24822000 DOI: 10.1007/s12663-013-0479-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 01/15/2013] [Indexed: 11/25/2022] Open
Abstract
Juvenile psammomatoid ossifying fibroma is a rare benign fibro-osseous tumor of the gnathic and extragnathic craniofacial bones, particularly the periorbital, frontal and ethmoid bones. It is slowly progressive with aggressive local growth, invasion and destruction of the surrounding tissue, bone erosion and recurrence after surgical excision. It is distinguished from the other fibro-osseous lesions by its age of onset, clinical presentation and aggressive behavior.
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Affiliation(s)
- K Ranganath
- Dept of Oral and Maxillofacial Surgery, M. S. Ramaiah Dental College & Hospital, Bangalore, Karnataka India
| | - Sulata M Kamath
- Dept of Pathology, M. S. Ramaiah Medical College, Bangalore, Karnataka India
| | - Sejal K Munoyath
- Dept of Oral and Maxillofacial Surgery, M. S. Ramaiah Dental College & Hospital, Bangalore, Karnataka India
| | - Hamsa V Nandini
- M. S. Ramaiah Dental College & Hospital, Bangalore, Karnataka India
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de Noronha Santos Netto J, Machado Cerri J, Miranda AMMA, Pires FR. Benign fibro-osseous lesions: clinicopathologic features from 143 cases diagnosed in an oral diagnosis setting. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 115:e56-65. [PMID: 22981804 DOI: 10.1016/j.oooo.2012.05.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 05/26/2012] [Accepted: 05/28/2012] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to report the clinicopathologic and radiologic features of 143 benign fibro-osseous lesions (BFOLs). STUDY DESIGN Clinical and radiologic information were retrieved from the patients files, and histologic features were reviewed from hematoxylin and eosin-stained histologic slides. RESULTS There were 22 ossifying fibromas (OFs), 21 fibrous dysplasias (FDs) and 100 osseous dysplasias (ODs; 65 florid, 18 focal, and 17 periapical). The mean age of the FD/OF patients was a decade lower than those with OD. The mandible was more affected than the maxilla, except in FDs. All FDs and OFs presented local swelling, whereas this was observed in <40% of the ODs. Radiologic images of the florid/periapical ODs and OFs were predominantly mixed, whereas FDs and focal ODs were predominantly radiopaque. CONCLUSIONS Florid OD, OF, and FD were the most common diagnoses, and the clinicopathologic and radiologic features were somewhat distinct from the characteristics of other populations.
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Mithra R, Baskaran P, Sathyakumar M. Imaging in the diagnosis of cemento-ossifying fibroma: a case series. J Clin Imaging Sci 2012; 2:52. [PMID: 23029635 PMCID: PMC3440937 DOI: 10.4103/2156-7514.100373] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Accepted: 04/19/2012] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- R Mithra
- Department of Oral Medicine and Radiology, SRM Kattankulathur Dental College, Potheri, Kanchipuram District, Tamil Nadu, India
| | - Pavitra Baskaran
- Department of Oral Medicine and Radiology, SRM Kattankulathur Dental College, Potheri, Kanchipuram District, Tamil Nadu, India
| | - M Sathyakumar
- Department of Oral and Maxillofacial Pathology, SRM Kattankulathur Dental College, Potheri, Kanchipuram District, Tamil Nadu, India
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Hunasgi S, Raghunath V. A clinicopathological study of ossifying fibromas and comparison between central and peripheral ossifying fibromas. J Contemp Dent Pract 2012; 13:509-514. [PMID: 23151701 DOI: 10.5005/jp-journals-10024-1177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIMS AND OBJECTIVES To study the clinical, histological features of peripheral and central ossifying fibromas and also to compare between them. MATERIALS AND METHODS The sample comprised a total 50 cases of ossifying fibromas [25 central ossifying fibromas (COF) and 25 peripheral ossifying fibromas (POF)] inclusive of cemento-ossifying fibromas. RESULTS The mean age is 28.2 years in POF and 24.7 years in COF. The male: female ratio was 1:1.5 in POF and 1:1.8 in COF. The size of the lesions varied from 0.45 to 2.75 cm in cases of POF and in COF, it ranged from 1.25 to 13.5 cm. COF showed more duration (1-8 years) when compared with POF (1-3). Majority of cases of COF showed radiolucent, mixed radiolucent and radiopaque unilocular lesions. The predominant cell type in both POF and COF was a combination of both ovoid and spindle cells. Regarding vascularity it showed mild, moderate and intense vascularity. On comparison of all stromal changes between POF and COF showed no statistically significant difference. CONCLUSION The clinical parameters and radiographic changes of POF and COF in our study were similar to the previous studies. Histopathological features like type of cells, cellularity and vascularity in POF and COF were similar to previous studies. However, when clinical and histopathological features were compared between POF and COF showed no statistical significance except for site of the lesion. These features signify the behavior of two lesions. Further research on larger sample might give more insights into these lesions.
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Affiliation(s)
- Santosh Hunasgi
- Department of Oral Pathology, Navodaya Dental College Raichur-584103, Karnataka, India.
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Abstract
The cemento-ossifying fibroma is classified as a fibro-osseous lesion of the jaws. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. A case of cemento-ossifying fibroma involving the left mandible is described in a 35 year old female patient. The clinical, radiographic and histological features as well as surgical findings are presented. The cemento-ossifying fibroma is a central neoplasm of bone as well as the periodontium which has caused considerable controversy because of the confusion regarding terminology and the criteria for its diagnosis.
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Affiliation(s)
- Rangila Ram
- Department of Oral and Maxillofacial Surgery, Himachal Pradesh Government Dental College and Hospital, Shimla, India
| | - Anita Singhal
- Department of Oral Pathology and Microbiology, Himachal Pradesh Government Dental College and Hospital, Shimla, India
| | - Parul Singhal
- Department of Paediatrics and Preventive Dentistry, Himachal Pradesh Government Dental College and Hospital, Shimla, India
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Ponniah I, Sethurajan SB, Rajiah D. A multilocular radiolucency with spindle cell proliferation in a case of ossifying fibroma: a potential pitfall. Dentomaxillofac Radiol 2011; 41:605-8. [PMID: 22074876 DOI: 10.1259/dmfr/28249452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Ossifying fibroma (OF) is a benign tumour characterized by cementum or bone formation accompanied by a fibrocellular stroma. The diagnosis of OF may be apparent when the histological features are supported by clinical and radiological information. In this report, an OF with predominantly spindle cell proliferation and purely radiolucent, multilocular lesion in a middle-aged woman is presented.
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Affiliation(s)
- I Ponniah
- Department of Oral and Maxillofacial Pathology, Tamil Nadu Government Dental College and Hospital, Chennai, India.
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Khan SA, Sharma NK, Raj V, Sethi T. Ossifying fibroma of maxilla in a male child: Report of a case and review of the literature. Natl J Maxillofac Surg 2011; 2:73-9. [PMID: 22442615 PMCID: PMC3304240 DOI: 10.4103/0975-5950.85859] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Ossifying fibroma is a rare benign fibro-osseous neoplasm of the jaw characterized by substitution of normal bone by fibrous tissues and newly formed calcified products such as bone, cementum or both. It is a well-demarcated lesion that differentiates it from fibrous dysplasia. This case report describes a rare case of ossifying fibroma arising in the maxilla of an 11-year-old child treated with enucleation. The clinical, radiographical, surgical and histological findings are presented. Controversies regarding the terminology and classification along with the differential diagnosis are discussed and a review is provided of the literature on the subject.
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Affiliation(s)
- Suleman Abbas Khan
- Department of Pedodontics and Preventive Dentistry, Saraswati Dental College and Hospital, Lucknow, India
| | - Naresh Kumar Sharma
- Department of Oral and Maxillofacial Surgery, Saraswati Dental College and Hospital, Lucknow, India
| | - Vineet Raj
- Department of Oral and Maxillofacial Pathology, Saraswati Dental College and Hospital, Lucknow, India
| | - Tarun Sethi
- Department of Pedodontics and Preventive Dentistry, Saraswati Dental College and Hospital, Lucknow, India
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