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Muylaert F, De Kock L, Creytens D, Verstraete K, Coopman R. High-grade osteosarcoma arising in DCIA flap reconstruction after a prior resection of maxillar cemento-ossifying fibroma: A case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101591. [PMID: 37558180 DOI: 10.1016/j.jormas.2023.101591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023]
Abstract
Cemento-ossifying fibroma is a rare benign odontogenic tumour of the tooth-bearing jaws. Its concomitant occurrence with osteosarcoma, a malignant maxillofacial bone tumour, has never been described before. We present an uncommon case of a 43-year-old woman in whom a cemento-ossifying fibroma in the right maxilla was treated by resection and reconstruction using a deep circumflex iliac artery flap. During surgical prosthetic rehabilitation one-year post-operative, an osteosarcoma extending from the contralateral maxilla was coincidentally discovered in the deep circumflex iliac artery flap. The aim of this case report is to raise awareness on the extremely rare but possible simultaneous and independent occurrence of a cemento-ossifying fibroma and an osteosarcoma.
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Affiliation(s)
- Frances Muylaert
- Department of Oro-Maxillofacial, Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium.
| | - Lisa De Kock
- Department of Oro-Maxillofacial, Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium; Department of Diagnostic Sciences and Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
| | - Koenraad Verstraete
- Department of Diagnostic Sciences and Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium; Head of Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Renaat Coopman
- Department of Oro-Maxillofacial, Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium; Department of Diagnostic Sciences and Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
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Liu Y, Housley Smith M, Patel PB, Bilodeau EA. Pediatric Gnathic Bony and Mesenchymal Tumors. Pediatr Dev Pathol 2023; 26:621-641. [PMID: 37232383 DOI: 10.1177/10935266231170744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Evaluation of bone pathology within the head and neck region, particularly the gnathic bonesis is complex, demonstrating unique pathologic processes. In part, this variation is due to odontogenesis and the embryological cells that may be involved, which can contribute to disease development and histologic variability. As with any boney pathosis, the key is to have clinical correlation, particularly with radiographic imaging prior to establishing a definitive diagnosis. This review will cover those entities that have a predilection for the pediatric population, and while it is not all inclusive, it should serve as a foundation for the pathologist who is evaluating bony lesions involving the craniofacial skeleton.
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Affiliation(s)
- Yingci Liu
- Rutgers School of Dental Medicine, Newark, NJ, USA
| | | | - Paras B Patel
- Center for Oral Pathology, Dallas, TX, USA
- Oral and Maxillofacial Pathology ProPath, Dallas, TX, USA
| | - Elizabeth Ann Bilodeau
- Oral & Maxillofacial Pathology, Director, UDHS Oral Pathology Laboratory, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
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V D, Kumar Vadivel J, Ganapathy D. A Painless Bump: A Case Report of Cemento-Ossifying Fibroma of the Anterior Maxilla. Cureus 2023; 15:e41799. [PMID: 37457603 PMCID: PMC10338891 DOI: 10.7759/cureus.41799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
Cemento-ossifying fibroma (COF) is a benign odontogenic neoplasm. It is considered an ossifying fibroma with traces of interspersed cementum fragments. Here we present a case report of the occurrence of COF in the maxillary anterior region of an elderly woman. A 61-year-old female reported with a painless, progressive, slow-growing swelling on the upper front jaw region for the past five years. A single, localized, swelling on the anterior region of the maxilla which was non-tender and bony hard in consistency. Radiological examination consisting of orthopantomagram (OPG) and cone-beam computed tomography (CBCT) revealed increased thickness of bone over frontal, parietal and maxilla with alteration of trabecular pattern - cotton wool/ground glass. Serum alkaline phosphatase level was found to be 865 U/l, however, serum calcium level and other routine blood investigations (hemogram) were within normal limits. The above radiological and laboratory findings are more in favour of primary bone pathology and with a biopsy later correlating with histopathological findings; it was diagnosed as COF. Under conscious sedation, surgical excision of the bony mass was done along with extraction of associated teeth. The patient is currently on regular follow-up and planning for a dental prosthesis is in progress.
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Affiliation(s)
- Divyadharshini V
- Oral Medicine and Radiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Jayanth Kumar Vadivel
- Oral Medicine and Radiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Dhanraj Ganapathy
- Prosthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Collins LHC, Zegalie NFT, Sassoon I, Speight PM. A Clinical, Radiological and Histopathological Review of 74 Ossifying Fibromas. Head Neck Pathol 2023:10.1007/s12105-022-01522-w. [PMID: 36622534 DOI: 10.1007/s12105-022-01522-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 12/16/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Ossifying fibroma (OF) is a fibro-osseous lesion of the jaws and craniofacial bones. Accurate diagnosis can be challenging due to significant overlap of clinicopathological features. This study aimed to evaluate the clinical, radiological and histological features that can aid in diagnosis and identify characteristics that allow categorisation into the three subtypes: juvenile trabecular, psammomatoid and cemento-ossifying OF. METHODS A total of 74 cases of OF were systematically reviewed for their principle features. Of these, 46 cases were evaluated for their radiographic features including size, location and relationship to the teeth. Histological assessment and stereological point counting were performed in 69 cases to assess the pattern, type and proportion of calcification, the nature of the stroma, the border of the lesion and the presence of secondary changes. Fisher's exact test and Chi-squared tests were used to determine associations between clinicopathological parameters and maxillary, mandibular, odontogenic, non-odontogenic and psammomatoid or trabecular lesions. RESULTS OF showed a female predilection (F: M; 2:1) and a slight bimodal age distribution with peaks in the second (23%) and fourth decades (27%) (Mean age: 32.4 years). 83% of cases presented as an intra-oral swelling, with the mandible being the most common site (73%). Histologically, a range of morphological patterns were seen, with 50% of cases showing mixed trabecular and psammomatoid features. However, there were no significant differences between the variants of OF in terms of age, gender or histological features. CONCLUSION Histological features of OF cannot be used to differentiate between the subtypes.
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Affiliation(s)
- L H C Collins
- School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK. .,Head and Neck Pathology, Guy's Hospital, Floor 4 Tower Wing, London, SE1 9RT, UK.
| | - N F T Zegalie
- School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK
| | - I Sassoon
- Department of Computer Science, Brunel University, Kingston Lane, London, UB8 3PH, UK
| | - P M Speight
- School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK
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Tenório JR, Bártholo PRDA, Romañach MJ, Abrahão AC, Agostini M, de Andrade BAB. Psammomatoid juvenile ossifying fibroma of frontal sinus - surgical and reconstructive approach. AUTOPSY AND CASE REPORTS 2022; 12:e2021411. [PMID: 36506873 PMCID: PMC9731383 DOI: 10.4322/acr.2021.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/13/2022] [Indexed: 12/04/2022] Open
Abstract
Psammomatoid juvenile ossifying fibroma (PJOF) is a benign fibro-osseous lesion that mainly affects the paranasal sinuses and periorbital bones. It may cause significant esthetic and functional impairment. Herein, we describe the diagnosis and surgical approach of an extensive PJOF arising in the frontal sinus of a young male. After complete lesion removal and histopathological confirmation, the bone defect was repaired with a customized polymethylmethacrylate implant. PJOF may present aggressive clinical behavior. The excision of extensive PJOF in the orbitofrontal area can result in significant esthetic defects. Polymethacrylate implants restore functionally and esthetically the involved area.
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Affiliation(s)
- Jefferson Rocha Tenório
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Odontologia, Departamento de Patologia e Diagnóstico Oral, Rio de Janeiro, RJ, Brasil
| | | | - Mário José Romañach
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Odontologia, Departamento de Patologia e Diagnóstico Oral, Rio de Janeiro, RJ, Brasil
| | - Aline Corrêa Abrahão
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Odontologia, Departamento de Patologia e Diagnóstico Oral, Rio de Janeiro, RJ, Brasil
| | - Michelle Agostini
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Odontologia, Departamento de Patologia e Diagnóstico Oral, Rio de Janeiro, RJ, Brasil
| | - Bruno Augusto Benevenuto de Andrade
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Odontologia, Departamento de Patologia e Diagnóstico Oral, Rio de Janeiro, RJ, Brasil
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Villegas KM, Paparella ML. Cemento-ossifying fibroma with odontogenic epithelial remnants: A hallmark of its odontogenic nature. Oral Oncol 2022; 125:105668. [DOI: 10.1016/j.oraloncology.2021.105668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
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Baumhoer D, Haefliger S, Ameline B, Hartmann W, Amary F, Cleven A, Klein MJ, Thompson LDR, Harder D, O’Donnell P. Ossifying Fibroma of Non-odontogenic Origin: A Fibro-osseous Lesion in the Craniofacial Skeleton to be (Re-)considered. Head Neck Pathol 2021; 16:257-267. [PMID: 34173971 PMCID: PMC9018933 DOI: 10.1007/s12105-021-01351-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022]
Abstract
In the cranio-facial skeleton, a heterogeneous group of well characterized fibro-osseous lesions can be distinguished. Whereas fibrous dysplasia can affect any skeletal bone, ossifying fibroma and cemento-osseous dysplasia exclusively develop in the cranio-facial region, with most subtypes restricted to the tooth bearing areas of the jaws. Herein we present a series of 20 fibro-osseous lesions that developed mostly in the frontal bone and in the mandible, presenting as expansile intramedullary tumors with a unique histologic appearance and an indolent clinical course. We provide evidence that these tumors are distinct from the categories included in the WHO classification and are therefore currently unclassifiable. The definition of cemento-ossifying fibroma as an odontogenic neoplasm developing only in close proximity to teeth should be re-considered and incorporate also extragnathic lesions as shown here.
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Affiliation(s)
- Daniel Baumhoer
- Bone Tumor Reference Centre, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Schoenbeinstrasse 40, 4031 Basel, Switzerland
| | - Simon Haefliger
- Bone Tumor Reference Centre, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Schoenbeinstrasse 40, 4031 Basel, Switzerland
| | - Baptiste Ameline
- Bone Tumor Reference Centre, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Schoenbeinstrasse 40, 4031 Basel, Switzerland
| | - Wolfgang Hartmann
- Division of Translational Pathology, Gerhard-Domagk-Institut of Pathology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Fernanda Amary
- Cellular and Molecular Pathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Greater London, HA7 4LP UK ,Cancer Institute, University College London, Huntley Street, London, WC1E 6BT UK
| | - Arjen Cleven
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michael J. Klein
- Hospital for Special Surgery, 535 E 86th St, New York, NY 10021 USA
| | | | - Dorothee Harder
- Department of Radiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Paul O’Donnell
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Greater London, HA7 4LP UK ,Cancer Institute, University College London, Huntley Street, London, WC1E 6BT UK
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