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Arunkumar K, Prasad C, Balaji J, Rohini T, Supraja R. Familial Gigantiform Cementoma: Life-Saving Total Midface Resection and Reconstruction Using Virtual Surgical Planning and 3D Printed Patient-Specific Implant-A Clinical Study. J Maxillofac Oral Surg 2023; 22:145-150. [PMID: 37041944 PMCID: PMC10082875 DOI: 10.1007/s12663-023-01902-x] [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: 10/31/2022] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
Background Familial gigantiform cementoma (FGC) is a rare benign fibrocemento-osseous lesion of the jaw characterized by well-circumscribed, extensive, mixed radiolucent-radiopaque masses in the mandible and the maxilla that can cause severe facial deformity. This condition is extremely rare with less than 40 cases reported in the literature. Purpose The purpose of the paper is to highlight the importance of virtual surgical planning and patient-specific implant in the treatment of a complex lesion and reconstruction of the facial skeleton. The clinical presentations, and diagnostic challenges encountered when managing the lesion have been discussed in this article with emphasis on the treatment plan. Method/Surgical plan The sequence of treatment planned was resection of the lesion and immediate reconstruction with a patient-specific implant to improve the patient's quality of life. The management of FGC was a challenging one keeping in mind the rapid expansion of the lesion, widespread involvement of the jaws, and needs of the pediatric patient. Conclusion Virtual surgical planning (VSP) along with 3D printed implant was instrumental in reconstructing the facial form of the child where the maxilla was completely resected and rehabilitation provided support to the vital structures of the face.
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Affiliation(s)
- K. Arunkumar
- Department Of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai-3, India
| | - C. Prasad
- Department Of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai-3, India
| | - J. Balaji
- Department Of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai-3, India
| | - T. Rohini
- Department Of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai-3, India
| | - R. Supraja
- Department Of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai-3, India
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Prasad C, kumar KA, Balaji J, Arulmozhi M, Jayanandhini S, Priyadharshini R. A family of familial gigantiform cementoma: clinical study. J Maxillofac Oral Surg 2022; 21:44-50. [PMID: 35400930 PMCID: PMC8934829 DOI: 10.1007/s12663-021-01515-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background Familial gigantiform cementoma is an autosomal dominant fibro-cement osseous lesion that causes massive expansion of facial skeleton. Patients with such massive lesions have a compromised quality of life. The main goal of treating such patients is to restore and preserve the jaw as far as possible which would enhance their quality of life. Purpose This study was conducted to identify the occurrence of gigantiform cementoma which had affected three generations of a family and also to focus on documentation of the clinical course and management. Method Patients (one family-mother, grandmother, aunt and grandson) who had visited the Department of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai, over a period for their swelling in the maxillofacial region were clinically and radiographically evaluated and histopathologically diagnosed as familial gigantiform cementoma; later, they were surgically managed. Result It is very rare to document three generations of this disease which had shown varied clinical presentation (asymptomatic slow growth, arrested growth and one case of aggressive growth). Management of these cases varied from observation to aggressive resection. Conclusion Gigantiform cementoma follows an autosomal dominant pattern of inheritance with variable phenotypic expression without gender predilection. These cases require regular observation and intervention if necessary.
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Affiliation(s)
- C. Prasad
- Department of oral and maxillofacial surgery, Tamilnadu government dental college and hospital, Chennai, Tamilnadu India
| | - K. Arun kumar
- Department of oral and maxillofacial surgery, Tamilnadu government dental college and hospital, Chennai, Tamilnadu India
| | - J. Balaji
- Department of oral and maxillofacial surgery, Tamilnadu government dental college and hospital, Chennai, Tamilnadu India
| | - M. Arulmozhi
- Department of oral and maxillofacial surgery, Tamilnadu government dental college and hospital, Chennai, Tamilnadu India
| | - S. Jayanandhini
- Department of oral and maxillofacial surgery, Tamilnadu government dental college and hospital, Chennai, Tamilnadu India
| | - R. Priyadharshini
- Department of oral and maxillofacial surgery, Tamilnadu government dental college and hospital, Chennai, Tamilnadu India
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Nel C, Yakoob Z, Schouwstra CM, van Heerden WF. Familial florid cemento-osseous dysplasia: a report of three cases and review of the literature. Dentomaxillofac Radiol 2020; 50:20190486. [PMID: 32315206 DOI: 10.1259/dmfr.20190486] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Familial cases of benign fibro-osseous lesions of the jaws are rare and have been described under numerous terms including familial gigantiform cementoma, multiple cemento-ossifying fibromas, sclerotic cemental masses and familial florid cemento-osseous dysplasia. The synonymous and interchangeable use of these terms to describe distinct entities with overlapping features has resulted in confusion and inaccurate categorisation of these lesions. This study highlights three family members with diffuse fibro-osseous jaw lesions with areas of significant expansion. In the pursuit of finding the best clinicopathological categorisation for the reported cases, familial florid cemento-osseous dysplasia and familial gigantiform cementoma were investigated. The final consensus of these three cases was that of familial florid cemento-osseous dysplasia, and one patient presented with a concurrent "ossifying fibromatoid lesion". A literature review on the above entities was performed in an attempt to provide clarification and delineate distinguishing features of the individual diseases.
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Affiliation(s)
- Chané Nel
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Zarah Yakoob
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Ciska-Mari Schouwstra
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Willie Fp van Heerden
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Ray A, Frey HM, Carron JD. An Unusual Case of Lacrimal Duct Obstruction in a Teenager. JAMA Otolaryngol Head Neck Surg 2019; 145:381-382. [PMID: 30789663 DOI: 10.1001/jamaoto.2018.4264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Amrita Ray
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi
| | - Hudson M Frey
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi
| | - Jeffrey D Carron
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi
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Wang HW, Ma CY, Qin XJ, Zhang CP. Management strategy in patient with familial gigantiform cementoma: A case report and analysis of the literature. Medicine (Baltimore) 2017; 96:e9138. [PMID: 29390315 PMCID: PMC5815727 DOI: 10.1097/md.0000000000009138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Familial gigantiform cementoma (FGC) is a rare benign autosomal dominant fibrocemento-osseous lesion generally limited to the facial bones, typically in the anterior portion of the mandible; it is often associated with abnormalities of the long bones and prepubertal pathologic fractures. Owing to the small number of such patients, a uniform treatment criterion has not been established. This paper presents a patient with FGC who was treated in our department, and offers a systematic review of the patients reported in the literature. Our aim was to explore the treatment strategy for patients with FGC. PATIENT CONCERNS Our patient, a 13-year-old boy, presented with a painless enlargement of the mandible first noted 2 years earlier. It had grown rapidly over the preceding 8 months, affecting both his appearance and ability to chew. DIAGNOSIS Based on the pathologic, clinical, and radiographic features, FGC was diagnosed. INTERVENTIONS Mandibuloectomy was performed. The mandibular defect was immediately reconstructed with his right vascularized iliac crest flap. At the same time, a PubMed search was conducted to identify studies reporting on other patients with FGC. OUTCOMES A 3-dimensional computed tomography (3D-CT) scan demonstrated appropriate height of the new alveolar bone. Follow-up results showed recovery of the patient's appearance and mandibular function. He was free of recurrence at 4-year follow-up. LESSONS FGC is a rare benign fibrocemento-osseous lesion of the jaws that can cause severe facial deformity. Incomplete removal leads to more rapid growth of the residual lesion. Therefore, extensive resection is a suitable strategy to avoid recurrence. Defects of the facial bones found intraoperatively should be repaired with resort to an appropriate donor site. However, it is important to be aware that patients with FGC always have concomitant abnormalities of skeletal metabolism and structure, as well as a vulnerability to fractures of the long bones of the lower extremity. Therefore, the optimal management strategy should include a review of treatment options for other patients as reported in the literature. An optimal protocol can not only provide sufficient high-quality bone suitable for the reconstruction of bone defects, but also minimize complications and maximize quality of life.
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Mainville GN, Turgeon DP, Kauzman A. Diagnosis and management of benign fibro-osseous lesions of the jaws: a current review for the dental clinician. Oral Dis 2016; 23:440-450. [PMID: 27387498 DOI: 10.1111/odi.12531] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 06/28/2016] [Accepted: 07/02/2016] [Indexed: 02/07/2023]
Abstract
Benign fibro-osseous lesions of the maxillofacial skeleton constitute a heterogeneous group of disorders that includes developmental, reactive (dysplastic) and neoplastic lesions. Although their classification has been reviewed multiple times in the past, the most common benign fibro-osseous lesions are fibrous dysplasia, osseous dysplasia and ossifying fibroma. For the dental clinician, the challenges involve diagnosis and treatment (or lack thereof). A careful correlation of all clinical, radiologic and microscopic features is essential to establish a proper diagnosis and a clear treatment plan. This article aimed to review the clinical, radiologic and histopathologic characteristics of benign fibro-osseous lesions of the jaws, with emphasis on their differential diagnoses. With a deeper understanding of benign fibro-osseous lesions, clinicians will be better prepared to manage these lesions in their practice.
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Affiliation(s)
- G N Mainville
- Department of Stomatology, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
| | - D P Turgeon
- Department of Stomatology, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
| | - A Kauzman
- Department of Stomatology, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
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8
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Ma C, Wang H, He G, Qin X. Familial Gigantiform Cementoma: Case Report of an Unusual Clinical Manifestation and Possible Mechanism Related To "Calcium Steal Disorder". Medicine (Baltimore) 2016; 95:e2956. [PMID: 26945411 PMCID: PMC4782895 DOI: 10.1097/md.0000000000002956] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Familial gigantiform cementoma is an exceedingly rare but distinct subtype of cemento-osseous-fibrous lesion. Undocumented radiographic changes and related bone metabolism disorder are herein hypothesized and discussed. We present an adolescent case with recurrent familial gigantiform cementoma who received surgical intervention in our hospital. Apart from typical multiquadrant and expansile abnormalies involving both jaws, he also suffered from several times of fractures in lower extremity. Furthermore, radiographic examinations of calvaria, pelvis, femoris, tibia, and fibula all revealed radiolucent areas signifying diffuse osteopenic bone losses. Some of his consanguineous relatives bore the same burden of fractures during pubertal period.Considering these polyostotic conditions, a correlation of congenital bone metabolism disorder in cases with familial gigantiform cementoma, named "calcium steal disorder," was thus proposed. Familial gigantiform cementoma is closely associated with "calcium steal disorder." Whole-body dual-energy absorptiometry should be considered as a routine examination for fracture-related risk prediction.
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Affiliation(s)
- Chunyue Ma
- From the Department of Oral & Maxillofacial - Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology (CM, HW, XQ), and Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University (GH), Shanghai, China
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9
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Betz SJ, Green PT, Madden RN, Blakey GH, Padilla RJ. Massive enlargement of the anterior mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 122:3-9. [PMID: 26682515 DOI: 10.1016/j.oooo.2015.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/18/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Sasha J Betz
- Oral and Maxillofacial Pathology Resident, First Year, Department of Diagnostic Sciences, School of Dentistry, University of North Carolina at Chapel Hill, NC, USA.
| | - Peter T Green
- Oral and Maxillofacial Radiology Resident, First Year, Department of Diagnostic Sciences, School of Dentistry, University of North Carolina at Chapel Hill, NC, USA
| | - Rachel N Madden
- Oral and Maxillofacial Surgeon, Greene & Torio OMFS, Nashua, NH, USA
| | - George H Blakey
- Oral and Maxillofacial Surgery Program Director, Distinguished Associate Professor, University of North Carolina at Chapel Hill, NC, USA
| | - Ricardo J Padilla
- Oral and Maxillofacial Pathology Program Director, Clinical Associate Professor, University of North Carolina at Chapel Hill, NC, USA
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10
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El-Mofty SK. Fibro-osseous lesions of the craniofacial skeleton: an update. Head Neck Pathol 2014; 8:432-44. [PMID: 25409854 PMCID: PMC4245413 DOI: 10.1007/s12105-014-0590-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 11/05/2014] [Indexed: 10/24/2022]
Abstract
Benign fibro-osseous lesions of the craniofacial skeleton (BFOL) are a variant group of intraosseous disease processes that share similar microscopic features characterized by hypercellular fibroblastic stroma containing various combinations of bone or cementum-like tissue and other calcified structures [1-6]. Whereas some are diagnosable histologically, most require a combined assessment of clinical, microscopic and radiologic features. Some BFOL of the craniofacial complex are unique to that location whereas others are encountered in bones from other regions. Reactive, neoplastic, developmental and dysplastic pathologic processes are included under the rubric of BFOL and treatment varies from disease to disease. This review will discuss the clinical, microscopic and radiologic aspects of the more important types of BFOL of the craniofacial complex with updated information on underlying genetic and molecular pathogenic mechanisms of disease. Four main groups of BFOLs will be addressed.
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Affiliation(s)
- Samir K El-Mofty
- Department of Pathology and Immunology, Washington University School of Medicine, 660 Euclid Ave., Campus Box 8118, St. Louis, MO, USA,
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11
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Wang HW, Yu M, Qin XJ, Zhang CP. Familial gigantiform cementoma: distinctive clinical features of a large Chinese pedigree. Br J Oral Maxillofac Surg 2014; 53:83-5. [PMID: 25284619 DOI: 10.1016/j.bjoms.2014.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
Abstract
Familial gigantiform cementoma is a rare benign fibrocemento-osseous lesion of the jaws that can cause severe facial deformity. It has an autosomal dominant mode of inheritance, but varies in its phenotype. It is more common in white, African, and East-Asian patients. Here we report what is to our knowledge the first distinctive Chinese family with familial gigantiform cementoma involving 4 generations and 13 patients, and which suggests that the tumour presents with 3 distinctive growth phrases.
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Affiliation(s)
- H W Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Shanghai, China.
| | - M Yu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Shanghai, China.
| | - X J Qin
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Shanghai, China.
| | - C P Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Shanghai, China.
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12
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Koutlas IG, Forsman CL, Kyrkanides S, Oetting WS, Petryk A. Autosomal dominant mesomandibular fibro-osseous dysplasia: a self-resolving inherited fibro-osseous lesion of the jaws. Front Physiol 2012; 3:458. [PMID: 23230423 PMCID: PMC3515761 DOI: 10.3389/fphys.2012.00458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 11/19/2012] [Indexed: 11/16/2022] Open
Abstract
A hereditary congenital condition characterized by a fibro-osseous lesion sharing some features with fibrous dysplasia and affecting the middle aspect of the mandible is presented. The condition was initially described as congenital monostotic fibrous dysplasia in two siblings, a male and a female. However, there is sufficient evidence that the disorder is autosomal dominant since it has been encountered in two of four children, both males, of the female propositus and one child, a boy, of the male propositus. All patients presented at birth or right after birth with enlargement of the middle part of the mandible. Radiographs from affected individuals have shown mesomandibular enlargement with irregular trabeculation akin of “ground-glass” appearance. Histologically, samples from all patients revealed woven bone proliferation in a cellular fibroblastic stroma. Interestingly, the originally described siblings, now in their 30s, have no evidence of jaw lesions either radiographically or clinically, thus indicating that the condition is self-limiting or self-resolving. An autosomal dominant mode of inheritance with apparent male predilection is favored. The molecular basis of this condition is currently unknown. However, the location of the lesions in the middle aspect of the mandible suggests dysregulation of Bone Morphogenetic Protein (BMP) signaling since BMPs regulate mandibular morphogenesis in utero, particularly in the medial region as well as postnatal bone remodeling. Immunohistochemical evaluation for a BMP-binding protein Twisted Gastrulation (TWSG1) revealed mosaic pattern of staining, with some cells, including osteoclasts, strongly stained and others exhibiting faint or no staining, thus supporting active regulation of BMP signaling within the lesion. Future investigations will determine if dysregulation of BMP signaling plays a causative role or rather reflects secondary activation of repair mechanisms and/or bone remodeling.
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Affiliation(s)
- Ioannis G Koutlas
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota Minneapolis, MN, USA
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13
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Fibro-osseous disease: harmonizing terminology with biology. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:388-92. [DOI: 10.1016/j.oooo.2012.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 06/01/2012] [Indexed: 11/22/2022]
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Shah S, Huh KH, Yi WJ, Heo MS, Lee SS, Choi SC. Follow-up CT findings of recurrent familial gigantiform cementoma of a female child. Skeletal Radiol 2012; 41:341-6. [PMID: 21830054 DOI: 10.1007/s00256-011-1245-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 07/11/2011] [Accepted: 07/18/2011] [Indexed: 02/02/2023]
Abstract
Familial gigantiform cementoma (FGC) is a rare autosomal dominant, benign fibro-cemento-osseous lesion of the jaws that can cause severe facial deformity. True FGC with familial history is extremely rare and there has been no literature regarding the radiological follow-up of FGC. We report a case of recurrent FGC in an Asian female child who has been under our observation for 6 years since she was 15 months old. After repeated recurrences and subsequent surgeries, the growth of the tumor had seemed to plateau on recent follow-up CT images. The transition from an enhancing soft tissue lesion to a homogeneous bony lesion on CT may indicate decreased growth potential of FGC.
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Affiliation(s)
- Saiquat Shah
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongnogu, Seoul, 110-768, Republic of Korea
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15
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Sivasubramaniam V, Faduyile F, Zarka MA, Deery A, Field A. Maxillary cementifying fibroma: a case report with fine-needle aspiration cytology highlighting the expanding role of e-medicine in cytopathologist collaborations. Diagn Cytopathol 2011; 40:810-4. [PMID: 21472866 DOI: 10.1002/dc.21636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2010] [Accepted: 12/09/2010] [Indexed: 12/28/2022]
Abstract
Cementifying fibroma is an uncommon fibro-osseous lesion presenting in the oral cavity, which may present in children as an aggressive juvenile subtype of either psammomatoid or trabecular variant. Appropriate management, to achieve local control and prevent destructive expansion, requires early diagnosis, which fine-needle aspiration cytology (FNAC) can provide rapidly in a minimally invasive manner. The role of FNAC is even more powerful in situations where medical facilities are limited or where surgical biopsy is contraindicated. We report a case of a 6-year-old boy from Lagos, Nigeria, whose initial diagnosis of cementifying fibroma was made on photographed digital images in jpeg format of FNAC slides, which were then e-mailed as attachments to Sydney, Australia and to Scottsdale, USA. The tumor was subsequently confirmed as a juvenile trabecular variant of cementifying fibroma on histopathology on a surgical excision in London, United Kingdom. The ability to electronically send cytopathology images around the world for a definitive second opinion is a practical example of the power of e-medicine to achieve an accurate FNAC diagnosis.
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Affiliation(s)
- Vanathi Sivasubramaniam
- Department of Anatomical Pathology, St Vincent's Hospital, Victoria Street, Darlinghurst, NSW 2010, Australia
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Expansive osseous dysplasia: report of 9 lesions in an African population sample and a review of the literature. ACTA ACUST UNITED AC 2011; 111:e35-41. [DOI: 10.1016/j.tripleo.2010.10.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 10/01/2010] [Accepted: 10/04/2010] [Indexed: 11/18/2022]
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Eversole R, Su L, ElMofty S. Benign fibro-osseous lesions of the craniofacial complex. A review. Head Neck Pathol 2008; 2:177-202. [PMID: 20614314 PMCID: PMC2807558 DOI: 10.1007/s12105-008-0057-2] [Citation(s) in RCA: 206] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 04/22/2008] [Indexed: 10/22/2022]
Abstract
Benign fibro-osseous lesions of the craniofacial complex are represented by a variety of disease processes that are characterized by pathologic ossifications and calcifications in association with a hypercellular fibroblastic marrow element. The current classification includes neoplasms, developmental dysplastic lesions and inflammatory/reactive processes. The definitive diagnosis can rarely be rendered on the basis of histopathologic features alone; rather, procurement of a final diagnosis is usually dependent upon assessment of microscopic, clinical and imaging features together. Fibrous dysplasia and osteitis deformans constitute two dysplastic lesions in which mutations have been uncovered. Other dysplastic bone diseases of the craniofacial complex include florid osseous dysplasia, focal cemento-osseous dysplasia and periapical cemental dysplasia, all showing a predilection for African descent individuals; although no specific genetic alterations in DNA coding have yet to be uncovered and most studies have been derived from predominant high African descent populations. Ossifying fibromas are neoplastic lesions with four subtypes varying with regard to behavior and propensity for recurrence after surgical excision. The clinicopathologic and molecular features of this unique yet heterogeneous group of diseases are reviewed.
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Affiliation(s)
- Roy Eversole
- Department of Pathology and Medicine, Arthur Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA.
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Moshref M, Khojasteh A, Kazemi B, Roudsari MV, Varshowsaz M, Eslami B. Autosomal dominant gigantiform cementoma associated with bone fractures. Am J Med Genet A 2008; 146A:644-8. [PMID: 18247420 DOI: 10.1002/ajmg.a.32171] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Here, we report a family with gigantiform cementomas, bone fractures, and autosomal dominant inheritance. Lesions are composed of benign, lobulated, calcified masses resembling cementum. Identification of a COL1A2 mutation in one patient was a polymorphism of no pathological significance. The subject of gigantiform cementomas and the associated bone disorder is both confusing and complex. Reported familial instances indicate genetic heterogeneity with (1) osteopenia and bone fractures, (2) one form of osteogenesis imperfecta, and (3) a polyostotic diaphyseal bone disorder.
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Affiliation(s)
- Mohammad Moshref
- Department of Oral and Maxillofacial Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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19
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Genetic Disorders and Bone Affecting the Craniofacial Skeleton. Oral Maxillofac Surg Clin North Am 2007; 19:467-74, v. [DOI: 10.1016/j.coms.2007.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Abstract
Numerous metabolic disorders, teratogenic agents, and in utero infections lead to congenital bone disease and malformation. This review focuses on hereditary and familial disorders of bone with particular emphasis on impaired hematopoiesis, myelofibrosis, pathologic fractures, and dysmorphology of the forearm and craniofacial structures. The severity of bone disease and marrow dysfunction of any given disorder may vary considerably from one affected individual to the next, and intrapersonal variability over time may be substantial as well. Both can impart difficulty to the appropriate evaluation and delay the correct diagnosis. Many of these disorders are phenotypically quite similar but require very different therapeutic intervention.
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Affiliation(s)
- Hans-Christoph Rossbach
- Division of Pediatric Hematology/Oncology, St. Joseph Children's Hospital, and University of South Florida, Tampa, Florida 33607, USA.
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Rossbach HC, Letson D, Lacson A, Ruas E, Salazar P. Familial gigantiform cementoma with brittle bone disease, pathologic fractures, and osteosarcoma: a possible explanation of an ancient mystery. Pediatr Blood Cancer 2005; 44:390-6. [PMID: 15602717 DOI: 10.1002/pbc.20253] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We describe four individuals of an African-American family with a predominantly diaphyseal bone disease associated with familial gigantiform cementoma (FGC), a disorder typically seen in Caucasians. The mother and her children presented with deformities of the jaws, abnormalities of the long bones, and pre-pubertal pathologic fractures. The index patient carried the diagnosis of osteosarcoma (OS). In addition, we provide a possible explanation for the jaw abnormalities of King Tutankhamen's father in the 18th dynasty in Egypt around 1350 BC.
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Affiliation(s)
- Hans-Christoph Rossbach
- Division of Pediatric Hematology/Oncology, All Children's Hospital, St. Petersburg, Florida, USA.
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Beaman FD, Bancroft LW, Peterson JJ, Kransdorf MJ, Murphey MD, Menke DM. Imaging characteristics of cherubism. AJR Am J Roentgenol 2004; 182:1051-4. [PMID: 15039186 DOI: 10.2214/ajr.182.4.1821051] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We sought to describe the radiographic and imaging features of cherubism. CONCLUSION Cherubism is a rare osseous disorder of children and adolescents. Although the radiologic characteristics of cherubism are not pathognomonic, the diagnosis is strongly suggested by bilateral relatively symmetric jaw involvement that is limited to the maxilla and mandible. Imaging typically shows expansile remodeling of the involved bones, thinning of the cortexes, and multilocular radiolucencies with a coarse trabecular pattern.
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Affiliation(s)
- Francesca D Beaman
- Department of Radiology, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL 32224-3899, USA
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Bencharit S, Schardt-Sacco D, Zuniga JR, Minsley GE. Surgical and prosthodontic rehabilitation for a patient with aggressive florid cemento-osseous dysplasia: a clinical report. J Prosthet Dent 2003; 90:220-4. [PMID: 12942053 DOI: 10.1016/s0022-3913(03)00431-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Florid cemento-osseous dysplasia is an extensive form of periapical cemental dysplasia, which usually involves 1 to 4 posterior areas of the maxilla and mandible. The affected area undergoes changes from normal vascular bone into an avascular cementum-like lesion. The lesion is usually benign; however, treatment of a secondary infection of this lesion can be difficult and complicated. This clinical report describes a rare but aggressive secondary infection of this type, which was successfully treated by a combination of complex surgical and prosthodontic procedures, including dental implant therapy.
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Affiliation(s)
- Sompop Bencharit
- School of Dentistry, Department of Chemistry, CB #3290, University of North Carolina, Chapel Hill, NC, USA.
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