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Salge-Arrieta FJ, Vior-Fernández C, Lee P, Reguero-Callejas ME, Pian-Arias HG, Martínez-San Millán JS, Carrasco-Moro R. Giant fronto-spheno-orbitary juvenile psammomatoid ossifying fibroma: Case report and literature review. Childs Nerv Syst 2024; 40:939-945. [PMID: 38038744 DOI: 10.1007/s00381-023-06206-6] [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] [Received: 08/07/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023]
Abstract
Juvenile psammomatoid ossifying fibroma (JPOF) is an osteofibrous neoplasm that originates in the craniofacial skeleton typically during the first three decades of life. JPOFs usually involve the orbit, paranasal sinuses or the jaws. Extensive involvement of the anterior cranial base with compromised visual function is a rare phenomenon. In such clinical context, a definite diagnosis can only be made on the basis of histopathological findings, given the absence of pathognomonic radiological features. Despite being considered a benign entity, JPOFs present a locally aggressive behavior. Therefore, these neoplasms must be included in the differential diagnosis in every patient harboring a skull base osteofibrous lesion, and, once diagnosed, gross total surgical removal should be attempted. In this study, we present our experience in the diagnosis and treatment of a patient diagnosed with a giant JPOF involving the cranial base.
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Affiliation(s)
| | | | - Paul Lee
- Arkansas Neuroscience Institute, Sherwood, AR, USA
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2
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Bin Abdulqader S, Alluhaybi AA, Alotaibi FS, Almalki S, Ahmad M, Alzhrani G. Spheno-orbital juvenile psammomatoid ossifying fibroma: a case report and literature review. Childs Nerv Syst 2021; 37:3251-3255. [PMID: 33404728 DOI: 10.1007/s00381-020-05004-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
Ossifying fibroma (OF) is an uncommon benign fibro-osseous lesion. Based on its clinical, morphological, and radiological features, OF is further divided into cemento-ossifying fibroma (COF), juvenile psammomatoid ossifying fibroma (JPOF), and juvenile trabecular ossifying fibroma (JTOF). JPOF rarely involves the cranial base, with limited reports published on spheno-orbital JPOF. In this paper, we report a case of JPOF of the greater wing of the sphenoid bone and lateral orbital wall in an 11-year-old child and show a surgical video. Although rare, JPOF should be considered in the differential diagnosis of fibro-osseous lesions of the spheno-orbital region.
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Affiliation(s)
- Sarah Bin Abdulqader
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Abdulelah A Alluhaybi
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Fahad S Alotaibi
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Salman Almalki
- Anatomic Pathology Department, Pathology and Clinical Laboratory Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Maqsood Ahmad
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Gmaan Alzhrani
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia.
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Chung RT, Montejo JD, Kerr DA, Hong J. Juvenile psammomatoid ossifying fibroma of the parietal bone and review of calvarial presentations: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2021; 2:CASE21361. [PMID: 35855183 PMCID: PMC9265227 DOI: 10.3171/case21361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/19/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Juvenile psammomatoid ossifying fibroma (JPOF) is an uncommon benign fibro-osseous lesion that only rarely presents in the calvaria. OBSERVATIONS The authors reported a case of JPOF in the left parietal bone of a 20-year-old patient and reviewed the 27 other cases of JPOF occurring in the calvaria as reported in the literature. LESSONS JPOF rarely presents in the calvaria, and because diagnosis is a histopathologic one, clinicians should consider this entity when presented with a lytic, expansile mass on imaging. Little is known about the molecular mechanisms driving development of JPOF. MDM2 amplification may play a role, although this was not seen in the case presented herein.
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Affiliation(s)
- Robert T. Chung
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; and
| | | | | | - Jennifer Hong
- Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
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Dhawan S, Lal T, Pandey PN, Saran R, Singh A. Synchronous Occurrence of Colloid Cyst With Intracranial Ossifying Fibromyxoid Tumor Masquerading as Meningioma. Cureus 2020; 12:e10662. [PMID: 33014664 PMCID: PMC7526763 DOI: 10.7759/cureus.10662] [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] [Indexed: 11/05/2022] Open
Abstract
Ossifying fibromyxoid tumor (OFMT) is a rare fibro-osseous neoplasm. We present a case highlighting the occurrence of an intracranial OFMT masquerading as meningioma on imaging in a 46-year-old gentleman. Brain imaging revealed an extra-axial calcified lesion along the left cerebellar convexity appearing hypointense on T1- and T2-weighted MRI sequences with no post-contrast enhancement, suggestive of a meningioma. An intraventricular colloid cyst was also noted. The lesion, which was presumed to be meningioma, and the colloid cyst were resected in two subsequent operative settings. Histopathological examination of the calcified lesion confirmed the findings of an OFMT. This report aims to inform the physician about intracranial OFMT mimicking meningioma on imaging. In addition, since multiple brain tumors are not very common, the surgeon should always have a suspicion should there be any heterogeneous and peculiar radiological and histopathological characteristics.
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Affiliation(s)
| | - Tusharindra Lal
- Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - P N Pandey
- Neurosurgery, Maulana Azad Medical College/Lok Nayak Hospital, New Delhi, IND
| | - Ravindra Saran
- Neuro-Pathology, Gobind Ballabh Pant Institute of Postgraduate Medical Education and Research/Maulana Azad Medical College, New Delhi, IND
| | - Anutosh Singh
- Neurosurgery, Maulana Azad Medical College/Lok Nayak Hospital, New Delhi, IND
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Rahmani M, Hendi K, Dalfardi S, Larijani A, Alimohamadi M. Juvenile Psammomatoid Ossifying Fibroma of the Orbital Roof: A Rare Cause of Proptosis among Children. Pediatr Neurosurg 2020; 55:163-168. [PMID: 32756056 DOI: 10.1159/000508691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/14/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Juvenile psammomatoid ossifying fibroma (JPOF) is a rare bone tumor characterized by a predilection for the sinonasal region and a tendency to affect younger patients, with a potential for aggressive growth and high recurrence (30-56%). JPOF warrants complete surgical resection to avoid recurrence. CASE PRESENTATION In this article, we report a young boy who presented with unilateral prop-tosis with an expansile bony tumor with ground glass appearance involving the left frontal bone and orbital roof on his images. Complete surgical resection was done, and histopathological examination revealed JPOF with abundant psammomatoid bodies. DISCUSSION This patient is a rare case of neurocranial JOPF and adds new features to the typical features already described for JPOF.
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Affiliation(s)
- Mohammad Rahmani
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Hendi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Dalfardi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Larijani
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maysam Alimohamadi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran, .,Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran,
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Wang K, Ma XJ, Hao SY, Du J, Zhang LW, Zhang JT, Wu Z. Skull Base Juvenile Psammomatoid Ossifying Fibroma: Clinical Characteristics, Treatment, and Prognosis. World Neurosurg 2019; 125:e843-e848. [PMID: 30743026 DOI: 10.1016/j.wneu.2019.01.197] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/26/2019] [Accepted: 01/28/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The diagnosis and management for juvenile psammomatoid ossifying fibroma (JPOF) of the skull base are challenging, and clinical data are limited. METHODS A retrospective review of JPOF was performed, and the clinical characteristics, treatment strategy, and prognosis were analyzed. RESULTS There were 23 patients pathologically confirmed with JPOF, most with JPOF located in the skull base area (19/23, 82.6%). Of those tumors, 43.5% presented with dura matter breakthrough. Most of the chief complaints were headache (n = 8, 34.8%) and visual impairment (n = 5, 21.7%). Most of the tumors were solid tumors with spherical appearance, frequently accompanied by cysts of various size (n = 14, 60.9%). Craniotomy, mostly via the frontal approach, was the most common approach in the present series, comprising 73.6% (17/23) of all cases. The endoscopic endonasal approach was performed in 6 cases (26.1%). In total, 62.5% of patients (15/23) underwent gross total resection, 8.7% of patients (2/23) underwent subtotal resection, and 26.1% of patients (6/23) underwent partial resection. After a mean follow up of 66.1 ± 36.1 months (range, 3-124), 3 patients (13.6%) suffered from tumor recurrence with a mean recurrence time of 13 months. CONCLUSIONS The present series of skull base JPOFs showed that radical surgery combined with skull base reconstruction contributed to overall good prognosis. Further studies are needed to evaluate the long-term outcomes and to characterize its pathologic characteristics.
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Affiliation(s)
- Ke Wang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xiu-Jian Ma
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Shu-Yu Hao
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jiang Du
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, China
| | - Li-Wei Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jun-Ting Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
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Shenouda K, Yuhan BT, Mir A, Gonik N, Eloy JA, Liu JK, Folbe AJ, Svider PF. Endoscopic Resection of Pediatric Skull Base Tumors: An Evidence-Based Review. J Neurol Surg B Skull Base 2018; 80:527-539. [PMID: 31534896 DOI: 10.1055/s-0038-1676305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 10/13/2018] [Indexed: 10/27/2022] Open
Abstract
Objectives To perform a systematic review examining experiences with endoscopic resection of skull base lesions in the pediatric population, with a focus on outcomes, recurrence, and surgical morbidities. Methods PubMed/MEDLINE, Cochrane Library, Embase, and Web of Science databases were evaluated. Studies were assessed for level of evidence. Bias risk was evaluated using the Cochrane Bias tool, Grades of Recommendation, Assessment, Development and Evaluation (GRADE), and Methodological Index for Non-Randomized Studies (MINORS) criteria. Patient characteristics, pathology, site of primary disease, presenting symptoms, stage, procedure specific details, and complications were evaluated. Results were reported using the Preferred Reporting Systems for Systematic Reviews and Meta-Analysis guidelines. Results Ninety-three studies met criteria for inclusion, encompassing 574 patients with skull base tumors. The GRADE and MINORS criteria determined the overall evidence to be moderate quality. The most common benign and malignant pathologies included juvenile nasopharyngeal angiofibromas ( n = 239) and chondrosarcomas ( n = 11) at 41.6 and 1.9%, respectively. Of all juvenile nasopharyngeal angiofibroma tumors, most presented at stage IIIa and IIIb (25.8 and 27.3%, respectively). Nasal obstruction (16.5%) and headache (16.0%) were common symptoms at initial presentation. Surgical approaches included endoscopic endonasal ( n = 193, 41.2%) and endoscopic extended transsphenoidal ( n = 155, 33.1%). Early (< 6 weeks) and late (>6 weeks) complications included cerebrospinal fluid leak ( n = 36, 17.3%) and endocrinopathy ( n = 43, 20.7%). Mean follow-up time was 37 months (0.5-180 months), with 86.5% showing no evidence of disease and 2.1% having died from disease at last follow-up. Conclusion Endoscopic skull base surgery has been shown to be a safe and effective method of treating a variety of pediatric skull base tumors. If appropriately employed, the minimally invasive approach can provide optimal results in the pediatric population.
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Affiliation(s)
- Kerolos Shenouda
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Brian T Yuhan
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States.,Department of Otolaryngology, William Beaumont Hospital, Royal Oak, Michigan, United States
| | - Ahsan Mir
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Nathan Gonik
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States.,Children's Hospital of Michigan, Detroit, Michigan, United States
| | - Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Department of Ophthalmology and Visual Science, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - James K Liu
- Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Adam J Folbe
- Department of Otolaryngology, William Beaumont Hospital, Royal Oak, Michigan, United States.,Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States
| | - Peter F Svider
- Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States
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Ye P, Huang Q, Zhou B. Endoscopic resection of ossifying fibroma involving paranasal sinuses and the skull base in a series of 15 cases. Acta Otolaryngol 2017; 137:786-790. [PMID: 28125308 DOI: 10.1080/00016489.2017.1278791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONCLUSION The key technical challenges in the resection of OFs are rapid removal of tumors by image-guided navigation, determining the boundary of the resection and the proper control of blood supply through the anterior or posterior ethmoidal arteries. OBJECTIVE This study aimed to analyze the clinical data of adult patients with paranasal ossifying fibromas involving the anterior skull base and orbit. The surgical technique and indications are also discussed. METHODS This study reviewed the clinical data of 15 patients (age >16 years) who underwent resection of paranasal ossifying fibromas involving the anterior skull base and orbit by endoscopic surgery with an image guidance system between October 2006 and October 2014. RESULTS The mean age of the 15 patients was 33.2 years (range = 16-58 years). All tumors were completely resected via endoscopic surgery. Intra-operative cerebrospinal fluid (CSF) leaks (four cases) were repaired endoscopically. The mean follow-up duration was 43.1 months. One patient lost vision after surgery, recurrence was observed in two patients, one underwent a third excision 8 years after the second surgery, and the other exhibited residual osteoarthritis 3 years after the first surgery and remained under regular observation. One patient was lost to follow-up.
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Affiliation(s)
- Ping Ye
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, PR China
- Department of Otolaryngology, Qilu hospital, Shandong University, Key Laboratory of Otolaryngology, Chinese Ministry of Health, Jinan, PR China
| | - Qian Huang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, PR China
| | - Bing Zhou
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, PR China
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Strickler S, Hitchcock KE, Dziegielewski PT, Mendenhall WM. Radiotherapy for juvenile ossifying fibroma of the maxillary sinus: Case report and literature review. Head Neck 2017; 39:E81-E84. [PMID: 28467645 DOI: 10.1002/hed.24811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/08/2017] [Accepted: 03/14/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Juvenile ossifying fibroma (JOF) is a benign fibro-osseous lesion that can be locally aggressive. It is typically treated with surgical excision. A few cases using adjuvant radiotherapy have been reported in the literature. METHODS We report a case of JOF treated with surgical excision and adjuvant radiotherapy to minimize the risk of local recurrence. We also review the literature. RESULTS Our patient tolerated radiotherapy without complication and had not experienced a local recurrence at the time of writing this manuscript. CONCLUSIONS This is one of the first reports of adjuvant radiotherapy after surgical excision to improve local control in patients with JOF. Radiotherapy should be considered in patients for whom reexcision after a recurrence would result in unacceptable morbidity.
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Affiliation(s)
- Scott Strickler
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Kathryn E Hitchcock
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Peter T Dziegielewski
- Department of Otolaryngology, University of Florida College of Medicine, Gainesville, Florida
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida
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Barrena López C, Bollar Zabala A, Úrculo Bareño E. Cranial juvenile psammomatoid ossifying fibroma: case report. J Neurosurg Pediatr 2016; 17:318-23. [PMID: 26588460 DOI: 10.3171/2015.7.peds1521] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Juvenile psammomatoid ossifying fibroma (JPOF) is a fibroosseous tumor that arises in the craniofacial bones in young people. This lesion usually originates in the jaw, orbit, and ethmoid complex but can also be associated with the skull base and calvaria. Diagnosis must be made based on observing typical radiological and histopathological features. Although JPOF is a rare pathological entity, neurosurgeons must consider this odontogenic lesion in the differential diagnosis of skull masses given the lesion's aggressive behavior and locally invasive growth. Treatment must be gross-total resection. In the following article, the authors present a case of cranial JPOF and discuss various aspects of this entity.
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Affiliation(s)
- Cristina Barrena López
- Department of Neurosurgery, Pediatric Section, Donostia University Hospital, San Sebastián-Donostia, Guipúzcoa, Spain
| | - Alicia Bollar Zabala
- Department of Neurosurgery, Pediatric Section, Donostia University Hospital, San Sebastián-Donostia, Guipúzcoa, Spain
| | - Enrique Úrculo Bareño
- Department of Neurosurgery, Pediatric Section, Donostia University Hospital, San Sebastián-Donostia, Guipúzcoa, Spain
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Owosho AA, Hughes MA, Prasad JL, Potluri A, Costello BJ, Branstetter BF. Is Computed Tomography an Adequate Imaging Modality for the Evaluation of Juvenile Ossifying Fibroma? A Comparison of 2 Imaging Modalities (Computed Tomography and Magnetic Resonance Imaging). J Oral Maxillofac Surg 2015; 73:1304-13. [PMID: 25911216 DOI: 10.1016/j.joms.2015.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 01/17/2015] [Accepted: 01/17/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE Given the problems of overuse of medical technology and the current burden of health care cost in the United States, it is important to establish clear imaging guidelines to diagnose conditions such as juvenile ossifying fibroma (JOF). This study compared the efficacy of computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of JOF and thus could aid establishing such guidelines. MATERIALS AND METHODS Radiologic criteria were established by 2 radiologists to compare the efficacy of CT and MRI in the evaluation of JOF. The following parameters were compared: presence of a well-defined corticated border, presence of a well-delineated internal calcified component, fluid-to-fluid levels, and anatomic extent of the lesion. Six patients diagnosed with JOF of the craniofacial bones from 2002 to 2013 had preoperative CT and MRI studies available for review. RESULTS After review of CT and MRI images, fluid-to-fluid levels and anatomic extent of the lesions were comparable on CT and MRI. However, the corticated borders and the internal calcified component were better defined on CT images, which also enabled for distinction between the 2 subtypes of JOF. No MRI characteristics were identified that allowed for this distinction. CONCLUSION Based on these findings, CT is an adequate and preferable imaging modality in the evaluation of JOF.
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Affiliation(s)
- Adepitan A Owosho
- Chief Resident, Department of Oral and Maxillofacial Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Marion A Hughes
- Assistant Professor, Division of Neuroradiology, Department of Radiology, University of Pittsburgh, Pittsburgh, PA
| | - Joanne L Prasad
- Assistant Professor, Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Anitha Potluri
- Assistant Professor, Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA.
| | - Bernard J Costello
- Professor of Craniofacial and Cleft Surgery, Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Barton F Branstetter
- Professor of Radiology, Otolaryngology, and Biomedical Informatics, Division of Neuroradiology, Department of Radiology, University of Pittsburgh, Pittsburgh, PA
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