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Sarode GS, Sarode SC. Psammomatoid ossicles in odontogenic keratocyst: A rare and unusual phenomenon. Oral Oncol 2023; 147:106618. [PMID: 37924744 DOI: 10.1016/j.oraloncology.2023.106618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
The Odontogenic Keratocyst (OKC) is characterized by pathognomonic histomorphological features and rarely exhibits significant deviations. We present a case of OKC of mandibular posterior region in a 25-year-old female patient. In addition to the classical histopathological characteristics of OKC, the connective tissue near the juxta-epithelial area displayed numerous small round basophilic calcifications resembling psammomatoid ossicles. These calcifications displayed a focal distribution pattern, with round calcifications evenly spaced from each other. Some of these round calcified bodies bore a resemblance to Liesegang ring calcifications. The presence of psammomatoid ossicles in this specific OKC challenges established knowledge, emphasizing the necessity for more comprehensive investigations into these cystic variants especially related to their biological behavior.
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Affiliation(s)
- Gargi S Sarode
- Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra State, Pune, India
| | - Sachin C Sarode
- Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra State, Pune, India; Dr. D.Y. Patil Unitech Society's Dr. D.Y. Patil Institute of Pharmaceutical Sciences and Research, Pimpri, Pune 411018, Maharashtra, India.
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Ma J, Zhou B, Huang Q, Cui S, Cao D. Prognostic factors in transnasal endoscopic surgery for paediatric patients with ossifying fibroma of the paranasal sinuses and skull base. J Otolaryngol Head Neck Surg 2023; 52:48. [PMID: 37491362 PMCID: PMC10369828 DOI: 10.1186/s40463-023-00641-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 04/10/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Ossifying fibroma of the paranasal sinuses and skull base in paediatric patients is difficult to operate and can recur easily after surgery. This study aimed to analyse factors associated with recurrence after transnasal endoscopic resection of ossifying fibroma in paediatric patients. METHODS This retrospective observational study included 34 patients under 17 years of age who underwent transnasal endoscopic resection of ossifying fibroma of the paranasal sinuses and skull base from 2005 to 2021 at a single tertiary medical centre. Clinical indicators such as age; surgical history; pathological type; intraoperative bleeding; and orbit, anterior skull base, sphenoid bone, sella turcica, clivus, or frontal sinus involvement were subjected to univariate analysis using the χ2 test, to investigate whether any of these factors affected recurrence. RESULTS All 34 patients underwent transnasal endoscopic resection. The follow-up period was 6-120 months (mean: 48.0 months). Five patients experienced local recurrence during the follow-up period (14.7%). Results of χ2 tests indicated that a history of previous surgery, the amount of intraoperative bleeding, and sphenoid and/or sella turcica and clivus involvement were significantly associated with recurrence (P < 0.05). Age; pathological stage; and orbit, anterior skull base, and frontal sinus involvement were not associated with recurrence (P > 0.05). CONCLUSIONS The increased risk of recurrence after transnasal endoscopic resection of nasal-skull base ossifying fibroma should be considered during endoscopic surgery in paediatric patients with a history of previous surgery, intraoperative bleeding tendency, and sphenoid and/or sella turcica and clivus involvement. These patients require careful postoperative follow-up.
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Affiliation(s)
- Jingying Ma
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology and Head and Neck Surgery, Ministry of Education, 1 Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Bing Zhou
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology and Head and Neck Surgery, Ministry of Education, 1 Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Qian Huang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology and Head and Neck Surgery, Ministry of Education, 1 Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Shunjiu Cui
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology and Head and Neck Surgery, Ministry of Education, 1 Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Dingfang Cao
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
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Adham M, Dewi DJ, Reksodiputro MH, Ranakusuma R. Single stage maxillofacial reconstruction combined radical surgery for managing juvenile ossifying fibroma: A case report. Natl J Maxillofac Surg 2023; 14:334-338. [PMID: 37661994 PMCID: PMC10474534 DOI: 10.4103/njms.njms_170_22] [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: 09/20/2022] [Revised: 11/03/2022] [Accepted: 11/28/2022] [Indexed: 01/18/2023] Open
Abstract
Ossifying fibroma (OF) in craniofacial is a rare disease, benign, locally aggressive fibro-osseous tumor. The 2017 World Health Organization classifications divided OF into two types: OF of odontogenic origin and juvenile ossifying fibroma (JOF). Determining the right surgical treatment to reduce the postoperative recurrence rate is incredibly challenging. The author reports two cases of paranasal sinuses with disease onset progressed from pre-pubertal age. The first case is an example of a recurrent case after undergoing conservative surgery, and the second is a new one. All cases underwent radical surgery with subtotal maxillectomy and reconstructive surgery in one stage. After observing all patients until one year, there was no sign of recurrence through clinical and endoscopic examination. There are two types of surgery that compare in this case report: conservative surgery and radical surgery. Conservative surgical procedures include curettage, enucleation, or peripheral osteotomies. Several studies have shown high recurrence levels in OF patients when curettage or enucleation is performed; residue caused by incomplete excision is the most common reason that is easily caused by conservative surgery. Radical surgery such as open maxillectomy is a promising approach for degrading the level of recurrence. JOF, especially trabecular juvenile ossifying fibroma, shows a high recurrence percentage comparing other types. The first-choice management for treating OF was the surgical approach. Types of surgery depend on the disease's aggressiveness and morbidity. Radical surgery was proven better at decreasing recurrence level than conservative surgery.
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Affiliation(s)
- Marlinda Adham
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dwi J. Dewi
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Mirta Hediyati Reksodiputro
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Respati Ranakusuma
- Department of Clinical Epidemiology and Evidence Based Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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R. C, R. S, Mohideen K, Balasubramaniam M, Ghosh S, Dhungel S. Juvenile psammomatoid ossifying fibroma of the maxilla and mandible: A systematic review of published case reports. Clin Exp Dent Res 2023; 9:186-197. [PMID: 36325758 PMCID: PMC9932254 DOI: 10.1002/cre2.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate recent evidence-based data that summarize the clinicopathological findings and treatment along with follow-up measures taken in terms of published cases of Juvenile psammomatoid ossifying fibroma (JPOF) of the maxilla and mandible by a systematic review. MATERIALS AND METHODS: The databases searched were PubMed, MEDLINE, Scopus, Google scholar, and Cross references. Only those case reports of JPOFs published in the English language from 2000 to 2022 were considered. All cases included confirmed JPOF lesions histopathologically. The SR-included details like clinical and radiographic data, follow-up details such as recurrence, and the presence of any adverse outcome. RESULTS The database search produced 595 articles from 2000 to 2022, among which 22 case reports were included in the systematic review. The mean age of JPOF occurrence in patients was 18 ± 16 years. A male predilection was noted among patients younger than 14 years of age, whereas a female predilection was noted in patients older than 14 years of age. Frequent involvement of the mandible (56%) compared to the maxilla (44%) was reported. The posterior mandible was the most commonly affected site involving numerous adjacent structures. The expansile nature of the JPOF displayed 57% buccolingual expansion, 50% downward displacement or erosion of the lower border of the mandible and 81% of involvement of the maxillary antrum/pterygoid plate/orbital floor. Among the 20 cases reported, the treatment provided included surgical excision in 45% of the patients, jaw resection in 35% of the patients, and enucleation and curettage in 18% of the patients. Follow-up details were provided in 80% of the reports that showed recurrence. CONCLUSIONS The diagnosis of JPOF requires correlation of the clinical and radiographic features with key histopathological features. Although long-term follow-up of the case reports has been reported, the data lack information about the long-term outcomes of JPOF.
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Affiliation(s)
- Chandini R.
- Department of Oral PathologySathyabama Dental College and HospitalChennaiIndia
| | - Saranya R.
- Department of Oral PathologySathyabama Dental College and HospitalChennaiIndia
| | - Khadijah Mohideen
- Department of Oral PathologySathyabama Dental College and HospitalChennaiIndia
| | | | - Snehashish Ghosh
- Department of Oral PathologyCollege of Medical SciencesBharatpurNepal
| | - Safal Dhungel
- Department of Oral and Maxillofacial SurgeryCollege of Medical SciencesBharatpurNepal
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Sonone A, Hande A, Gawande MN, Patil SK, Pakhale A. Aneurysmal Bone Cyst Plus Lesions: A Case Report and a Literature Review. Cureus 2022; 14:e27912. [PMID: 36120211 PMCID: PMC9467493 DOI: 10.7759/cureus.27912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/11/2022] [Indexed: 11/05/2022] Open
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Aggressive juvenile ossifying fibroma of the ethmoid sinus with orbital and intracranial extension: A case report. Int J Surg Case Rep 2022; 96:107255. [PMID: 35738137 PMCID: PMC9218808 DOI: 10.1016/j.ijscr.2022.107255] [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: 03/18/2022] [Revised: 05/22/2022] [Accepted: 05/28/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Juvenile ossifying fibroma is a rare benign destructive lesion of nose and paranasal sinuses. It occurs in the craniofacial bones of children below 15 years of age. It is usually discovered in the mandible and maxilla and rarely in the paranasal sinuses. CASE PRESENTATION We present a case of a 15-year-old girl with extensive right ethmoid sinus juvenile ossifying fibroma with intracranial and orbital involvement that was managed endoscopically at our center followed by lateral rhinotomy and frontal craniotomy with reconstruction due to the aggressive nature and recurrence of the disease. Patient was followed up post operatively for 3 years and was found free of symptoms ever since. CONCLUSION In this case report we present our experience in managing this aggressive recurrent disease of juvenile ossifying fibroma which requires multiple endoscopic and open surgical procedures. Such pathology needs a close and long follow up due to the aggressive nature of this disease.
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Liu Y, Zhou J, Shi J. Clinicopathology and Recurrence Analysis of 44 Jaw Aneurysmal Bone Cyst Cases: A Literature Review. Front Surg 2021; 8:678696. [PMID: 34250007 PMCID: PMC8260671 DOI: 10.3389/fsurg.2021.678696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/19/2021] [Indexed: 11/13/2022] Open
Abstract
In the past half-century, considerable attention has been paid to oral and maxillofacial skeletal cyst, however, aneurysmal bone cyst (ABC), unlike other common bone diseases, still contours numerous unanswered questions in terms of classification, etiology and pathological mechanism. The purpose of this article was to evaluate the proportion of primary ABC and secondary ABC, and to assess the recurrence of ABC and related factors. A methodical search of Embase, MEDLINE, Cochrane Library, Web of Science was conducted for well-documented jaw aneurysmal bone cyst (JABC) cases. One hundred thirty-one articles were identified after database searching and 31 of them were included in our study for further research with 44 JABC cases. All the articles were analyzed by two separate authors. About 25% of the reported jaw aneurysmal bone cyst was secondary. Both the pathological classification and surgical treatment had a significant influence on recurrence rate (P = 0.0082, P = 0.0022), while patients' age or radiographic features rarely affected prognosis. Jaw aneurysmal bone cysts can present variable clinical and histological presentations. Recurrence may be attributed to omittance of underlying potential blood supply or conservative surgical protocol.
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Affiliation(s)
- Yu Liu
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, The Affiliated Hospital of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinhan Zhou
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, The Affiliated Hospital of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| | - Jue Shi
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, The Affiliated Hospital of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
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Kamalakaran A, Ramakrishnan B, Thirunavukkarasu R. Juvenile psammomatoid ossifying fibroma of Orbit-A rare case report and review of literature. J Clin Exp Dent 2021; 13:e614-e619. [PMID: 34188769 PMCID: PMC8223155 DOI: 10.4317/jced.57897] [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: 09/26/2020] [Accepted: 12/20/2020] [Indexed: 11/23/2022] Open
Abstract
Fibro osseous lesions of the craniofacial skeleton are a benign condition in which the normal architecture of the bone is replaced by fibrous connective tissue with varying degrees of mineralization. JOF forms a special entity among the fibro osseous lesions because of its age of occurrence and its aggressive nature thereby mimicking a malignancy. The Juvenile Ossifying Fibromas were further subdivided into Psammomatoid and Trabecular variant based on their histopathological characteristics. They tend to differ in their mineralized portion with the trabecular variant showing woven bone while the psammamotoid shows lamellated and spherical ossicles in various shapes in a myxoid stroma intermingled with bone cyst like areas. The reported cases of JPSOF are few, hence histopathological examination is a valuable tool in the diagnosis of this rare lesion and JOF should always be considered in the differential diagnosis of the lesions of the craniofacial skeleton. Early diagnosis and a complete surgical excision with adequate margins and a long term follow up is mandatory for a good prognosis of this highly recurrent and aggressive lesion.The diagnosis of JOF requires a careful correlation of clinical, radiological and histopathological features. The purpose of this paper is to report a case of JPOF of the orbit to stress the need for consideration of JOF in the differential diagnosis of the aggressive lesions of the Cranio facial skeleton. Key words:Juvenile psammomatoid ossifying fibroma, orbit, ossifying fibroma.
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Affiliation(s)
- Arunkumar Kamalakaran
- Associate Professor, Department of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai
| | - Bharathi Ramakrishnan
- Professor, Department of Oral and Maxilofacial Pathology, Tamilnadu Government Dental College and Hospital, Chennai
| | - Rohini Thirunavukkarasu
- Senior Assistant professor, Department Of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai
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Semus RL, Zielinski E, Foster WC. Juvenile psammomatoid ossifying fibroma of the calcaneus. BMJ Case Rep 2020; 13:13/8/e234555. [PMID: 32816930 DOI: 10.1136/bcr-2020-234555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Juvenile ossifying fibromas (JOFs) are a rare group of fibro-osseous lesions, typically of odontogenic origin. Juvenile psammomatoid ossifying fibroma (JPOF) is one variant, that is, histopathologically distinguished by spherical ossicles resembling psammoma bodies. JPOF tumours are most commonly found in craniofacial skeletal structures and can be locally aggressive. Thus, early management by complete surgical excision is crucial for good outcomes, although recurrence is still possible. Secondary aneurysmal bone cyst (ABC) formation has been reported with JOF lesions, but less commonly with the JPOF variant. We describe an unusual case of JPOF that presented in the calcaneus with secondary ABC formation.
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Affiliation(s)
- Rachel L Semus
- Department of Orthopaedics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Elizabeth Zielinski
- Department of Orthopaedics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - William C Foster
- Department of Orthopaedics, Virginia Commonwealth University, Richmond, Virginia, USA
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Rabelo N, da Silva VTG, do Espírito Santo MP, Solla D, Oberman DZ, da Costa BS, Frassetto FP, Teixeira MJ, Figueiredo EG. Orbit ossifying fibroma - Case report and literature review. Surg Neurol Int 2020; 11:35. [PMID: 32257561 PMCID: PMC7110299 DOI: 10.25259/sni_492_2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/25/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Ossifying fibroma (OF) is benign bone lesions, most frequent in young children, more common in the maxillary sinus and mandible (75–89%), the pathogenesis of the tumor is not clear, there are many subtypes of OF. This paper aims to report an OF a case and literature review. Case Description: Male, 19 years old, with a progressive history proptosis since 2012, diagnosed as a right supraorbital lesion at an external service and assigned to conservative management. Then, he evolved with double vision, which worsened in February of 2018, associated with a moderate headache. On admission: proptosis and downward deviation of the right orbit was noticed on the physical exam and with exception of limited right upgaze, external ocular movements were maintained. Head computed tomography showed a multiloculate expansive osteolytic lesion at the right orbital roof. On magnetic resonance imaging, the lesion had an inner content with septations, T1-weighted imaging heterogeneous signal, T2-weighted imaging high signal intensity, and peripheral contrast enhancement. The patient underwent a right frontal craniotomy with a gross total resection and the postoperative follow-up was uneventful. Menzel reported the first case in 1782. The clinical findings depend on localization. There are five subtypes. In general, the lesions have a radiological appearance with hyperdense boundary and cause deformity and destruction in bones with high recurrence risk. Radical resection is curative. Conclusion: As a result, the correlation of clinical, radiologic, and pathologic data is significant while going for a specific diagnosis in cases of craniofacial fibrous lesions. Total excision is the best treatment, but it can recur.
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Affiliation(s)
- Nicollas Rabelo
- Departments of Neurosurgery, University of São Paulo, São Paulo, Brazil
| | | | | | - Davi Solla
- Departments of Neurosurgery, University of São Paulo, São Paulo, Brazil
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