1
|
Tahir M, Ahmed Z, Elkadi O. Cranial Juvenile Psammomatoid Ossifying Fibroma: A Rare Entity. Cureus 2023; 15:e42122. [PMID: 37602120 PMCID: PMC10438793 DOI: 10.7759/cureus.42122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Juvenile ossifying fibroma (JOF) is an unusual fibro-osseous lesion primarily occurring in children and young adolescents. Anatomically, this lesion could predominantly arise from the bilateral orbits, paranasal sinuses, maxilla, or mandible. Although it is a benign lesion of osseous origin, it is an aggressive variant of ossifying fibroma of the jaw. Due to the aggressive nature of this lesion and its high tendency for recurrence, early radiological detection and prompt surgical treatment are required. The histologic diagnosis of this entity is purely based on hematoxylin and eosin (H&E), but immunohistochemistry and molecular diagnostic studies can also be performed in challenging cases. A thorough histopathological examination of this lesion is recommended because it can easily be mistaken for another benign fibrosis lesion arising at the same anatomical location. Here, we report the case of a juvenile psammomatoid ossifying fibroma (JPOF) occurring in a 12-year-old boy. The tumor is arising at an extracranial location behind the left anterior cranial fossa.
Collapse
Affiliation(s)
- Muhammad Tahir
- Pathology and Laboratory Medicine, University of South Alabama Health University Hospital, Mobile, USA
| | - Zan Ahmed
- Pathology and Laboratory Medicine, University of South Alabama Health University Hospital, Mobile, USA
| | - Osama Elkadi
- Pathology and Laboratory Medicine, University of South Alabama Health University Hospital, Mobile, USA
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Wong YP, Tan GC, Mukari SAM, Palaniandy K. Heterotopic ossification in psammomatous spinal meningioma: a diagnostic controversy. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2021; 14:627-632. [PMID: 34093948 PMCID: PMC8167497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
Heterotopic ossification (HO), a synonym for osseous metaplasia, is a pathological phenomenon, characterized by abnormal bone formation outside the skeletal system observed commonly in various neoplastic and non-neoplastic diseases. HO occurring in meningioma is exceptionally rare. We reportherein an unusual case of spinal meningioma containing numerous calcified psammoma bodies and extensive HO in a 75-year-old woman, who presented with progressive worsening bilateral lower limb weakness and numbness. The presence of remarkable bone formation within a meningioma is controversial among pathologists; while some regard them as psammomatous meningioma as the primary diagnosis, others prefer osteoblastic meningioma, a form of metaplastic meningioma. There is compelling molecular data to advocate that HO is an active disease process involving metaplastic (osseous) differentiation of meningioma stroma mesenchymal stem-like cells, but not the meningothelial-derived tumor cells. Henceforth, the term "metaplastic meningioma" may not be appropriate in this context. A plausible designation as "psammomatous meningioma with osseous metaplasia" defines this entity more accurately. This paper highlights the need for a unifying nomenclature to reduce diagnostic controversy caused by conflicting terms in the literature. The possible pathogenesis of this intriguing phenomenon is discussed.
Collapse
Affiliation(s)
- Yin Ping Wong
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan MalaysiaJalan Yaacob Latiff, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia
| | - Geok Chin Tan
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan MalaysiaJalan Yaacob Latiff, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia
| | - Shahizon Azura Mohamed Mukari
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan MalaysiaJalan Yaacob Latiff, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia
| | - Kamalanathan Palaniandy
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universiti Kebangsaan MalaysiaJalan Yaacob Latiff, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia
| |
Collapse
|
5
|
Rao S, Singh V, Hafeez A A, Agarwal SS. Juvenile Psammomatoid Cemeto-ossifying Fibroma of Mandible: a Diagnostic dilemma. BMJ Case Rep 2021; 14:e240952. [PMID: 33741572 PMCID: PMC7986957 DOI: 10.1136/bcr-2020-240952] [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] [Accepted: 03/06/2021] [Indexed: 11/04/2022] Open
Abstract
Psammomatoid Juvenile ossifying fibroma (PsJOF) is a rare benign fibro-osseous lesion characterised to grow to unusually large size very rapidly. Its usual presentation is in younger age group mostly children and predominately involving the Sino-Naso-Orbital region. Its aggressive nature gimmicks a malignant lesion but it is rather a benign lesion with a higher recurrence rate than the conventional ossifying fibroma but lacking metastatic potential. The high recurrence rate makes it essential that the lesion is not reconstructed immediately and thorough monitoring in the follow-up period. Lesion of such clinical importance needs to be diagnosed preoperatively to provide a better and radical surgical treatment option, but the variability in its presentation as seen in this case makes it even harder to diagnose. We aim to draw attention to the rare phenomena that PsJOF presents to help readers broaden their purview in diagnosis and thereby manage them accordingly.
Collapse
Affiliation(s)
- Santhosh Rao
- Dentistry-Oral & Maxillofacial Surgey, All India Institute of Medical Sciences-Raipur, Raipur, Tatibandh, India
| | - Vandita Singh
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences-Raipur, Raipur, Chhattisgardh, India
| | - Abdul Hafeez A
- Dentistry-Oral & Maxillofacial Surgey, All India Institute of Medical Sciences-Raipur, Raipur, Tatibandh, India
| | - Subham S Agarwal
- Dentistry-Oral & Maxillofacial Surgey, All India Institute of Medical Sciences-Raipur, Raipur, Tatibandh, India
| |
Collapse
|
6
|
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.
Collapse
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,
| |
Collapse
|
7
|
Abstract
Benign fibro-osseous lesions (BFOLs) are a particularly challenging set of diagnoses for the pathologist. This diverse collection of diseases includes fibrous dysplasia, ossifying fibroma and cemento-osseous dysplasia. While all three conditions have similar microscopic presentations, their treatment and prognosis differ, demanding an accurate and definitive diagnosis. A practical and systematic approach considering the patient's history, demographics, intraoperative presentation, and gross appearance with an emphasis on radiology and histology will be discussed.
Collapse
|
8
|
Sarode SC, Sarode GS, Ingale Y, Ingale M, Majumdar B, Patil N, Patil S. Recurrent juvenile psammomatoid ossifying fibroma with secondary aneurysmal bone cyst of the maxilla: a case report and review of literature. Clin Pract 2018; 8:1085. [PMID: 30090219 PMCID: PMC6060481 DOI: 10.4081/cp.2018.1085] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/21/2018] [Indexed: 11/30/2022] Open
Abstract
Juvenile ossifying fibroma is a benign fibro-osseous lesion commonly affecting the extra-gnathic craniofacial skeleton of the young individuals. The psammomatoid and trabecular variants are its two histopathological subtypes having distinctive clinico-pathological characteristics. Secondary aneurysmal bone cysts are frequently reported to arise in the pre-existing fibro-osseous lesions but rarely reported in the psammmomatoid variant of the juvenile ossifying fibroma. Such hybrid lesions, especially massive in size, tend to exhibit a greater aggressive growth potential and higher recurrence rate and mandate complete surgical removal of the lesion along with a long-term follow-up. The objective of this case report was to present a rare incident of recurrent psammomatoid ossifying fibroma associated with a secondary aneurysmal bone cyst in the maxillary jaw bone of a young patient and review the similar published reports in the English literature.
Collapse
Affiliation(s)
- Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Gargi S Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Yashwant Ingale
- Department of Dentistry, Yashwantrao Chavan Memorial Hospital, Pimpri, Pune, Maharashtra, India
| | - Manjusha Ingale
- Department of Oral Medicine and Radiology, M A Rangoonwala College of Dental Science & Research Centre, Pune, Maharashtra, India
| | - Barnali Majumdar
- Department of Oral Pathology and Microbiology, Bhojia Dental College & Hospital, Baddi, Himachal Pradesh, India
| | - Nilesh Patil
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Krishna Institute of Medical Sciences, Karad, Maharashtra, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| |
Collapse
|