Juvenile active ossifying fibroma of the mandible: A report of 2 cases
| Autor: | Riitta Leimola-Virtanen, Stina Syrjänen, Kimmo Vähätalo |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
Pathology medicine.medical_specialty Odontogenic Tumors Diagnosis Differential medicine Humans Periodontal fiber Juvenile active ossifying fibroma Cementum Child Immature Bone Osteoid business.industry Fibrous dysplasia Mandible medicine.disease Mandibular Neoplasms medicine.anatomical_structure Paranasal sinuses Otorhinolaryngology Fibroma Ossifying Female Surgery Neoplasm Recurrence Local Oral Surgery business Follow-Up Studies |
| Zdroj: | Journal of Oral and Maxillofacial Surgery. 59:439-444 |
| ISSN: | 0278-2391 |
| DOI: | 10.1053/joms.2001.21883 |
| Popis: | Maxillofacial fibrosseous lesions usually present a diagnostic dilemma for clinicians and pathologists. The concepts and criteria of benign fibrosseous lesions were presented in 1973 by Waldron and Giasanti1,2 after reviewing more than 60 cases. According to them, most of the so-called “fibrous osteomas” of the jaws should be considered examples of fibrous dysplasia.1 They also identified a group of lesions that did not fulfill the criteria of fibrous dysplasia. These lesions consisted of varying proportions of bone, cementum, and fibrous connective tissue. The authors concluded that this group of lesions are best considered a spectrum of processes arising from cells in the periodontal ligament and having the potential to form bone, cementum, and fibrous tissue in combination.2 They considered only some of the lesions neoplastic, whereas others appeared reactive in nature. The World Health Organization’s (WHO) histologic typing of odontogenic tumors groups the fibrosseous lesions into 2 main categories: osteogenic neoplasms and nonneoplastic bone lesions.3 Osteogenic neoplasms include cementossifying fibroma.3 According to the WHO classification, the term juvenile active ossifying fibroma (JAOF) is used for an actively growing lesion mainly affecting persons younger than age 15. JAOF consists of a cell-rich fibrous tissue containing bands of cellular osteoid without osteoblastic rimming together with trabeculae of more typical woven bone. Small foci of giant cells may be present, and in some parts, there may be abundant osteoclasts related to the woven bone. Waldron and Giasanti1,2 were rather skeptical as to the term JAOF. Because of the lack of any documented series illustrating the pathology and prognosis of JAOF, they were unable to comment on how JAOF might or might not relate to the lesions they called ossifying fibroma.1,2 Typically, the tumor involves the maxilla, paranasal sinuses, orbital, and frontoethmoid bones; however, single cases of mandibular lesions have also been reported (Table 1).4-7 In the mandible, JAOF is considered a neoplasm that develops from undifferentiated cells of the periodontal ligament, most often in the mandibular premolar-molar region. The typical histologic features for JAOF are stromal cellularity and the presence of mineralized particles. The nature of the hard tissue varies from scattered ossicles to irregular trabeculae of woven immature bone, although lamellar bone may also be present. The tumor is usually asymptomatic, achieving a large size, exhibiting aggressive behavior, producing significant osseous destruction, and having a tendency to recur. The distinction between other fibrosseous lesions (ie, cementifying fibroma and fibrous dysplasia) is mainly based on the nature of the calcified product of the tumor. This article presents 2 cases of mandibular JAOF in a teenage girl and boy, respectively. |
| Databáze: | OpenAIRE |
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