Radiographically, the tumor presents as a well marginated radiolucent lesion, with a distinct multilocular appearance. A nof is a result from failure of the bone to properly close at its outer shell. Indian journal of dental research, 222, 2011 352 received. Juvenile ossifying fibroma journal of pathology and translational. Juvenile ossifying fibroma genetic and rare diseases. Cemento ossifying fibroma cof is a benign fibroosseoustumor that the world health organization who classifies as a fibroosseous neoplasm. Nonossifying fibroma musculoskeletal medicine for medical.
Other synonyms of cemento ossifying fibroma besides ossifying fibroma include 7. A case of pof in the maxillary gingiva of a 20 year old male patient is described in this report. In early stage it appears as unilocular, welldefined radiolucency. It is difficult to differentiate the calcified tissue within the lesion between bone and cementum. These lesions can arise from any part of the craniofacial skeleton, although the majority of the cases occur in the maxilla and mandible. Lehrer, md, new orleans the he term ossifying fibroma is ap plied to a localized fibroosseous dysplasia encountered in the bones of the face and skull which presents clinically and radio graphically as a monostotic expansile lesion. Cemento ossifying fibroma presenting as a mass of the parapharyngeal and masticator space. However, it is controversial whether it represents a true neoplasm or rather a developmental disorder of growing bone. Cemento ossifying fibroma is a rare benign tumor most often discovered incidentally. Cemento ossifying fibroma of mandible a case report. Ossifying fibroma an overview sciencedirect topics. The who classifies cementoossifying fibroma as a fibroosseous neoplasm, included among the nonodontogenic tumors, derived from the mesenchymal blast cells of the periodontal ligament, and with a potential to form fibrous tissue, cement and bone, or a combination of such elements.
A nonossifying fibroma nof is one of the most common benign bone tumors found in 30 to 40% of children between 820 years of age. Cementoossifying fibroma cof are rare, benign neoplasms that usually arise from the mandible or maxilla. The cemento ossifying fibroma cof is an uncommon benign fibroosseous lesion composed of fibrocellular component and calcified materials like cementum and woven bone. Earlier, it was classified as two different entities depending upon whether the bone ossifying fibroma or cementum cementifying fibroma forms the major calcified product. A 37yearold female patient undergoing chronic haemodialysis reported to our. The central matured ossified nodules were of low density on ct scans and high signal intensity on t1. An ex tensive, destructive cemento ossifying fi broma of the ethmoid region was found in a patient. Aggressive cemento ossifying fibroma of the ethmoid region anthony s. Oct 01, 2015 juvenile ossifying fibroma jof is rare, benign tumor of the craniofacial skull and face bones. Peripheral ossifying fibroma a clinical and histological. Cementoossifying fibroma cof is a benign fibro osseous lesion of the jaws which has been described as a demarcated or rarely encapsulated neoplasm consisting of fibrous tissue and varying amounts of mineralized material resembling bone andor cementum dinkar et al. Case report bilateral synchronous ossifying fibromas of the mandible. Majority of the lesions are found in the posterior region of the mandible.
The term cementifying fibroma was originally applied to the lesion of the mandibular incisor teeth now referred to as periapical cemental dysplasia pindborg. Jan 14, 20 the concept of fibroosseous lesions of bone has evolved over the last several decades and now includes two major entities. The orthopantomogram showed a wellcircumscribed radiolucent osteolytic image, 1 cm in. The presence of chronic renal disease crd is a predisposing factor for the occurrence of soft and hard tissue lesions in the oral cavity. Assessing the contribution of hrpt2 to the pathogenesis of. Affected people generally experience a gradual or rapid, painless expansion of the affected bone or region. Cementoossifying fibromas cofs are benign lesions affecting the jaws and other craniofacial bones. It has been reported from birth to old age, but peaks in the teenage years. These tumours occur in the third and fourth decades of life, with predilection for women. Traditionally, this type of lesion was subclassified histologically into ossifying fibroma and cementifying fibroma according to the hard tissues formed, but both types are now known by the unified term, ossifying fibroma. Mandible maxilla benign tumors tumorlike conditions. She gave history of sudden onset, with lancinating type of pain which is severe in nature.
Ct scan findings revealed a bony expansion due to a huge multiloculated mass with varying density figure 3. Commonly used synonyms include cementifying fibroma, peripheral. Fibro osseous lesions classifications, pathophysiology. Cementoossifying fibroma in a patient with endstage renal. Most of the lesions typically show slow and often expansile growth. A 20yrold apparently healthy male patient reported to the department of periodontics. Cemento ossifying fibroma is a slowgrowing lesion most commonly seen in women during the third and fourth decades of life. The term ossifying fibroma includes lesions with similar histological compositions and different forms of clinical behavior. Peripheral ossifying fibroma is a fairly common lesion, representing % of all oral biopsies in most series. Affected people generally experience a gradual or rapid, painless expansion of the affected bone or. Usually, of appears as a single, painless and slowgrowing lesion, mostly found in the posterior region of the mandible, specifically in the premolars and molars area 2, 3. It is an uncommon lesion of juveniles and adolescents. Peripheral cemento ossifying fibroma shows parakeratinised epithelium and well cellularised connective tissue containing mineralized components ranging from bone to cementum. Cementoossifying fibroma is a benign osteogenic tumor with membranous ossification.
A case report of cementoossifying fibroma springerlink. The cementoossifying fibroma is hard and fibrous, most frequently seen in the jaw or mouth, sometimes in connection with a fracture or another type of injury. Ossifying fibroma definition of ossifying fibroma by. They commonly affect adult females between the third and fourth decade of life, predominantly occurring in the premolarmolar region of the mandible. Orthopaedic institute for children nonossifying fibroma. They most often arise from the tooth bearing areas of these bones. They are noncancerous and do not spread to other areas of the body. An extragnathic variant of cemento ossifying fibroma. Shetty memorial institute of dental sciences, mangalore. It originates from the proliferation of fibrous tissue and histocytes. Cemento ossifying fibroma is a benign, non odontogenic tumour of the jaw, a subdivision of. The tumor is composed of bone that develops within fibrous connective tissue.
It is usually located in the premolarmolar area in the mandible. It is relatively common in mandible but rare in maxilla. The case presented here is case of cemento ossifying fibroma in a female patient. Cementoossifying fibroma of the mandible request pdf. Peripheral cemento ossifying fibroma pcof is a reactive gingival overgrowth occurring frequently in the maxillary anterior region in teenagers and young adults. Introduction cemento ossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cement ossifying dysplasia 1. This condition should be differentiated from nonossifying fibroma and fibrous dysplasia of bone. Pofs comprises of, one or more mineralized tissues, including bone, cementum like material or dystrophic calcification, within a matrix of cellular fibroblastic tissue 2. This lesion seems to arise from the periodontal membrane, which contains pluripotential cells capable of forming.
Central ossifying fibroma is a lesion in which diagnosis has proved intriguing and unclear for presenting clinical, radiographic, and even. In the 2005 who histological classification of odontogenic tumors, this tumor is referred to as ossifying fibroma but in this article, the term cemento ossifying tumor is used to differentiate from peripherally occurring ossifying fibromas. It is a slowgrowing benign tumor with non odontogenic origin which may. Fibrous dysplasia and ossifying fibroma an advent in. Cemento ossifying fibroma of the jaw dental jounal424 3.
Peripheral ossifying fibroma is a reactive lesion and peripheral odontogenic fibroma is an extraosseous variant of central odontogenic fibroma. Aarthinisha sree balaji dental college and hospital, bharath university, chennai, india abstract. Cementoossifying fibroma presenting as a mass of the. Ossifying fibroma is a benign bone neoplasm often considered to be a type of fibroosseous lesion. Ossifying fibroma of is a benign, nonodontogenic tumor of the jaw, a type of fibroosseous lesion. Fortytwo surgically resected fibroosseous lesions of the cran iofacial bones were retrieved from the surgical pathology files of. The most common location are the distal femoral and distal tibial methaphyses. Juvenile ossifying fibroma jof is a rare variant of ossifying fibroma of, a benign fibroosseous lesion it has aggressive behavior it has two histologic subtypes. Non ossifying fibroma, fibrous cortical defect, fibroxanthoma, jaffecampanacci syndrome, cortical desmoids tumor, soap bubble, ground glass, eccentric. Some ossifying fibromas consist of cementumlike calcifications. Peripheral ossifying fibroma pof is a reactive gingival overgrowth which is relatively uncommon in nature. This lesion occurs more often in females in the third and fourth decades of life.
Sep 22, 2010 the concept of fibroosseous lesions of bone evolved over the last several decades to include two major entities. Cherubism familial multilocular cystic disease of the jaws d. It is arises from periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone. Ossifying fibroma of the jaw is a slowgrowing, well circumscribed benign fibroosseous neoplasm 3. It is typically more aggressive than an ossifying fibroma and usually affects the paranasal sinuses and bones around the orbit. More chandramani, thakkar krushna, mukesh asrani2011 cemento ossifying fibroma indian journal of dental research222 5. Cemento ossifying fibroma cof is considered by most as relatively rare, benign, nonodontogenic neoplasm of the jaw bones and other. Peripheral ossifying fibroma, also known as ossifying fibrous epulis, is a gingival nodule which is composed of a cellular fibroblastic connective tissue stroma which is associated with the formation of randomly dispersed foci of mineralised products, which consists of bone, cementumlike tissue, or a dystrophic calcification. Here we present a case of 18 year old female having slow growing painless swelling on left side of mandible over 2year period. The radiographic examination revealed radiolucency with scattered. Ct scanning and mr imaging showed a large extraosseous mass with central conglomerated, wellmatured ossified nodules and fatty marrow. Nonossifying fibroma it is estimated that 30% to 40% of people under the age of 20 have an nof, although few will have any symptoms.
Diagnostic pathology two cases of multiple ossifying fibromas in the jaws tingting wang 1 ran zhang 0 lin wang 1 yan chen 0 qing dong 1 tiejun li 0 2 3 0. It comprises fibrous tissue containing a variable quantity of mineralized material resembling bone andor cement, whence the term cementoossifying. Peripheral cemento ossifying fibroma is a relatively rare tumour classified between fibroosseous lesions. Osteofibrous dysplasia is considered as a separate pathological entity in view of its different presentation and treatment, although histopathologically similar to ossifying fibroma. Clinical data were obtained from the patient files and the radiographic features were evaluated in each case. The clinical and histological data of 51 cases of peripheral ossifying fibroma were retrieved from the records of department of oral pathology and microbiology, a. Because it shares many features with other lesions of the jaws, definitive diagnosis of the cemento ossifying fibroma is a challenge for the clinician and requires the integration of histopathological, radiological, and clinical examinations. Massive ossifying british journal of ophthalmology. Osteofibrous dysplasia is a rare, benign nonneoplastic condition with no known cause. Juvenile ossifying fibroma who type rathore as1, ahuja p1 and chhina s2 1depmtar ent of oral and maxilofacil al phatolog, yi. Here we present a case of 18year old female having slow growing painless swelling on left side of mandible over 2year period.
Cementoossifying fibroma of the mandible sciencedirect. Cemento ossifying fibroma in a patient with endstage renal disease cemento ossifying fibroma in a patient. It is often encapsulated and predominantly located in the mandible, and presents as a slowgrowing lesion, but may cause deformity if left untreated. Ossifying fibromas are benign asymptomatic neoplasms of the maxillae that generally have slow growth and present proliferation of fibrous cell tissue, with a varying quantity of bone products that include bone, cement or a combination of these. Ossifying fibroma is a rare benign fibroosseous neoplasm of the jaw. Cemento ossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and. September 2015 residency program case of the month. On comparing the two lesions, if was found that the ox. Children and adolescents are the most common group of age affected. The aim was to report on a case of ossifying fibroma, consisting of a. They tend to persist or increase in size as the child grows but decrease in size or close once growth ends.
A 72yearold patient was referred for a subclinical lesion of the mandible. Cemento ossifying fibroma is a benign fibroosseous lesion of the jaws that consists of cellular fibroblastic tissue containing varying amounts of osteoid tissue, bone, cementum, and cementum like calcified tissue. Cemento ossifying fibroma cof is a benign odontogenic tumor which is believed to be derived from periodontal ligament cells. Cof is considered under fibroosseous lesion in who classification. Florid cemento osseous dysplasia gigantiform and familial multiple cementoma iii. Apr 27, 2014 cryotherapy is also indicated in treating ossifying fibroma for conditions which are lying adjacent to the bone or lying within the bone. Peracetic acidaldehyde fuschinmodified hami stain collagen appears green. Massive ossifying fibroma of mandible pubmed central pmc. Juvenile ossifying fibroma is a variant of the ossifying fibroma. We report a case of cementoossifying fibroma that presented as a large extraosseous mass in the masticator and parapharyngeal space. Majority of lesions occur in the mandible and only few cases of cofs of the maxillary sinus and. It is considered to be the soft tissue counterpart to central ossifying fibroma. Peripheral cementoossifying fibroma pcof is a reactive gingival over growth, occurring frequently in the maxillary anterior region of teenage and young females.
Pdf juvenile aggressive cementoossifying fibroma of the. Nofs are often discovered by chance when a patient requires xrays for another reason, such as a knee injury. Peripheral cemento ossifying fibroma n ravi1 and shyam prasad reddy d2 abstract. Juvenile ossifying fibroma jof is rare, benign tumor of the craniofacial skull and face bones. Case report bilateral cemento ossifying fibroma of mandible. Cemento ossifying fibroma is a rare benign neoplasm, affecting the jaws. May 12, 2016 cemento ossifying fibroma is a benign growth, considered to originate from the periodontal ligament.
Juvenile ossifying fibroma is a rare, benign fibroosseous tumour. Its origin is believed to be from periodontal membrane, and it shows more predilection toward females. Ossifying fibroma of the orbital roof its distinction from blistering or intraosseous meningioma harold z. A nonossifying fibroma is a common benign bone tumor in children and adolescents. American journal of pharmacology and pharmacotherapeutics. Case report open access juvenile ossifying fibroma who type. However, in most cases both features are present, warranting the generic term cemento ossifying fibromas 1. They have a predilection for females between the third and.
Cemento ossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cement ossifying dysplasia. George zografakis, md \sb\aggressive cemento ossifying fi broma is the most aggressive tumor of all cementumcontaining neoplasms. Nonossifying fibroma is a benign intracortical, multilocular and well circumscribed lesion that affects young patients. Slootweg pj, panders ak, nikkels pg 1993 psammomatoid ossifying fibroma of the paranasal sinuses.
The myxofibroma fibroma myxomatodes is produced by liquefaction of the underlying soft tissue. Cemento ossifying fibromas cofs are relatively rare, benign lesions affecting the jaws and other craniofacial bones and are included in the group of mesodermal odontogenic tumors by gorlin. It is most commonly seen between the third and fourth decades of life 26, and is more frequent in women than in. It is considered a fibroosseous neoplasm because it is characterized by an overgrowth of bone. First description of ossifying fibroma was given by menzel in 1872 while the term was given by montgomery in 1927. Ossifying fibromas are benign bone lesions that should be differentiated from non ossifying fibromas and fibrous dysplasia. Khademi b, niknejad n, mahmoudi j 2007 an aggressive psammomatoid ossifying fibroma of the sinonasal tract. Campanacci described this condition in two leg bones, the tibia and fibula, and coined the term. Cementoossifying fibroma is a benign growth, considered to originate from the periodontal ligament. Juvenile ossifying fibroma is a rare benign fibroosseous lesion. The ossifying fibroma of is a benign neoplasm that affects the jaws. Skills and competencies a medical student should be able to recognize and describe the lesion radiographically as diagnosis on plain radiograph is the single essential skill needed to manage. It was first described as relatively uncommon, solitary, nonneoplastic gingival growth by eversol and robin. The cemento ossifying fibromas cof, in some cases has been demarcated into ossifying and cementifying fibromas, based on the tissue content of encapsulated neoplasms appearing as bone andor cementum.
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