May 12, 2016 cemento ossifying fibroma is a benign growth, considered to originate from the periodontal ligament. Cemento ossifying fibroma is a rare benign tumor most often discovered incidentally. Case report bilateral cemento ossifying fibroma of mandible. Cementoossifying fibroma more c, thakkar k, asrani m. Fibrous dysplasia and ossifying fibroma an advent in their. American journal of pharmacology and pharmacotherapeutics. Pdf 34 page peripheral cementoossifying fibromaa case.
Affected people generally experience a gradual or rapid, painless expansion of the affected bone or. 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. Peripheral cementoossifying fibroma is a relatively rare tumour classified between fibroosseous lesions. Non ossifying fibroma is one of the skeletal dont touch lesions. A case of giant cemento ossifying fibroma cof that is invading the maxilla, maxillary sinus, nasal nostril, inferior orbital floor iof and inferior orbital rim ior was resected along with total hemimaxillectomy and reconstructed immediately. A lot of confusion has prevailed in the nomenclature of peripheral ossifying fibroma, with various synonyms being used, such as peripheral cementifying fibroma, ossifying fibroepithelial polyp, peripheral fibroma with. Fibroosseous lesions of the head and neck diagnostic. The cementoossifying fibroma cof is an uncommon benign fibroosseous lesion composed of fibrocellular component and calcified materials like cementum and woven bone. If large involving more than 50% of the diameter of the parent bone then prophylactic curettage and bone grafting may be prudent to avoid a pathological fracture 1. Ossifying odontogenic fibroma e589 case report a 43yearold woman with noncontributory medical, social, and cultural records was referred to the oral and. Peripheral cemento ossifying fibroma a case report with. Peripheral cementoossifying fibroma n ravi1 and shyam prasad reddy d2 abstract. A 72yearold patient was referred for a subclinical lesion of the mandible.
Cementoossifying fibroma is a benign fibroosseous maxillary tumor. The concept of fibroosseous lesions of bone evolved over the last several decades to include two major entities. Campanacci described this condition in two leg bones, the tibia and fibula, and coined the term. Despite the similarities in clinical, radiographic and. Assessing the contribution of hrpt2 to the pathogenesis of. Ossifying fibroma an overview sciencedirect topics.
The findings in a 40 yo female are compatible with cementoossifying fibroma. 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. The lesion was welldefined, and some areas of cystic degeneration were encountered. Cementoossifying fibroma cof is classified as, and behaves like, a benign bone neoplasm. The histological pattern of these lesions varies with the stages.
Central ossifying fibroma cof is a benign osseous neoplasm which consists of highly cellular, fibrous tissue with varying amounts of calcified tissue, which resembles the bone, the cementum or both 1, 2. First description of ossifying fibroma was given by menzel in 1872 while the term was given by montgomery in 1927. Peripheral ossifying fibroma is a reactive lesion and peripheral odontogenic fibroma is an extraosseous variant of central odontogenic fibroma. Peripheral cementoossifying fibroma is a focal, reactive, nonneoplastic tumorlike growth of soft tissue, often arising from the interdental papilla. The myxofibroma fibroma myxomatodes is produced by liquefaction of the underlying soft tissue. Pdf aggressive cementoossifying fibroma of the jaws. Pdf cementoossifying fibroma of the mandible dominique. A case of cemento ossifying fibroma involving the left mandible is described in a 35 year old female patient. Juvenile ossifying fibroma who type rathore as1, ahuja p1 and chhina s2 1depmtar ent of oral and maxilofacil al phatolog, yi. However, peripheral giant cell granuloma can be ruled on the basis of size of the lesion. It comprises fibrous tissue containing a variable quantity of mineralized material resembling bone andor cement, whence the term cementoossifying. Cemento ossifying fibroma of the jaw dental jounal424 3.
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. The cemento ossifying fibroma is hard the cemento ossifying fibroma is hard 1914 senboku earthquake 232 words view diff exact match in snippet view article find links to article. Radiographically, the tumor presents as a well marginated radiolucent lesion, with a. Cementoossifying fibroma in a patient with endstage. Definition of cementoossifying fibroma medicinenet. Peripheral ossifying fibroma pof is a reactive gingival overgrowth which is relatively uncommon in nature.
So what is the nature of cementum and, in the context of fibroosseous lesions, is there a way to differentiate it from bone. The cementoossifying fibroma is odontogenic in origin, whereas ossifying fibroma is of bony origin. Pdf central cementoossifying fibroma of posterior maxilla. Fibroosseous lesions of the head and neck sciencedirect. The cemento ossifying fibroma is classified as a fibroosseous lesion of the jaws. A weberfeguson incision was used to expose the lesion, which was excised. Surgical management of ossifying fibroma in maxilla. The concept of fibroosseous lesions of bone has evolved over the last several decades and now includes two major entities. The full text of this article is available in pdf format.
Cementoossifying fibroma of the mandible sciencedirect. Benign fibroosseous lesions,fibrous dysplasia,cementifying fibroma, ossifying fibroma,peripheral giant cell granuloma 1. Nofs are often discovered by chance when a patient requires xrays for another reason, such as a knee injury. A nonossifying fibroma is a common benign bone tumor in children and adolescents. Cementoossifying fibroma of the mandible request pdf. The orthopantomogram showed a wellcircumscribed radiolucent osteolytic image, 1 cm in diameter, on the mandibular angle. Cemento ossifying fibroma is a benign growth, considered to originate from the periodontal ligament. This lesion occurs more often in females in the third and fourth decades of life. 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. They are initially lucent on xray with soft tissue attenuation on ct.
The presence of chronic renal disease crd is a predisposing factor for the occurrence of soft and hard tissue lesions in the oral cavity. Overall, the imaging appearances are of a benign lesion with differential diagnosis including fibrous dysplasia. It is distinguished from the adult variant of ossifying fibroma on the basis of age, site, cilinical behaviour and. Osteofibrous dysplasia is a rare, benign nonneoplastic condition with no known cause. Lowgrade osteosarcoma arising from cementoossifying. Florid cemento osseous dysplasia mixed fibrous dysplasia mixed cementoossifying fibroma 2nd stage paget disease mixed osteogenic sarcoma mixed chondrosarcoma mixed metastatic tumors mixed osteoradionecrosis mixed. Intraoral ossifying fibromas have been described in the literature since the late 1940s. Almost all cases of ossifying and cementifying fibromas reported previously occur as a solitary lesion. Central ossifying fibroma is a lesion in which diagnosis has proved intriguing and unclear for presenting clinical, radiographic, and even. In early stage it appears as unilocular, welldefined radiolucency. Case report open access juvenile ossifying fibroma who. 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.
When curvilinear trabeculae or spheroidal calcifications were encountered, the lesion was often referred to as cementifying fibroma. Peripheral ossifying fibroma a clinical and histological. A hard fibrous growth that continues to enlarge, sometimes to very significant size, unless treated, most frequently seen in the jaw or mouth, sometimes in connection with a fracture or another type of injury. Pdf management of giant maxillary cementoossifying fibroma. Case report juvenile aggressive ossifying fibroma of the. Today, however, the term cementoossifying fibroma is widely used because both osseous and cemental tissues are seen commonly in a single lesion. These are rare lesions of the mandible, less commonly occurring in the maxilla. After excision of the primary tumor, local recurrence develops in 25% to 44% of patients, and is often associated with inadequate. Introduction cemento ossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cement ossifying dysplasia 1. This paper reports a case of multiple cementoossifying fibroma involving the maxilla and mandible of a 55yearold male. It was first described as relatively uncommon, solitary, nonneoplastic gingival growth by eversol and robin. We report a case of jof of left side of the maxilla in an 11 year old girl which is an uncommon site of occurrence. Peracetic acidaldehyde fuschinmodified hami stain collagen appears green.
The definitive diagnosis of these lesions requires integration of its clinical, radiological and histological features. The lesion is considered part of an ossifying fibroma, but that. Pofs comprises of, one or more mineralized tissues, including bone, cementum like material or dystrophic calcification, within a matrix of cellular fibroblastic tissue 2. National library of medicine pubmed database was performed for the nonmedical subject heading mesh search term ossifying. Juvenile ossifying fibroma genetic and rare diseases. Cementoossifying fibroma of the jaw bmj case reports. Cementoossifying fibroma radiology reference article. It is often encapsulated and predominantly located in the mandible, and presents as a slowgrowing lesion, but may cause deformity if left untreated. It is usually located in the premolarmolar area in the mandible. It is difficult to differentiate the calcified tissue within the lesion between bone and cementum. Report of two cases international journal of laser dentistry, septemberdecember 20. Features are consistent with an unusually large cementoossifying fibroma. They tend to persist or increase in size as the child grows but decrease in size or close once. Juvenile ossifying fibroma journal of pathology and translational.
Here we present a case of 18year old female having slow growing painless swelling on left side of mandible over 2. Choose from a variety of file types multiple pdf files, microsoft word documents, microsoft excel spreadsheets, microsoft powerpoint. Trabecular type of juvenile ossifying fibroma a rare. Peripheral cementoossifying fibroma pcof is a reactive gingival over growth, occurring frequently in the maxillary anterior region of teenage and young females. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. 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. Indian journal of dental research, 222, 2011 352 received.
It is considered a fibroosseous neoplasm because it is characterized by an overgrowth of bone. Ossifying fibroma definition of ossifying fibroma by. A case report of cementoossifying fibroma springerlink. The definitive diagnosis of these lesions requires integration of its clinical, radiological. A hard fibrous lesion that continues to grow, sometimes to very large size, unless treated, most frequently seen in the jaw or mouth, sometimes in connection with a fracture or another type of injury. It is most commonly seen between the third and fourth decades of life 26, and is more frequent in women than in. Juvenile ossifying fibroma of mandible ram k s, kumar a. Psammomatoid active ossifying fibroma cementifying or cemento ossifying fibroma is a variant that typically occurs in the sinonasal tract and may behave aggressively, with locally invasive and destructive capabilities.
More chandramani, thakkar krushna, mukesh asrani2011 cemento ossifying fibroma indian journal of dental research222 5. However, it is controversial whether it represents a true neoplasm or rather a developmental disorder of growing bone. Shipra arora et al treatment of peripheral ossifying fibroma. Central cementoossifying fibroma is a fibroosseous lesion causing slow expansion of the involved bone and is usually manifested after attaining significant growth. Cementoossifying fibroma is a benign neoplasm characterized by replacement of normal bone by fibrous tissue and varying amounts of newly. Bilateral central ossifying fibroma affecting the mandible. On comparing the two lesions, if was found that the ox. Histopathological examination showed the presence of a benign bone lesion suggestive of ossifying fibroma.
A 37yearold female patient undergoing chronic haemodialysis reported to our. Cementoossifying fibroma is a benign growth, considered to originate from the periodontal ligament. Ossifying fibromas which appear as fast growing mass between 5 and 15 years of age, radiologically well bordered, and consistent with ossifying fibroma histologically, are referred as juvenile aggressive ossifying fibroma. Peripheral ossifying fibroma a clinical and histological evaluation of 51 cases p. It is most commonly seen between the third and fourth decades of. 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. Lesions histologically similar to peripheral ossifying fibroma have been given various names in existing literature. Peripheral cemento ossifying fibroma shows parakeratinised epithelium and well cellularised connective tissue containing mineralized components ranging from. Ossifying fibroma of the nose and paranasal sinuses. They have a predilection for females between the third and.
The cementoossifying fibroma cof is a mesodermal, nonodontogenic tumour of ectopic multipotential periodontal membrane blast cells. Cementoossifying fibroma of the jaw journal unair universitas. The ossifying fibroma of is a benign neoplasm that affects the jaws. It is highly aggressive and has a high tendency to recur. This condition should be differentiated from nonossifying fibroma and fibrous dysplasia of bone. Ossifying fibroma of is a rare type of tumor characterized by fibrous tissue proliferation with cementum. It is estimated that 30% to 40% of people under the age of 20 have an nof, although few will have any symptoms.
Pdf juvenile aggressive cementoossifying fibroma of the. Treatment of peripheral ossifying fibroma using er,cr. There is variable terminology of these lesions, known commonly as cemento ossifying fibroma or just as ossifying fibromas. An immature tenyear longstanding case of ossifying fibroma. They are noncancerous and do not spread to other areas of the body. Juvenile ossifying fibroma jof is a rare controversial fibroosseous lesion affecting the craniofacial skeleton and occurring commonly in childrens and young adults. Cementoossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cementossifying dysplasia. Orthopaedic institute for children nonossifying fibroma. Ossifying fibroma is an uncommon benign osteogenic neoplasm, and it is derived from the multipotential mesenchymal cells of the periodontal ligament. American journal of pharmacology and pharmacotherapeutics peripheral ossifying fibroma mimicking pyogenic granuloma a case report sivakumarashankari, gaurav, jayanthi k and kamala r dept. It is aggressive, locally destructive, and has a high. When the bone predominated, ossifying fibroma was assigned. Many names have been given to similar lesions, such as epulis,1 peripheral fibroma with calcification,1 peripheral ossifying fibroma,2,3 calcifying fibroblastic granuloma,4 peripheral cementifying fibroma, peripheral fibroma with cementogenesis5. It is often considered a type of fibroosseous lesion.
A nof is a result from failure of the bone to properly close at its outer shell. The term ossifying fibroma includes lesions with similar histological compositions and different forms of clinical behavior. It is a slowgrowing benign tumor with non odontogenic origin which may. Nonossifying fibromas nofs are the most common benign bone tumor in children. Juvenile ossifying fibroma of mandible k srivastava ram 1, anand kumar 1, iqbal ali 1, puneet wadhwani 1, anurag saxena 1, mariyam iqbal ali 2 1 department of oral and maxillofacial surgery, career postgraduate institute of dental sciences and hospital, ghaila, lucknow, uttar pradesh, india 2 department of prosthodontics, career postgraduate institute of dental sciences and hospital, ghaila. It therefore involves exclusively the maxillofacial bones 1, 2. Majority of lesions occur in the mandible and only few cases of cofs of the. Juvenile ossifying fibroma jof is rare, benign tumor of the craniofacial skull and face bones.
Cemento ossifying fibroma is a mesodermal, slowgrowing, benign fibroosseous lesion of the jaws composed of lamellar bone, fibrous tissue and cementum. Cementoossifying fibroma is a rare benign tumor most often discovered incidentally. Fibrous dysplasia, osseous dysplasia and ossifying fibroma compose the group of fibroosseous lesions. 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 other synonyms of cementoossifying fibroma besides ossifying fibroma include 7. Ossifying fibroma has previously been referred to as cementifying fibroma and cemento ossifying fibroma, creating some confusion as to the nature of the hard tissue component. How to combine files into a pdf adobe acrobat dc tutorials.
Cementoossifying fibroma is a benign osteogenic tumor with membranous ossification. The orthopantomogram showed a wellcircumscribed radiolucent osteolytic image, 1 cm in. As they mature, they gradually develop increasing amounts of calcification ossification as the. Two cases of multiple ossifying fibromas in the jaws. Peripheral cementoossifying fibroma pcof is a reactive gingival overgrowth occurring frequently in the maxillary anterior region in teenagers and young adults. Cemento ossifying fibroma is the preferred term to better reflect the pathologies found in most individuals and families,and to emphasize the significance of the jaw lesions in the diagnosis of.
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