11/110. Ossifying fibromyxoid tumor of the retroperitoneum. A case of ossifying fibromyxoid tumor (OFMT) in an unusual site, the retroperitoneum, in a 71 year old Japanese man is reported. The well demarcated tumor contained a large amount of mature bony tissue within the tumor. The tumor cells were round to spindle-shaped, and showed a high cellularity in some areas and were loosely arranged in other areas. Although the majority of tumor cells expressed vimentin, neuron specific enolase and Leu-7, there were no tumor cells positive for S-100 protein, myogenic or epithelial markers. We would like to emphasize that tumors classified as OFMT contain a wide spectrum of histologic features and heterogeneity. ( info) |
12/110. Peripheral giant cell granuloma: a potentially aggressive lesion in children. A slowly enlarging gingival mass with a reddish-purple surface is observed in a school-age boy. The lesion was first noted 3 months ago during a routine oral examination but recently it has increased in size and interferes with eating. A periapical radiograph demonstrated focal loss of the alveolar crestal bone in the mandibular incisor region. The diagnosis of peripheral giant cell granuloma, a benign reactive gingival lesion, is confirmed by histopathologic examination. Early detection and excision of this hyperplastic nodule is important to minimize potential dentoalveolar complications. ( info) |
13/110. Aggressive cemento-ossifying fibroma of the jaws. The cemento-ossifying fibroma is probably the most frequent fibro-osseous lesion seen by oral pathologists. Occasionally, reports of lesions behaving in an aggressive fashion appear in the literature. At the present time, the relationship if these "aggressive" lesions to the "usual" fibromas is unclear. Two cases of "aggressive" cemento-ossifying fibroma are reported. Certainly, clinical, radiological, and histological characteristics of aggressive and usual fibromas do coincide. There are, however, diverging features warranting separation of different forms. These mild differences may be detected during preoperative assessment of the lesion, allowing a diagnosis of aggressive form to be made. ( info) |
14/110. Juvenile ossifying fibroma of the mandible. An 8 year radiological follow-up. An 8-year follow-up of a juvenile ossifying fibroma in the left mandible of a 4-year-old boy is presented. The case demonstrated initial lack of radiological evidence of demarcation and subsequent eccentric enlargement, selective tooth displacement and a multilocular appearance in areas of active growth. An aneurysmal bone cyst and a decrease in the bone content was present in the excision specimen. ( info) |
| Ossifying fibroma, a rare tumor entity, is a well-demarcated benign fibro-osseous tumor composed of bone, fibrous tissue and cementum. It is commonly found in the mandible, but also found in the maxilla and paranasal sinuses. Simple curettage is enough when the fibrous lesions are located in the mandible but a complete en bloc excision is required when these lesions are located in the maxilla and paransal sinuses to relieve symptoms and prevent recurrence. With the advent of sinonasal endoscopy in the mid 1980s, and subsequent advances in surgical techniques, endoscopic management of the fibrous-osseous lesions has become possible. In the current case study, we report a successful endoscopic removal of a huge ossifying fibroma located in the right ethmoid sinus and nasal cavity. ( info) |
16/110. Atypical peripheral ossifying fibroma. A case report. The typical peripheral ossifying fibroma (POF) usually occurs on the free margin of the gingiva. POF is also thought to arise from the periodontal ligament. The case presented here is unique by virtue of its etiology, size and location. ( info) |
17/110. Developing cementoblastoma: case report and update of differential diagnosis. The benign cementoblastoma is a rare odontogenic tumor that tends to occur in the jaws of young people. It is most commonly characterized as a circumscribed radiopaque mass attached to the tooth roots and rimmed by a thin radiolucent zone. Early lesions, however, are radiolucent and can be confused with periapical conditions resulting from nonvital teeth. The tumor is seldom recognized until it produces pain or expansion of the jaw. If the diagnosis is established early, the tooth can be saved by endodontic treatment followed by apical root resection and surgical enucleation of the tumor. This case report documents the origin, development, and unlimited growth potential of a cementoblastoma. Radiographs taken at yearly intervals reveal an initial widening of the periodontal ligament space that grew into a 3-cm mixed radiolucent and radiopaque tumor over a 4-year period. The differential diagnosis and some criteria to help distinguish the cementoblastoma from similar-appearing lesions are reviewed. ( info) |
18/110. Ossifying fibromyxoid tumor of soft parts: report of a case with novel cytogenetic findings. A slowly growing tumor of the left thenar region in a 40-year-old man had the classic features of an ossifying fibromyxoid tumor of soft parts, including an incomplete shell of lamellar bone; a center composed of nodular aggregates of small spindled, oval, and stellate cells in abundant myxoid stroma; and strong expression of vimentin, S-100, and neuron-specific enolase by the tumor cells. Clonal chromosomal abnormalities included loss of a chromosome 6, extra material of unknown origin attached to the long arm of chromosome 12, and an unbalanced translocation involving the short arm of a chromosome 6 and the long arm of a chromosome 14. The karyotype was interpreted as 45,XY, der(6;14)(p10;q10),add(12)(q24.3). The chromosomal abnormalities suggest osteochondroblastic rather than neuronal or schwannian lineage. ( info) |
19/110. Excision and repair of the peripheral ossifying fibroma: a report of 3 cases. BACKGROUND: The peripheral ossifying fibroma (POF), one of the most common gingival lesions, has a recurrence rate of nearly 20%. To minimize the reappearance of this lesion, it must be completely excised. In the maxillary anterior region, total excision of a POF can result in an unsightly gingival defect. methods: Three cases are presented in which a POF was excised from the gingiva facial to a maxillary central incisor. One of these lesions had previously undergone 2 cycles of conservative excision and recurrence. In all cases, the lesions were excised down to bone. Each of the resulting gingival defects was repaired by a distinct plastic surgery procedure, including a laterally positioned flap, a subepithelial connective tissue graft, and a coronally positioned flap. RESULTS: The defects resulting from the biopsies were satisfactorily repaired. The patients were followed over postsurgical intervals of 10 to 30 months. None of the lesions recurred. CONCLUSIONS: It is customary to manage POF by aggressive excisional biopsy. Several different surgical approaches may potentially be used to repair the resultant gingival defect and minimize patient esthetic concerns. ( info) |
20/110. Peripheral ossifying fibroma. Report of a case and review of the literature. Peripheral ossifying fibroma, a reactive gingival disorder known under the generic term of epulis, is widely considered to originate from the cells of the periodontal ligament. A 39-year-old woman presented with a well circumscribed, hard pedunculated exophytic tumor measuring 2 cm in size, without ulceration. The lesion had developed three months before in the interdental space, between the lower left lateral incisor and canine. No radiological signs of involvement of the alveolar ridge were observed, and the clinically manifest diastema was confirmed. The histological study of the specimen after simple resection with a cold scalpel confirmed the diagnosis of peripheral ossifying fibroma. The patient posteriorly suffered three recurrences that were respectively treated via simple resection, carbon dioxide laser exeresis and finally wide resection including the periodontal ligament, periosteum and underlying bone. There have been no further recurrences following wide resection. In addition to presenting this new case of peripheral ossifying fibroma, the present study reviews the literature, comments on the predisposing factors and treatment options, and suggests the importance of this disorder in the differential diagnosis of gingival lesions. ( info) |