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RESIDENT
CASE
STUDIES
Week 9 June 16 - June 20, 2003: Case
2
Table
of Contents | List
of Diagnoses | Case 1 | Case 2
| Case
3
1 year old male with a well-defined, 1.0cm,
expansile lesion with variable amount of calcifications in the mandible,
on CT
Discussion
Juvenile Ossifying Fibroma (JOF) is a rare,
benign, but potentially aggressive, fibro-osseous tumor of the
craniofacial bones.1 Some authors2 restrict the use of JOF to the tumors that mainly affect patients 15 years or
younger with a highly cellular, but loose fibroblastic stroma containing strands of osteoid with entrapped
osteoblasts. When very cellular, JOF may be
indistinguishable from osteoblastoma.3 It was previously
thought that there are no definitive histologic criteria for
distinguishing JOF and osteoblastoma from more central ossifying fibroma (cemeto-ossifying
fibromas).3 However, JOF has recently been separated from other fibro-osseous lesions,
including cemento-ossifying fibromas.4 El-Mofty5
suggested that there are two distinct types of JOF – psammomatoid and
trabecular. This suggestion by El-Mofty has however, not yet caught on.
Simple sugical excision is usually curative.3
References:
1Rinaggio J,
Land M, Cleveland DB. Juvenile ossifying fibroma of the mandible. J
Pediatr Surg. 2003 Apr;38(4):648-50.
2Slootweg PJ,
Muller HJ. Juvenile ossifying fibroma. Report of four cases. J Cranio Max
Fac Surg 1990;18:125-129
3Cawson RA
Binnie WH, Speight PM, Barrett AW, Wright JM. Lucas’s Pathology of
Tumors of the Oral Tissues. 1999 (5th Ed). New York. Churchhill
Livingstone.
4Williams HK, Mangham C, Speight PM. Juvenile ossifying
fibroma. An analysis of eight cases and a comparison with other
fibro-osseous lesions. J Oral Pathol Med. 2000 Jan;29(1):13-8.
5El-Mofty S.
Psammomatoid and trabecular juvenile ossifying fibroma of the craniofacial
skeleton: two distinct clinicopathologic entities.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002
Mar;93(3):296-304.
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