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PubMed1998

[Psammomatoid ossifying fibroma].

OBJECTIVE: To clarify the histopathological, clinical behavior biological characterics and the relationship among the psammomatoid ossifying fibroma (POF), ossifying fibroma and fibrous dysplasia of bone. METHODS: Thirty-one cases of POF in the ear and sinonasal region were studied retrospectively. The sections, clinicopathological records from June, 1956 to November, 1996 were reviewed. The reticulum fiber and Masson's stain and alkaline phosphatase immunostain were done in 10 cases, Vimentin, Desmin, EMA and smooth actin immunohistochemical stain were done in 5 cases. One case was studied by transmission electron microscope. RESULTS: The specimens were broken tissue with the sand-like felling, eleven specimens with intact thin shell consisted of bone tissue were used to study the changes in the area between tumor and normal bone. Histopathologically they were rich in mesenchymal tumor cells and a lot of calcifying psammomatoid-like osteoid and a few of calcified bodies similar to those described by Shafer, and the bony trabecula was not found in the center of the tumor. In addition, three zones were noted at the junction of normal bone and tumor, namely, the normal bone-reactive proliferative bone-tumor. In some cases, the reactive bony proliferation may be not marked. The normal bone adjacent to the tumor may be absorbed and disappeared, and were then replaced by the tumor, and finally led to tumor tissue invasion into the soft tissue, but the infiltration appearance is not present. CONCLUSION: POF is the slowly growing benign tumor and is different from ossifying fibroma and fibrous dysplasia of bone.

Adolescent↗
PubMedDate not supplied

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.

Adult↗
PubMed2003

[Ossifying fibroma of the face and hyperparathyroidism in a chronic hemodialysis patient].

The bony complications in secondary hyperparathyroidism in chronic renal failure are varied. The ossifying fibroma is a rare manifestation. We report a case of a 40 years old woman with indeterminate nephropathy undergoing hemodialysis since 1982. Since may 1995, the patient had a diffuse and intensive bone pain of the two inferior members inducing functional importance with apparition of endobuccal tumefaction in the hard palate with an important increase of the volume of the maxillo-mandibular complex six months later associated to disturbances of the deglutition and phonation. In december 1995, the serum parathyroid hormone level is measured at 1527.6 pg/ml and the serum alkaline phosphatase level at 1620 UI/l. The bony lesions are disseminated to all the skeleton in the form of a demineralization with an ossifying expansive process affecting the maxillo-mandibular complex. Calcemia was at 2.3 mmol/l and phosphoremia at 2.1 mmol/l. The surgical biopsy of this pseudotumor showed an aspect of ossifying fibroma. The cervical echography showed a left inferior parathyroid nodular. In june 1996, a subtotal parathyroidectomy was done. The 9th day after surgery, the serum parathyroid hormone level was at 103 pg/ml with normal calcemia and phosphoremia. Five years later, the volume of the tumor reduced moderately. This observation induces 3 commentaries: the bony manifestations associated to secondary hyperparathyroidism have sometimes a tumoral aspect, the ossifying fibroma may be for known as well as the brown tumor and the treatment of these tumors in complex justifying furthermore a rigorous prevention of the hyperparathyroidism in hemodialyzed patients.

Adult↗
PubMed1992

Virus-induced loss of class I MHC antigens from the surface of cells infected with myxoma virus and malignant rabbit fibroma virus.

Shope fibroma virus (SFV) is a leporipoxvirus that causes localized benign fibromas in immunocompetent adult rabbits that spontaneously regress due, in part, to a cell-mediated immune response. Myxoma virus (MYX) and malignant rabbit fibroma virus (MRV) are related leporipoxviruses that induce rapidly lethal generalized infections accompanied by tumors and immunosuppression. Because only these latter two viruses are known to compromise cell-mediated antiviral responses, cell surface levels of class I MHC molecules in SFV-, MRV-, and MYX-infected cells were investigated by fluorescent activated cell sorting analysis using a variety of different anti-HLA mAb. After infection with MYX or MRV there is a rapid decrease in the levels of detectable surface class I epitopes as detected by each antibody and by 24 h postinfection class I MHC Ag levels at the cell surface approach the level of background fluorescence observed with control antibodies. In contrast, only a moderate class I decrease is seen during infection with either SFV or vaccinia virus, an orthopoxvirus that is neither tumorigenic nor immunosuppressive. Surface class I marker loss induced by MYX and MRV is not simply due to nonspecific inhibition of total cellular protein synthesis by the viruses because class I levels decrease much further than the extent measured by estimating surface marker turnover in the presence of the protein synthesis inhibitor cycloheximide. Thus the loss of cellular surface class I molecules greatly exceeds the drop in level caused by complete blockage of host cell gene expression, and must involve removal or masking of preexisting class I epitopes from the cell surface by MRV/MYX. Cell surface levels of the transferrin receptor are unaffected by MYX and MRV infection, suggesting the observed class I decrease is not a nonspecific effect on total cell surface glycoproteins. Analysis of cells infected with MRV/MYX in the presence of cycloheximide or of cytosine arabinoside, an inhibitor of poxviral DNA replication, indicates that the class I marker loss is mediated in part by one or more viral late gene products. A probable explanation is that MRV/MYX late protein(s) interact with the class I MHC complex to either physically sequester these away from the cell surface and inhibit their recycling or else induce a conformational change that precludes recognition by all class I antibodies tested. In either event, we propose that such a major perturbation of the class I MHC complex would likely downregulate the class I-mediated presentation of viral Ag required to initiate cell-mediated immunity to these viruses.

Animals↗
PubMed2004

Endoscopic sinus surgery treatment for a huge sinonasal fibroma.

Fibromas are rare tumors of the nasal cavity, which may result from progressive inflammation or fibroblastic proliferation of the nasal mucosa. The tumors are usually too small to cause symptoms. We present a 47-year-old woman suffering through right nasal obstruction, purulent rhinorrhea and severe headaches for 6 months. A gray-white, smooth-surfaced, gigantic firm mass occupying the right nostril was found in physical examination. Sinus computed tomography revealed 4 x 3 x 3 cm soft-tissue-density mass in the right nasal cavity and right maxillary sinusitis. The huge sinonasal fibroma measuring 4.5 x 3 x 3-cm in the right posterior ethmoid sinus, which was successfully endoscopically resected. The final diagnosis of fibroma was made histologically, according to light microscopy and immunohistochemical stain examinations, which were important for determining the patient's treatment. After endoscopic resection, her initial signs and symptoms were relieved and no recurrence was noted after 2 years of follow up.

Endoscopy↗
PubMedDate not supplied

Ossifying fibroma of the upper jaw: report of a case and review of the literature.

A number of processes generically referred to as benign fibroosseous lesions comprise different disorders such as fibrous dysplasia, sclerotizing osteomyelitis and ossifying or cementing fibroma. These processes are all characterized by the existence of a vascular fibroblastic stroma, with the production of a calcified matrix ranging from bone to cementum. Ossifying fibroma involves slow-evolving growth with deforming swelling generally arising in the mandible, with possible early dental displacement. From the radiological perspective the disorder generally manifests as a well defined and delimited, unilocular radiotransparency, as a radiotransparent image with central opacifications, or as multilocular transparencies. The lesions exceptionally can be radiopaque. We present the case of a 22-year-old male presenting for evaluation of a three-month, asymptomatic tumor mass in the anterior sector of the upper jaw. Radiologically, the lesion appeared as a radiotransparent zone surrounded by a poorly delimited sclerotic halo. The definitive diagnosis following surgical resection of the lesion was ossifying fibroma. The case is discussed, and a review is provided of the literature on the subject.

Adult↗
PubMed2004

[Ossifying fibroma in nasal cavity and paranasal sinus (with 9 cases reported)].

OBJECTIVE: To improve the clinical diagnosis and treatment of ossifying fibroma in nasal cavity and paranasal sinus. METHOD: The data of 9 cases with ossifying fibroma in nasal cavity and paranasal sinus were analyzed retrospectively and the relative literatures were reviewed. RESULT: Two cases recurred after operation eight to nine months later and had to receive the second operation but the other 7 cases cured without complications. CONCLUSION: Ossifying fibroma in nasal cavity and paranasal sinus was found mainly in juveniles and was a benign tumor with local aggression. Clinical diagnosis was established by the clinical representation, epecially CT scanning. Complete excision of the lesions was the only curing treatment. It is easy to make a proper diagnosis with understanding of the disease characteristic. Prognosis is good after surgical excision.

Adolescent↗
PubMed2004

Cemento-ossifying fibroma: case report and review of the literature.

Although the neoplastic nature of intrabony cemento-ossifying fibromas is beyond dispute, controversy exists regarding the soft tissue counterpart. Peripheral cemento-ossifying fibroma has been referred to by a variety of terms depending on whether it is accepted as being a true odontogenic tumor or a reactive gingival overgrowth. The management of a patient with peripheral cemento-ossifying fibroma in the masticatory mucosa of the anterior region of the maxilla is presented. The differential diagnosis of reactive gingival overgrowths with and without calcification is discussed.

Adult↗
PubMed2004

[Chondromyxoid fibroma of bone: a rare benign bone tumor in children].

Chondromyxoid fibroma is a rare benign tumor that is typically found in the metaphyseal ends of long tubular bones, such as the tibia. The radiographic appearances are those of a single, lytic lesion with lobulated margins, septations, cortical expansion and a sclerotic rim. The classic histological feature of a chondromyxoid fibroma is stellate or spindle-shaped cells arranged in lobules in a myxoid or chondroid background. Two cases are presented here: 8, and 12-year-old patients, both with lesions in the proximal tibia. The first case showed an unusual feature: it was diaphyseal chondromyxoid fibroma. In the second case, the lesion was metaphyso-diaphyseal. The differential diagnosis includes chondroblastoma, myxoma, aneurysmal cyst as well as chondrosarcoma. A surgical conservative treatment with complete excision is recommended even in case of recurrence.

Bone Neoplasms↗
PubMed1991

Ossifying fibroma of the jaws: a case report.

This communication presents the first case report of ossifying fibroma of the jaw from Kenya and reviews the literature including the available published case reports from Africa. The relationship between ossifying fibroma and other related benign fibro-osseous lesion of the jaws is briefly discussed. Intensified research work on this condition in Africans is called for so that more cases should be published since it is reportedly more common in black race. The majority of the African cases are generally reported in advanced stages indicating neglect or delay in seeking for medical help. Since ossifying fibroma is a well encapsulated and expansile benign bone neoplasm, surgical enucleation appears to be the treatment of choice; recurrence is rare.

Adolescent↗
PubMed1988

[Fibroma of the tendon sheath. Diagnosis and differential diagnosis].

Ten cases of fibroma of the tendon sheath were examined by means of histological, topochemical, and immunohistochemical methods. Investigations were aimed at re-evaluation of histological variability and definition of diagnostic criteria. Microscopic observations suggested the following features to be typical of fibroma of the tendon sheath: Primitive mesenchymal or fibroblastic cells without further differentiation, slit- and cleft-like spaces with lining cells decorated by endothelial markers, and collagenous, cartilaginous or myxoid basic substance at least in areas rich with sulphated glycosaminoglycans. Differential diagnostic distinction of tendon sheath fibroma from myxoid cartilage tumors, fasciitis nodularis, and myxoid fibromatosis as well as from fibrohistiocytic lesions and giant cell tumors of tendon sheath is discussed with reference to the above definition.

Adult↗
PubMed1987

[Fibrous dysplasia and ossifying fibroma. Morphologic criteria].

Among a series of 42 ossifying fibromas and 32 fibrous dysplasias, 5 cases were studied by histoenzymological and electron microscopic methods. The histological study in 2/3 of cases is sufficient for the diagnosis between the two diseases: trabecular bone in a connective tissue with regular collagen fibres in the ossifying fibroma; nodular indented bony areas with irregular collagen frame in fibrous dysplasia. By histoenzymology, the diagnosis between the two affections is not easy: same activity of ATPases and alkaline phosphatases in fibroblasts and osteoblasts. By electron microscopy, the morphology of the two lesions is different: in ossifying fibroma, numerous well-differentiated osteoblasts and large areas of ossification are seen; in fibrous dysplasia, undifferentiated cells are numerous and the collagen frame is irregularly mineralized. This method is also useful for the histogenetic understanding of these two osteopathies.

Collagen↗
PubMed1986

Fibroma of the cecum. Case report.

The case of a young woman with pain and a tumor in the right lower abdomen is reported. Ultrasound revealed an echogenic tumor of 10 cm diameter. Fibroma of the uterus was diagnosed. During the operation in the gynecological department, the tumor turned out not to be of gynecological origin. After more extensive examinations laparotomy was performed. Histologic examination of the tumor revealed a fibroma, originating from the muscular layer of the cecum. In the literature of the last 35 years, only 5 similar cases have been reported and in 2 of them it was also misdiagnosed as fibroma of the uterus.

Adult↗
PubMed1985

Desmoplastic fibroma of bone. A report of eight cases and review of the literature.

Desmoplastic fibroma of bone is a rare benign tumor consisting of thin, wavy fibroblasts set in an abundant matrix of collagen fibers. At times it is difficult to distinguish desmoplastic fibroma from other fibrous lesions, especially low-grade fibrosarcomas. Fewer than eight cases have been previously reported. We have reviewed the diagnostic and therapeutic findings of eighty additional cases. Six patients had the lesions located in an extremity and two had an axial lesion. The average age of the patients was twenty-five years (range, twelve to fifty-six years) and all of the patients had more than two years of follow-up (range, two to seventeen years). The radiographic findings in all but one patient were of a purely lytic, honeycombed lesion that often widened the bone, and was metaphyseal in long bones. The tumor replaced the medullary cavity with a grayish-white, rubbery to firm tissue that was often, but not always, contained by a rim of periosteal reactive bone. Histologically, the features were: (1) prominent loose bundles of fibrous tissue composed of slim, spindle-shaped fibroblasts with wavy, elongated nuclei; (2) variable amounts of bands of collagen fibers; and (3) absence of mitoses or atypical cells. Areas of metaplastic bone were found only around sites, of pathological fractures. The biology of desmoplastic fibroma is different from that of other benign fibrous lesions in that the lesion is very destructive locally and often recurs after incomplete excision. It is also distinguished from low-grade malignant lesions (for example, fibrosarcoma) in that metastases have never been reported. In our series an intralesional excision was initially performed in six of the eight patients and a marginal resection, in two. There were four recurrences, treated by a marginal resection in two patients and repeat curettage in one. The recurrence in the fourth patient required an amputation above the knee after two additional intralesional procedures had been unsuccessful. Wide or marginal resection appears to be the treatment of choice when the lesion is located in a site that can be resected without significant loss of function. In other areas, an attempt at curettage, instillation of phenol, and bone-grafting seems to be warranted, resorting to more radical procedures only if this fails to control local disease.

Adolescent↗
PubMed1985

[A case of ossifying fibroma of the skull].

A 23-year-old woman was admitted to our hospital because of a soft, painful mass in the right parietal region for a month. Neurological examination revealed no abnormality. Laboratory data including serum Ca, P and alkaline phosphatase were normal. Skull x-ray film showed a partially osteolytic, not well circumscribed lesion in the right frontal, parietal and occipital bone. No remarkable sclerotic area was seen in the lesion. CT scan showed that the lesion was located in the diploë, destroying both inner and outer tables of the bone. Right external carotid angiogram revealed that the lesion is supplied by the branches of superficial temporal artery and middle meningeal artery. 99mTc bone scan showed increased uptake in the lesion. The patient underwent a right parietal craniectomy. The skull bone was invaded by the tumor, which was yellow-brown in color, thickened and fragile. We could easily perforate it through. The tumor didn't invade the dura mater or periosteum. It was extensively removed with an airtome and rongeurs. A cranioplasty was carried out using a plastic resin. The pathological specimen showed that the tumor was mainly composed of mature, regularly-aligned bone and intermingled fibrous tissue. Neither mitosis nor atypical cellular features was seen. These findings were compatible with the diagnosis of ossifying fibroma. The postoperative course was uneventful and the patient was discharged in a good condition. There was no evidence of local recurrence 10 months later. Ossifying fibroma is a rare, benign bone tumor that mainly involves the craniofacial bone. The differential diagnosis of ossifying fibroma versus fibrous dysplasia is difficult. These diseases can be differentiated on combined clinical, radiological and morphological grounds.

Adult↗
PubMed1985

[Ossifying fibroma of the temporal bone].

A case of ossifying fibroma of the cranial vault is described. Several reports emphasized the rare existence of this lesion limiting in the cranial vault. The patient was a 76-year-old woman who suffered mild headache in the parietal region after a trivial head trauma. Physical and neurological examination were normal. Plain skull X-P revealed irregularly bordered, 4 X 4 cm sized radiolucent area in the left temporal bone. The bone scintigraphy using 99mTc-MDP showed an abnormal uptake like a doughnut. Levels of serum P, Ca and alkaline phosphatase were within normal range. A tumor was softer than normal skull, and undertaken piecemeal removal. The dura was normal. After the total removal of the tumor, cranioplasty using Resin plate was performed. Microscopically the lesion was composed immature, irregular spicules of bone and fibrous tissue. Abundant fibroblasts were arranged in a random fashion in the stroma. Characteristically, the spicules of bone surrounded by rimming of osteoblasts. Ossifying fibroma is a benign fibroosseous tumor. Although this tumor is typically found in the maxillary sinus and mandible, it has also been reported in the paranasal sinuses, frontal, ethmoid, sphenoid bone and orbital roof of the young adult. But previously reported cases involving the cranial vault alone were only 7 cases. Etiology of ossifying fibroma is almost unknown.

Aged↗
PubMed1984

[A case of fibroma of the spermatic cord].

A case of fibroma of the spermatic cord is presented. A 26-year-old man was admitted with the complaint of a painless swelling in the left scrotum. On physical examination, the tumor seemed to be in the left spermatic cord. It was removed surgically on May 2, 1983. Microscopic examination of the specimen revealed that the tumor was composed of collagen fibers and fibroblasts. This histological finding was compatible with that of fibroma. Seven cases of fibroma of the spermatic cord so far reported in Japan, including this case, were reviewed.

Adult↗
PubMed1981

[Maxillary and mandibular desmoid fibromas (author's transl)].

Desmoid fibromas in the abdominal wall were described by Mac Marlene in 1832, and Jaffe reported a similar condition in bones in 1958. These bone desmoid fibromas are infrequently observed (0.5% of all bone tumors) and are of rare occurrence in the maxillary bones. Four such cases (3 mandibular and 1 maxillary) are reported by the authors, who also reviewed the published literature and found a total of 26 patients with similar lesions possessing very similar characteristics to dermoid fibromas in other locations. Therapy is difficult because of the frequency of recurrence after simple enucleation due to the poorly defined limits of the lesion and subclinical peripheral spread, and two mandibular resections had to be performed.

Adolescent↗