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Multiple cemento-ossifying fibroma is a very rare jaw lesion. A unique case is reported involving a 43-year-old Korean woman with rapidly growing, multiple cemento-ossifying fibromas in all four quadrants over an 18-year period which resulted in severe facial deformity and orbital compression.
Cemento-ossifying fibromas are slow growing, benign lesions. Recurrence is considered rare. A mandibular periapical radiolucent lesion in a 30-year-old female was diagnosed histologically as a cemento-ossifying fibroma and excised. A recurrence was found 2 years and 6 months postoperatively. CT demonstrated that the recurrent lesion was larger than indicated by conventional radiography.
Chondromyxoid fibroma is a rare benign tumor that usually occurs in the long bones. A 50-year-old patient presented with chondromyxoid fibroma of the nasal bone with extension into the frontal and ethmoidal sinuses. This is the fourth case reported to date in the literature. The clinical manifestations of the tumor were very limited, and the appearance at rhinoscopy was misleading. Radiologic imaging showed a soft tissue lesion invading the adjacent bony structures and the dura mater. Surgery was performed by a combined team of otorhinolaryngologists and neurosurgeons, and total excision of the tumor was achieved. The histologic diagnosis of this tumor is difficult because of its similarities to chondrosarcoma. [Editorial comment: The authors concisely review management of this rare tumor, emphasizing that complete surgical excision, rather than curettage, is required for long term control.]
29 cases of chondromyxoid fibroma (CMF) from the material submitted to the Bone Tumour Register in Münster were reviewed. The tumour was observed most frequently in the second and third decades of life, with a slight female preponderance in our series. The diaphyseal and metaphyseal regions of the lower limb were most commonly affected, with a particular predisposition for the knee. The lesions were located eccentrically in 71% showed cortical expansion in 72%, and pseudotrabeculation in 51% of cases. The lytic patterns were classified as Lodwick IA in 35%, as Lodwick IB in 45%, as Lodwick IC in 17% and as Lodwick II in 3% of cases. Due to the absence of characteristic radiographic features, the differential diagnosis from aneurysmal bone cyst, giant cell tumours and non-ossifying fibroma is often difficult. Radiographic findings would however indicate benignity and, therefore, help to differentiate the lesion from chondrosarcoma, to which it bears strong histological similarity.
A 26 yr old Caucasian, previously healthy, noticed a painless swelling of the left palate of 2 mths duration. On examination, a left maxillary swelling was noted with extension into the cheek. The mass was compressible. The CT scan revealed a large expansive tumor. Histological diagnosis of the enucleated lesion was cementifying fibroma. We describe a case of cementifying fibroma of the maxilla, an unusual location for this tumor.
Three cases of chondromyxoid fibroma arising in the skull base are reported. The tumors arose in females 34, 65, and 66 (median 55) years of age. Two women presented with headaches, and one with nasal obstruction. Radiographic studies revealed that all three lesions were expansile soft tissue masses centered in the clivus, at least 4 cm in greatest diameter. One lesion involved primarily the clivus, the others extended from the clivus into the sphenoid and ethmoid sinuses. Two of the three cases were initially misdiagnosed as chordoma or chondrosarcoma. The initial treatment was curettage of gross disease in all three cases. One patient also received radiation therapy. One patient had local progression of disease, which was treated with surgery and radiation therapy. All patients are clinically free of disease 11 to 26 months following the most recent treatment. Chondromyxoid fibroma can and should be distinguished from chondrosarcoma and chordoma, two tumors which more commonly arise in the skull base and which have the potential to metastasize.
Cementifying fibromas are rare fibro-osseous tumors that arise from the periodontal ligament. These tumors are usually small, asymptomatic lesions noted on routine dental radiography, but they can develop into aggressive, expansile masses. The authors report the case of a 12-year-old boy with a tumor involving the maxillary, ethmoid, and frontal sinuses that extended to the right orbit, causing proptosis and disfigurement of the right side of his face. Removal of the tumor with facial reconstruction resulted in significant improvement of vision, despite long-standing disc edema and tension on the optic nerve. On histopathologic examination the lesion was found to be a cementifying fibroma.
RATIONAL AND OBJECTIVES: To quantitate radiographic features that distinguish the plain radiographic appearance of nonossifying fibroma (NOF) from other solitary lesions of bone. MATERIALS AND METHODS: Seven hundred nine cases of focal bone lesions, including 34 NOFs, were analyzed according to demographic, anatomic, and plain radiographic features. Vector analysis of groups of features was performed to determine those that are most sensitive and specific for the appearance of NOF in contrast to other lesions in the data base. RESULTS: The radiographic appearance of NOFs was most consistently a medullary based (97%), lytic lesion (100%) with geographic bone destruction (100%), marginal sclerosis (97%), and well-defined edges (94%). A statistically significant number of lesions were located in the distal aspect of long bones. Unicameral bone cyst shared the most radiographic features with the NOF. Vector analysis showed a large degree of overlap between NOF and other lesions such as aneurysmal bone cyst, chondromyxoid fibroma, and eosinophilic granuloma. The description that optimized sensitivity and prevalence for detection of NOF is a medullary based, ovoid lesion in the distal or proximal portions of a long bone with well-defined edges, a partial or complete rind of sclerosis, and absence of fallen fragment, periosteal reaction, and cortical disruption. CONCLUSION: The radiographic appearance of NOF is relatively nonspecific but, using vector analysis, can be better elucidated over current textbook descriptions.
OBJECTIVE AND IMPORTANCE: The clinical, pathological, and imaging findings in a patient with a chondromyxoid fibroma involving the C2 vertebra are reported. Seven cases that involve the cervical spine have previously been reported in the literature; the posterior vertebral body and posterior elements are the most frequently involved. To our knowledge, this is the first reported case of C2 involvement and craniocervical instability. CLINICAL PRESENTATION: A 20-year-old man presented with intermittent neck pain resulting from a fall 4 years earlier. X-rays and magnetic resonance imaging demonstrated a lytic lesion in the body of C2, as well as instability at C1-C2. INTERVENTION: Preoperative transcatheter angiography and embolization were performed. An expansile tumor of the C2 vertebral body was resected via a transoral approach. Because of craniocervical instability, fusion from the occiput to posterior elements of C1 through C4 was performed. CONCLUSION: Chondromyxoid fibroma is a rare benign bone tumor that is uncommonly found in the spine and may mimic other lesions, particularly radiographically. We report the first known involvement of C2 by this tumor in the modern English-language literature. The patient has had excellent clinical and radiographic resolution of the prior instability with no neck pain, instability, or local recurrence.
Cementifying fibroma is a benign fibro-osseous lesion that may occur in either the mandible or the maxilla, with a predilection for the mandible. In the patient described, a recurrent mandibular cementifying fibroma was successfully resected, with microsurgical preservation of the inferior alveolar nerve and immediate reconstruction via an autogenous iliac bone graft.
Chondromyxoid fibroma is an uncommon bone neoplasm, accounting in our series for less than 1% of all connective tissue tumors. The tumor is more common in males, and located mostly in the metaphyseal areas of the lower extremity. The tumor is benign and there have been no reports of metastases. The method of treatment that has been used since the initial identification of the tumor has been curettage, which has a 20-25% recurrence rate. In our 30 patients, the average length of followup was 11 years (range, 1-29 years. Most of the tumors were in the pelvis, proximal tibia, distal femur, and foot. Tumors that were treated with curettage alone did less well than those that were packed with allograft bone or polymethylmethacrylate. Tumors treated by excision did not recur. The most difficult problem with chondromyxoid fibroma is pathologic identity because it often is confused with more aggressive tumors that may metastasize.
A 12-year-old girl presented with an isolated soft tissue recurrence of chondromyxoid fibroma after two previous excisions of tumor from the proximal tibia. Chondromyxoid fibroma is a rare benign tumor of bone. We present this case report of isolated soft tissue recurrence to emphasize a rarely reported complication of surgical extirpation.
The ameloblastic fibroma is an odontogenic tumour with an unusual presentation. It is considered to have both epithelial and mesenchymal elements, but it lacks any calcified dental structures. Two new cases are presented. The first of these began as a mandibular tumour whereas the second was discovered by chance. The radiographic finding in each case was a unilocular cystic radiolucency. Treatment consisted of excisional biopsy by enucleation in both patients. Histopathological findings were consistent with ameloblastic fibroma.
This article concerns rare odontogenic tumors that occur predominantly in the mandibular incisor region of young cattle and which have often in the past been referred to as ameloblastomas, or as the outdated synonym, adamantinoma. Twenty-two examples from the literature and two new ones were studied. Six consisted of epithelial islands which resembled those of ameloblastoma but which were located within a cellular fibrous connective tissue that was the second component of the tumor; these mixed odontogenic tumors therefore represented ameloblastic fibromas, not ameloblastomas. Eight consisted of a combination of ameloblastic fibroma and odontoma and therefore were ameloblastic fibro-odontomas, and one was apparently malignant (ameloblastic fibro-odontosarcoma). Excluding this last lesion, these tumors should respond well to enucleation, like their human counterparts but, to confirm this hypothesis, the margins of future examples should be carefully examined to determine that they are well-demarcated, not invasive. The microscopic features of the remaining 9 tumours could not be evaluated adequately, while another 17 tumors in cattle and water buffalo reported briefly could not be studied to any extent because of insufficient information.
Peripheral ameloblastic fibroma is an exceedingly rare lesion. Only three reports could be found, two of which appeared in the Japanese literature. Here, we report a case of peripheral ameloblastic fibroma occurring in a 5-year-old girl. The diagnosis was made after careful microscopic examination, to exclude other lesions. The lesion was excised and has not recurred 1 year after removal.
Israeli, Ella (Rambam Hospital, Haifa, Israel). Mechanism of pock formation by Shope fibroma virus on monolayers of rabbit cells. J. Bacteriol. 92:727-732. 1966.-The mechanism of pock formation by the Shope fibroma virus (SFV) on rabbit cultures in vitro was studied with the use of p-fluorophenylalanine, 5-bromodeoxyuridine, and 5-iododeoxyuridine. The inhibitors were used to inhibit, and to initiate, virus replication at different times after infection. It was shown that pock formation required virus replication to a threshold value of 25 plaque-forming units per pock area, and that this amount of virus can be accumulated during a period about 3 days less than that required for pock formation. Inhibition of virus growth, and of cell multiplication, after this threshold has been reached, did not prevent pock development. A delay in the onset of virus growth required to reach the threshold virus content, caused an about equivalent delay in the time of pock formation. In the absence of inhibitors, pocks were not formed after infection of 84 rabbit embryo clones, or five mixtures of clones containing five to seven clones each. The results indicate that pock formation by SFV in vitro was the result of cell aggregation, and not of cell multiplication, in special types of cells.
Incorporation of (3)H-thymidine by BSC-1 cells infected with Shope fibroma virus was studied by means of high-resolution electron microscopic radioautography. One-hour pulses with the radioactive precursor were given at various times after infection, during a one-step growth cycle of the virus. In the cytoplasm of infected cells, reacted grains occurred over foci of viroplasm; these foci are believed to represent the true sites of viral deoxyribonucleic acid (DNA) replication. Shope fibroma virus DNA synthesis began before 3 hr postinfection, reached a maximum at 8 to 9 hr, and then declined rapidly. It was demonstrated that the decline in (3)H-thymidine uptake is correlated with the onset of viral morphogenesis. In comparison with the noninfected culture, the nuclear labeling, which reflects host DNA metabolism, was slightly reduced by 4 hr postinfection. Inhibition became more marked as infection progressed, and host DNA synthesis was almost completely suppressed in late stages of viral development.
Cultural changes that follow infection of rabbit kidney cells with fibroma virus were studied. Characteristic alterations of cell morphology and development of multilayered piles and cords of cells were found to occur in infected cultures in which cell division was blocked by gamma radiation or by cell crowding and serum deprivation, thus indicating no dependence upon cell division. Fibroma virus infection did not remove blocks to cell division, but it did exert distinct effects upon nuclear deoxyribonucleic acid synthesis in cells blocked by radiation or cell crowding. Use of tritium-labeled thymidine and autoradiography demonstrated that after infection initial inhibition of nuclear incorporation was followed by sharply increased nuclear labeling at a time that coincided with beginning alterations of cell morphology and development of cell piling.