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The article presents a case of central odontogenic fibroma occurring in the maxilla. The literature is reviewed, in the belief that a discussion of the controversial issues surrounding this neoplasm, its treatment and follow-up information, is warranted, due to the small number of cases (13) of this tumor that have been recognised and reported up to the present.
Odontogenic fibroma is a very rare lesion. Although it is considered to be of odontogenic origin, the exact mechanism of its histogenesis is not clear. A case of this rare neoplasm is presented.
A case of peripheral granular cell ameloblastic fibroma arising in the right upper premolar gingiva in a 34-year-old Japanese woman is reported. Ultrastructural examination revealed a clear separation of granular cells and epithelial component, and indicated granular cells were derived from mesenchymal cells, probably fibroblasts. Direct communication between the overlying gingival epithelium and the epithelial component of the tumor was found. It is postulated that residual ectomesenchymal influence may be responsible for proliferation of both epithelial and mesenchymal components which subsequently are transformed into granular cells.
A case of central odontogenic fibroma is reported. The clinical, radiological and pathological features are discussed. It is of particular interest because of its maxillary location and the severe external root resorption associated with the tumour.
A series of 15 digital lesions in 8 pediatric patients is presented. All infantile digital fibromas appear early in life at the distal or proximal interphalangeal joint level, characteristically involve the ulnar three digits, may be multicentric, and undergo rapid growth within a short time. Histology reveals deep dermal origin and intracytoplasmic inclusion bodies not observed in any other fibrous proliferative disorders. A viral etiology has never been proved. The lesions may recur despite wide excision followed by resurfacing with a flap or graft. This distinctive lesion has no adult counterpart and should be considered in the differential diagnosis of hard, immobile distal digital masses in children.
Oncogenic osteomalacia is a rarely described clinical entity characterized by hypophosphatemia, phosphaturia, and a low concentration of 1,25-dihydroxyvitamin D(3). It is most often associated with benign mesenchymal tumor and can be cured with surgical removal of the tumor. In this paper, we present a case of oncogenic osteomalacia caused by chondromyxoid fibroma in the soft tissue of the sole of the foot in a 56-year-old woman.
A case of a central odontogenic fibroma in a 16-year-old boy is presented. The clinical appearance and surgical treatment are described; and the pathogenesis and histopathologic diagnosis are discussed.
Six cases of ameloblastic fibroma of the jaw are reported, and the radiographic and histologic features and clinical symptoms are described. A conservative surgical approach, including enucleation and mechanical curettage of the surrounding bone, appeared to be successful for these patients.
A rare case of central odontogenic fibroma - a simple type according to Gardner's classification - is presented. Clinical manifestations and treatment are described. The aetiology and histopathological differential diagnosis are discussed.
Chondromyxoid fibroma is a benign tumor of bone that is characterized by chondroid and myxoid differentiation and by ultrastructural and immunohistochemical evidence of chondral origin. It is rare in the jaws and skull bones, where only about 2% of all cases have been reported. A review of the 20 acceptable gnathic cases in the literature and of the current case revealed both a higher incidence in the mandible (76%) than in the maxilla (24%) and an equal sex distribution. The sites of occurrence in both jaws are compatible with origin from developmental cartilaginous remnants. The controversies regarding malignant transformation and therapeutic approach are addressed.
Ameloblastic fibroma (AF) is a true mixed tumor, in which the epithelial and the ectomesenchymal elements are neoplastic. There are two rare variants of AF; granular cell AF and peripheral AF. Ameloblastic fibrosarcoma is a rare tumor, and is regarded as the malignant counterpart of the benign AF. Recent immunohistochemical study using MIB-1 shows labelling indices in the mesenchymal component of the recurrent AF and ameloblastic fibrosarcoma are quite high, in contrast with the conventional AF. Ameloblastic fibrodentinoma is a histologic variant of AF in which dentin or dentinoid tissue has formed, but there is no eveidence that ameloblastic fibrodentinoma exhibit a different biologic behavior than ordinary AF. Ameloblastic fibro-odontoma is a lesion similar to AF, but also showing inductive changes that lead to the formation of both dentin and enamel. Some lesions diagnosed as ameloblastic fibro-odontoma are probably developing odontoma, but the others should not be considered as hamartomatous in nature, since there are rare cases of ameloblastic fibro-odontoma showing true neoplastic behavior, and since the existence of malignant variant is evident. In revised WHO's classification of odontogenic tumors, the terms "ameloblastic fibrodentinoma" and "dentinoma" are used synonymously, however, there are histologic difference between several cases reported previously as "dentinoma" and ameloblastic fibrodentinoma.
A patient who for five years had obstinate unilateral facial pain, difficult to interpret, was found to have an expanding process in the left retromaxillary space. Histological examination of a biopsy specimen revealed chondromyxoid fibroma. This tumour is rarely seen in the bones of the face and has never before been described in this area. The clinical and histological findings are described and discussed.
Chondromyxoid fibroma is a rare benign tumour whose histological appearance may easily be misinterpreted as chondrosarcoma. It has a tendency to recur locally unless completely excised. A rare case of the tumour affecting the nasal bone with extension into the frontal and ethmoidal sinuses and impingement on the cribiform plate is presented. Complete excision was achieved by the craniofacial resection approach.
An interesting case of cementifying fibroma of the ethmoidal sinus is presented. This benign tumour, in this unusual site, tends to behave in an aggressive manner and radical surgery is necessary. Recurrence is frequent.
Ten cases of odontogenic myxoma (OM) and six cases of ameloblastic fibroma (AF) were subjected to comparative analysis by the AgNOR technique, in order to determine a possible difference in cell proliferation index between these lesions. The mean AgNOR number of the mesenchymal component of AF was compared with its epithelial component and the difference was not found to be statistically significant. The mean AgNOR index of the AF group was significantly higher than that of the OM group. Moreover, the mesenchymal component of AF demonstrated increased AgNOR numbers compared with that of OM (P<0.05). These results suggest that the epithelial and mesenchymal components of AF may have similar cell proliferative activity. However, the cell proliferative index of this lesion seems to be higher than that of OM.
A 75-year-old man presented with a protuberant stable lesion of many years on his left second toe. Histology on an incisional biopsy showed myxoid pleomorphic fibroma. Over the subsequent 21 months, the lesion enlarged and became exophytic and irregular. Repeat biopsy showed features consistent with a grade III myxofibrosarcoma. Treatment involved amputation of his toe. Six months later he remains well, with no evidence of local recurrence or systemic spread.
Formalin-fixed paraffin-embedded sections of three cases of ameloblastic fibrodentinoma (AFD) were studied by the avidin-biotin-peroxidase complex method using antibodies against neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP) and S100 protein and the results were compared with those in ameloblastic fibroma (AF). A striking histopathological characteristic of AFD was the formation of abortive dentin with various degrees of maturation at the epithelial-mesenchymal tissue interface. Central cells of enamel organ-like epithelia with various stages of abortive dentin induction in AFD were generally positive for NSE. Dental lamina-like epithelial cells also showed positive staining in some areas. No cells were positive for NSE in AF. Positive staining for GFAP was observed in the juxta-epithelial mesenchymal tissue of the formation stage of immature dentin with various numbers of entrapped cells in AFD, but GFAP staining was negative in other mesenchymal and epithelial tissues at other stages. In AF, no GFAP-positive cells were found. There were a few S100 protein-positive cells found in the foci of epithelial components in both AFD and AF. Mesenchymal cells showing a dendritic or spindle shape were positive for S100 protein in some areas of AFD and AF. Although such cells in the mesenchymal component of pigmented AFD were more numerous than in non-pigmented AFD and AF, their distribution pattern in the former condition was basically similar to that in the latter. Although the present results, obtained from conventional immunohistochemical procedures, do not directly reflect the expression of neural crest-derived cells in the dentinogenesis of AFD, such results do not disprove the possibility of the expression of neural proteins probably related to neural crest-derived cells in dentinogenesis under certain pathologic conditions in odontogenic mixed tumors. Such a phenomenon may also occur during dentinogenesis in other odontogenic mixed tumors and in normal tooth differentiation, but at an undetectable level.
An 11-year-old American Quarterhorse gelding presented for moderate periorbital swelling and exophthalmia of the left eye. The menace response, and direct and consensual pupillary light reflexes were absent in the left eye. Conjunctival hyperemia, blepharedema, a mydriatic pupil, resistance to retropulsion, and an increased intraocular pressure were present. A soft-tissue mass could be palpated in the left retrobulbar space by pressing onto the orbit over the supraorbital fossa. Incomplete surgical resection of the mass was performed and histopathologic evaluation was consistent with a fibroma. Normal pupillary light reflexes and vision returned following surgery. The mass has not recurred 14 months after surgery.