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Ossifying fibroma

Ossfying fibromas (OF) (also known as osteofibrous dysplasia (OFD)) are benign bone lesions that should be differentiated from non ossifying fibromas 1 and fibrous dysplasia (osteoblastic rimming).

Epidemiology

They tend to occur in young children (often under 10 years of age).

Pathology

Histologically, they comprise haphazardly distributed lamelleated bony spicules on a background of fibrous stroma. Despite being benign they can be locally aggressive. Immunohistochemical staining of lesions show keratin positive cells in majority of the cases.

Common locations

Radiographic features

Plain film and CT
  • seen as a well-circumscribed lesion
  • demonstrates evidence of intracortical osteolysis with characteristic sclerotic band (osteoblastic rimming)
  • moderate cortical expansion
  • homogenous lesion matrix
MRI

Reported signal characteristics include

  • T1 - low signal
  • T2 - iso-high signal
  • T1 C+ (Gd) - typically shows enhancement

Complications

Treatment and prognosis

Tends to regress over time. For locally aggressive lesions, surgical resection is often curative although recurrence has been reported.

Differential diagnosis

Imaging differential considerations include


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The differential diagnosis for bone tumours is dependant on the age of the patient, with a very different set of differentials for the paediatric patient.

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