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Ossifying fibromas are benign bone lesions that should be differentiated from non-ossifying fibromas and fibrous dysplasia. Osteofibrous dysplasia is considered as a separate pathological entity in view of its different presentation and treatment, although histopathologically similar to ossifying fibroma.
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These lesions are most frequently encountered in young children (often <10 years).
tibia: most frequent site 5 (90% of the time); there is a predilection for the anterior tibial cortex
femur: occurs in a diaphysial location
mandible and maxilla: these are examples of cementum-poor cemento-ossifying fibromas 2 (see WHO classification scheme for odontogenic tumors)
sinonasal: expansile lesions with peripheral ossification and central lucency
They comprise haphazardly distributed lamellated bony spicules on a background of fibrous stroma. Despite being benign, they can be locally aggressive.
Immunohistochemical staining of lesions shows positive keratin cells in the majority of the cases.
Plain radiograph / CT
evidence of intracortical osteolysis with a characteristic sclerotic band (osteoblastic rimming)
moderate cortical expansion
homogeneous lesion matrix
Reported signal characteristics include:
T1: low signal
T2: iso-high signal; fluid-fluid levels may be present 8
T1 C+ (Gd): typically shows enhancement
Treatment and prognosis
Ossifying fibromas tend to regress over time. For locally aggressive lesions, surgical resection is often curative although recurrence has been reported.
Imaging differential considerations include:
fibrous dysplasia: has no osteoblastic rimming
adamantinoma: may share a common origin with ossifying fibromas
- 1. Chang HJ, Donahue JE, Sciandra KT et-al. Best cases from the AFIP: juvenile ossifying fibroma of the calvaria. Radiographics. 29 (4): 1195-9. doi:10.1148/rg.294085240 - Pubmed citation
- 2. Jung SL, Choi KH, Park YH et-al. Cemento-ossifying fibroma presenting as a mass of the parapharyngeal and masticator space. AJNR Am J Neuroradiol. 1999;20 (9): 1744-6. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 3. Kendi AT, Kara S, Altinok D et-al. Sinonasal ossifying fibroma with fluid-fluid levels on MR images. AJNR Am J Neuroradiol. 2003;24 (8): 1639-41. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 4. Kamineni S, Briggs TW, Saifuddin A et-al. Osteofibrous dysplasia of the ulna. J Bone Joint Surg Br. 2001;83 (8): 1178-80. doi:10.1302/0301-620X.83B8.12114 - Pubmed citation
- 5. Lee RS, Weitzel S, Eastwood DM et-al. Osteofibrous dysplasia of the tibia. Is there a need for a radical surgical approach? J Bone Joint Surg Br. 2006;88 (5): 658-64. doi:10.1302/0301-620X.88B5.17358 - Pubmed citation
- 6. Levine SM, Lambiase RE, Petchprapa CN. Cortical lesions of the tibia: characteristic appearances at conventional radiography. Radiographics. 23 (1): 157-77. doi:10.1148/rg.231015088 - Pubmed citation
- 7. Pathology And Genetics of Tumours of the Head And Neck. World Health Organization. ISBN:9283224175. Read it at Google Books - Find it at Amazon
- 8. Kendi A, Kara S, Altinok D, Keskil S. Sinonasal Ossifying Fibroma with Fluid-Fluid Levels on MR Images. AJNR Am J Neuroradiol. 2003;24(8):1639-41. PMC7973987 - Pubmed