Juvenile ossifying fibroma. An analysis of 33 cases with emphasis on histopathological aspects

Slootweg, Pieter J.; Panders, Ak; Koopmans, Ruud; Nikkels, Peter G. J.

doi:10.1111/j.1600-0714.1994.tb00081.x

Cited by 170 publications

(156 citation statements)

References 22 publications

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“…Lesions in this latter subgroup have also been called active or aggressive juvenile ossifying fibroma. This variant is generally felt to have a greater propensity for recurrence and exhibits aggressive clinical behavior (43,44).…”

Section: Ossifying Fibromamentioning

confidence: 99%

Odontogenic Cysts, Odontogenic Tumors, Fibroosseous, and Giant Cell Lesions of the Jaws

2002

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Odontogenic cysts that can be problematic because of recurrence and/or aggressive growth include odontogenic keratocyst (OKC), calcifying odontogenic cyst, and the recently described glandular odontogenic cyst. The OKC has significant growth capacity and recurrence potential and is occasionally indicative of the nevoid basal cell carcinoma syndrome. There is also an orthokeratinized variant, the orthokeratinized odontogenic cyst, which is less aggressive and is not syndrome associated. Ghost cell keratinization, which typifies the calcifying odontogenic cyst, can be seen in solid lesions that have now been designated odontogenic ghost cell tumor. The glandular odontogenic cyst contains mucous cells and ductlike structures that may mimic central mucoepidermoid carcinoma. Several odontogenic tumors may provide diagnostic challenges, particularly the cystic ameloblastoma. Identification of this frequently underdiagnosed cystic tumor often comes after one or more recurrences and a destructive course. Other difficult lesions include malignant ameloblastomas, calcifying epithelial odontogenic tumor, squamous odontogenic tumor, and clear-cell odontogenic tumor. Histologic identification of myxofibrous lesions of the jaws (odontogenic myxoma, odontogenic fibroma, desmoplastic fibroma) is necessary to avoid the diagnostic pitfall of overdiagnosis of similar-appearing follicular sacs and dental pulps. Fibroosseous lesions of the jaws show considerable microscopic overlap and include fibrous dysplasia, ossifying fibroma, periapical cementoosseous dysplasia, and low-grade chronic osteomyelitis. The term fibrous dysplasia is probably overused in general practice and should be reserved for the rare lesion that presents as a large, expansile, diffuse opacity of children and young adults. The need to use clinicopathologic correlation in assessing these lesions is of particular importance. Central giant cell granuloma is a relatively common jaw lesion of young adults that has an unpredictable behavior. Microscopic diagnosis is relatively straightforward; however, this lesion continues to be somewhat controversial because of its disputed classification (reactive versus neoplastic) and because of its management (surgical versus. medical). Its relationship to giant cell tumor of long bone remains undetermined.

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Section: Ossifying Fibromamentioning

confidence: 99%

Odontogenic Cysts, Odontogenic Tumors, Fibroosseous, and Giant Cell Lesions of the Jaws

2002

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“…1 These lesions develop in any facial bones, mostly in individuals around the age of 15 years, and most frequently in the maxilla and the mandible. 8 Juvenile ossifying fibroma is a distinct clinicopathological entity among fibroosseous lesions because of its rapid growth, its potential for local invasiveness and its tendency to recur (20-90%). 9,10 Surgical excision of juvenile ossifying fibroma is thus considered necessary.…”

mentioning

confidence: 99%

Chromosome 12 long arm rearrangement covering MDM2 and RASAL1 is associated with aggressive craniofacial juvenile ossifying fibroma and extracranial psammomatoid fibro-osseous lesions

et al. 2015

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To evaluate the diagnostic value of MDM2 status in craniofacial fibro-osseous lesions, we investigated MDM2 expression by immunohistochemistry and analyzed MDM2 amplification by qPCR in 30 cases of ossifying fibroma (including 13 cases of the juvenile variant) and 17 cases of fibrous dysplasia. Two cases of uncommon extragnathic psammomatoid fibrous dysplasia and a mixed control group of 15 cases of low-grade osteosarcoma and 15 cases of well-differentiated/dedifferentiated liposarcoma were included. MDM2 amplification was found in 33% of ossifying fibromas (peak of 69% for the juvenile variant) and in 12% of fibrous dysplasia, in none of which was MDM2 overexpressed. All control cases exhibited MDM2 amplification and overexpression. To investigate possible polysomy of chromosome 12, we studied RASAL1 amplification, a gene telomeric to MDM2 on the long arm of chromosome 12. RASAL1 amplification was reported in all benign fibro-osseous lesions exhibiting MDM2 amplification but not in controls. Simultaneous amplification of these two genes was significantly higher in juvenile ossifying fibromas compared with fibrous dysplasia (P ¼ 0.004), non-juvenile ossifying fibromas (P ¼ 0.001), and all other benign craniofacial fibro-osseous lesions combined (P ¼ 0.0001). Of the nine cases of juvenile ossifying fibroma exhibiting amplification, three were locally invasive and four were recurrent, suggesting aggressive disease. The two cases of extragnathic psammomatoid fibrous dysplasia also showed MDM2 and RASAL1 amplification with no MDM2 overexpression. This large chromosome 12 rearrangement, spanning MDM2 and RASAL1, is the first recurrent molecular abnormality to be reported in juvenile ossifying fibroma. It may represent both a molecular diagnostic marker and a characteristic of more aggressive forms with a higher risk of recurrence. Finally, the presence of this rearrangement in extragnathic psammomatoid fibro-osseous lesions mimicking ossifying fibromas might reflect a common molecular pathway in their pathogenesis and calls into question the classification of such lesions within fibrous dysplasia.

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“…In the majority of previous reports [6], FD, central ossifying fibroma, cemento ossifying fibroma, juvenile ossifying fibroma [7] and osseous dysplasias [8] have been categorized as FO lesions.…”

Section: Discussionmentioning

confidence: 99%

Management and Treatment Outcomes of Maxillofacial Fibro-osseous Lesions: A Retrospective Study

Kumar

Kishore

Mohan

et al. 2014

J. Maxillofac. Oral Surg.

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Juvenile ossifying fibroma. An analysis of 33 cases with emphasis on histopathological aspects

Cited by 170 publications

References 22 publications

Odontogenic Cysts, Odontogenic Tumors, Fibroosseous, and Giant Cell Lesions of the Jaws

Odontogenic Cysts, Odontogenic Tumors, Fibroosseous, and Giant Cell Lesions of the Jaws

Chromosome 12 long arm rearrangement covering MDM2 and RASAL1 is associated with aggressive craniofacial juvenile ossifying fibroma and extracranial psammomatoid fibro-osseous lesions

Management and Treatment Outcomes of Maxillofacial Fibro-osseous Lesions: A Retrospective Study

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