Management of fibro-osseous lesions of the craniofacial area. Presentation of 19 cases and review of the literature

Abstract

Introduction: Fibro-osseous lesions constitute a rare benign type of pathology with a non-odontogenic lineage that affect the craniofacial area. According to Waldrom’s classification, these lesions are divided into: fibrous dysplasia (FD), cemento-ossifying fibroma (COF) and desmoplastic fibroma (DF). Material and Methods: A retrospective study was performed on patients diagnosed with fibro-osseous lesions of the craniofacial area at the Hospital Universitario La Fe, Valencia, during 1987-2009. A total of 19 cases were collected: 15 cases compatible with an FD diagnosis, 3 cases with a COF diagnosis and 1 case with a DF diagnosis. Results: In the differential diagnosis, entities having similar clinical manifestations in the maxillofacial area with possible involvement of teeth or manifestations present as an asymptomatic radiolucent image should be ruled out. We hereby present the management and development of patients treated in our hospital for fibro-osseous lesions. Conclusions: Fibro-osseous lesions share many clinical and radiological characteristics in common, with histological features confirming the nature of the lesion. Management of patients should be individualized and case-specific, assessing the clinical evolution of each case and taking into account the benign nature and growth behavior of this type of tumors. Key words:Fibro-osseous, fibrous dysplasia, cemento-ossifying fibroma, desmoplastic fibroma.

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

“…1 Although these lesions frequently overlap in morphology, it is important to distinguish between them because their evolution, prognosis, and management differ. [2][3][4] Morphologically, the lesions share a mixed fibrous component comprising varying proportions of small ovoid or spindle cells, associated with a variably mature bone component consisting of spherules and/or trabeculae of woven bone. In the craniofacial area, particular morphological features can confuse the diagnosis.…”

Regression of orbital brown tumor after surgical removal of parathyroid adenoma

“…However, as a result Differential diagnoses for nasosinusal tumors includes: osteoma [most frequent benign tumor of the paranasal sinuses (15)], stesioneuroblastoma, giant cells central granuloma, extramedullary plasmocytoma, angiomatoid lesions (glomangioma and nasosinusal hemangiopericytoma), neurofibroma, cement-ossifying fibroma (13,16,17), osteoblastoma and metastasis (14).…”

Masses of the Nose, Nasal Cavity, and Nasopharynx in Children

“…The growth of this lesion tends to decrease after puberty. The diagnosis is confirmed by the presence of the mutation of GNAS 1α, which enables the differentiation of fibrous dysplasia from other fibro-osseous lesions (53).…”

“…affected bones. Fibrous dysplasia is more common in the 1st and 2nd decades of life and has a slight female predilection (53,54).…”

“…Curettage, decompressive surgery, and rarely, total resection are reserved for cases involving compression of critical structures such as the optic nerve, or cases of substantial craniofacial involvement resulting in functional or aesthetic impairment. Biopsy is often the only procedure required (53).…”