Ossifying Fibroma of the Superior Maxilla

Abstract

Ossifying fibroma is a rare benign tumor of nondental origin. Fibroma of this type is mixed with osseous elements in varying amounts. It has been described as ossifying fibroma, osseous fibroma, fibro-osteoid osteoma, central osteoma, sclerosing fibroma, hypertrophic localized osteitis, localized osteodystrophic fibroma and localized osteitis fibrosa.1 Ewing 2 called this type of growth secondary osteoma since it appears as a result of secondary ossification of the connective tissue. Because of the comparative rarity of the tumor and clinical unfamiliarity with it, some observers have unwittingly treated it as a cancer, needlessly subjecting the patient to a radical resection, often with disastrous cosmetic results. REPORT OF THREE CASESThe data on the first 2 of the 3 cases to be reported originated from the Research and Educational Hospital of the University of Illinois.A histologic study of the first case was recently reported by Dr. Hans Brunner.3 CASE 1.\p=m-\The patient was a 29 year old white married woman. Six months before admission to the hos¬ pital her dentist had completed the extraction of the remaining teeth in her upper jaw. He then recognized a small swelling in the hard palate on the left alveolar margin. There was no pain on account of this growth. The swelling became rapidly larger following trauma incident to the extraction. At the first examination in the hospital, Nov. 18, 1940, it occupied the greater portion of the left half of the hard palate (fig. I A). The tumor was smooth and hard, not yielding on pres¬ sure. The overlying mucous membrane was healthy in appearance. The nasal passages were open. The left maxillary sinus appeared dark on transillumination. The results of a chemical examination of the blood were within normal limits. Roentgenograms of the nasal sinuses showed increased density of the left antrum.Operation and Course.-With the region under anes¬ thesia induced by infiltration of procaine hydrochloride and epinephrine hydrochloride, a sublabial incision was made in the left canine fossa as in the usual Caldwell-Luc operation. The overlying periosteum was elevated. The anterior bony wall was no thicker than a cigaret Fig. 1 (case 1).-A, appearance of the growth on the hard palate when the patient was admitted to the hospital. B, tumor. Its actual measurements were 3 by 4 by 5 cm.paper. Beneath this thin bony jacket there was a hard, well circumscribed, creamy-colored tumor completely filling the lumen of the antrum. Owing to the size of the growth, considerable difficulty was encountered in its mass extraction. Finally, the posterior limb of From the

Primary Benign Neoplasms of the Nose

“…Sinus fibromas may be met with ossifying. A well-demonstrated article on this subject is written by H. James Hara (1944). In my series (Case 1-fibroma of the ethmoid) showed ossification but this was not a prominent feature in the histopathology of the tumour.…”