Psammomatoid and trabecular juvenile ossifying fibroma of the craniofacial skeleton: Two distinct clinicopathologic entities

doi:10.1067/moe.2002.121545

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 93, Issue 3, March 2002, Pages 296-304

https://doi.org/10.1067/moe.2002.121545 Get rights and content

Abstract

The term juvenile ossifying fibroma is used in the literature in naming 2 microscopically distinct fibro-osseous lesions of the craniofacial skeleton. One is characterized by small uniform spherical ossicles resembling psammoma bodies (psammomatoid juvenile ossifying fibroma). The other is distinguished by trabeculae of fibrillary osteoid and woven bone (trabecular juvenile ossifying fibroma). Three new cases of each type are reported, and the literature is extensively reviewed for published cases of these 2 entities. Psammomatoid juvenile ossifying fibroma is reported more commonly than trabecular juvenile ossifying fibroma. It affects patients from a wider age range (3 months to 72 years) and an older mean age range (16-33 years) as compared with 2 to 12 years and 8½ to 12 years, respectively, for trabecular juvenile ossifying fibroma. In both types there is a slight male predominance and the lesions are unencapsulated and tend to infiltrate adjacent bone. A significant difference between the 2 tumors is their site of occurrence. Although psammomatoid juvenile ossifying fibroma occurs predominantly in the sinonasal and orbital bones, trabecular juvenile ossifying fibroma predominantly affects the jaws. Aggressive growth occurs in some—but not all—cases of both types. Such behavior may be related to younger patient age and the concurrent development of aneurysmal bone cysts, which is seen more frequently in psammomatoid juvenile ossifying fibroma. This study demonstrates that not only histologic but also demographic and clinical differences between psammomatoid juvenile ossifying fibroma and trabecular juvenile ossifying fibroma warrant their classification as 2 distinct clinicopathologic entities. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:296-304)

Section snippets

Material and methods

Six cases of JOF of the craniofacial skeleton were retrieved from the files of the Division of Surgical Pathology, Department of Pathology, Washington University School of Medicine, St Louis, Mo. The cases were accessioned during the period from 1993 to 2001. Three cases were histologically consistent with the PsJOF, as described previously.4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 The other 3 were of the trabecular type.6, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 Clinical histories

PsJOF

The age, sex, and anatomical site of 3 patients with PsJOF are shown in Table I.Patient age ranged from 15 to 53 years, with an average age of 31.6 years. There was 1 female and 2 males. One lesion was located in the left parietal bone, another in the ethmoid sinus, and another in the left mandibular ramus. In all cases, the lesions were expansive, painless, and of several months' duration. In case 2, the patient reported nasal obstruction. The mandibular lesion in case 3 was fast-growing and

Discussion

The term ossifying fibroma has been used to describe clinically and microscopically heterogeneous lesions of the skull. Proper identification of these distinct entities is important—not only for academic purposes, but also, more importantly, for proper diagnosis and therapeutic management. It is generally agreed that ossifying fibroma of the jaws, also known as cemento-ossifying fibroma and cementifying fibroma, is an odontogenic neoplasm arising from the periodontal ligament affecting the

Acknowledgements

This article is dedicated to the memory of Dr Charles “Chuck” A. Waldron: a generous teacher, an esteemed colleague, a great friend, and a wonderful human being.

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^*: Reprint requests: Samir El-Mofty, DMD, PhD, Washington University School of Medicine, 660 South Euclid, Department of Pathology, Campus Box 8118, St Louis, MO 63110, [email protected]

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Oral and Maxillofacial PathologyPsammomatoid and trabecular juvenile ossifying fibroma of the craniofacial skeleton: Two distinct clinicopathologic entities*

Abstract

Section snippets

Material and methods

PsJOF

Discussion

Acknowledgements

Ophthalmology

J Craniomaxillofac Surg

Ophthalmology

Am J Otolaryngol

Oral Surg Oral Med Oral Pathol

Oral Surg Oral Med Oral Pathol

J Craniomaxillofac Surg

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol

J Oral Maxillofac Surg

J Craniomaxillofac Surg

Das osteoid-fibroma mit atypischer Verkalkung im sinus frontalis

Acta Otolaryngol

Das psammo-osteoid fibroma der nase und ihrer Nebenhöhlen

Monatsschr Ohrenheilkd Laryngorhinol

Bone Pathology Seminar

Juvenile active ossifying fibroma: its nature, dynamic and origin

Acta Otolaryngol Suppl

Clinical pathology of fibro-osteo-cemental lesions of the cranio-facial skeleton and jaw bones

Tumors of the mandible and maxilla in children. I. Clinicopathologic study of 46 histologically benign lesions

Cancer

Sinonasal psammomatoid ossifying fibromas: CT and MR manifestations

Am J Neuroradiol

Oral and Maxillofacial Pathology
Psammomatoid and trabecular juvenile ossifying fibroma of the craniofacial skeleton: Two distinct clinicopathologic entities*