Diagnostic Challenges of Benign Fibro-Osseous Lesions and Psammomatous Meningiomas of the Craniofacial Region: A Comparative Review of their Clinico-pathological Features

Abstract

Conventional ossifying fibroma (COF), juvenile psammomatoid ossifying fibroma (JPOF), juvenile trabecular ossifying fibroma (JTOF), fibrous dysplasia (FD), cemento-osseous dysplasia (COD) and psammomatous meningioma (PM) share overlapping clinico-pathologic characteristics. This can be diagnostically challenging for pathologists. Although remarkable progress has been made over the years using ancillary studies like immunohistochemistry and molecular cytogenetics to distinguish histologically similar diseases; such diagnostic aids are yet to be successfully employed within this group of lesions. The implication is that pathologists have to rely heavily on

Histochemical evaluation of stromal components in fibrous dysplasia, central ossifying fibroma and juvenile ossifying fibroma affecting the jaw bones

“…Our results were in agreement with the reports of other authors that cases of fibrous dysplasia usually exhibit mild to moderate cellularity. The cellularity of the stroma decreases in old fibrous dysplasia cases with a relative increase in collagen arranged in a parallel fashion and has a rather monotonous distribution [Nwizu et al (2010) (Riminucci et al 2006). In contrast, the central ossifying fibroma and juvenile ossifying fibroma lesions show moderate to severe cellularity and contain dense collagenous stroma arranged in whorls with comparatively more vascularity.…”

“…Amongst the broad category of FOLs, some lesions are considered neoplastic while others are developmental or reactive in nature. Juvenile ossifying fibroma (JOF) and central ossifying fibroma (COF) are considered true neoplastic lesions, while fibrous dysplasia (FD) and cemento-osseous dysplasia (COD) are said to be developmental and reactive lesions respectively (Nwizu et al 2010). Central ossifying fibroma and fibrous dysplasia of the jaws are the two most common fibro-osseous lesions which may be associated with significant cosmetic and functional disturbances.…”

Fibroosseous Lesions of the Craniofacial Region: A 14 Year Experience

“…. According to Nwizu et al (4), there is an equal sex distribution in FD except in polyostotic where there is female predilection.…”

“…They are characterized by the replacement of normal bone by fibrous connective tissue matrix displaying varying degrees of mineralization in the form of woven bone or cementum-like structures (1,2). These pathologic conditions can be categorized as developmental lesions, reactive or dysplastic diseases, and neoplasms (3,4,5).…”

Safe and rapid contouring of fibro-osseous lesions in the orbital area using navigation with minimally invasive cranial bone registration

“…1 The best-known fibro-osseous lesion is fibrous dysplasia, which can be monostotic or polyostotic and mainly affects the cranial bones or extremities. Ossifying fibromas include juvenile psammomatoid ossifying fibroma and juvenile trabecular ossifying fibroma, which show aggressive growth and invasion of surrounding structures at an early age.…”