Juvenile ossifying fibroma. An ultrastructural study

Abstract

The ultrastructural features of a juvenile ossifying fibroma of the maxilla are described. The stromal portion of the tumor was composed of osteoblasts and to a lesser extent of fibroblasts. The bone spicules were rimmed by osteoblasts and osteoclasts. Calcification was seen to occur along the collagen fiber matrix, corresponding to calcification of osteoid, and also in the form of intracellular and extracellular crystallization. The latter form of calcification corresponded to so-called psammoma-like bodies, and was considered characteristic of this subtype of ossifying fibroma.Cancer 42:2668-2674, 1978.UVENILE OSSIFYING FIBROMA is a relatively rare fibro-osseous jaw lesion that occurs mostly in children. O t h e r names used for this lesion are young ossifying f i b r~m a ,~ psammoosteoid fibroma6 or juvenile active ossifying fibroma.8 The t u m o r is locally aggressive, a n d has a tendency t o recur. Morphologically it has the basic features of a n ossifying fibroma but also forms psammoma body-like islands in a highly cellular stroma, that contains numerous osteoblasts. Both morphologically a n d clinically, juvenile ossifying fibroma differs from other fibro-osseous lesions of t h e jaws, such as fibrous dysplasia, fibro-osteoma, giant cell tumor, cherubism, aneurysmal bone cysts, Paget's disease a n d various cemento-osteoid lesions. Various aspects of differential diagnosis ofjaw bone lesions were comprehensively reviewed by Hamner et a1.8 a n d Fu and P e r~i n .~ I n this report we present the ultrastructural features of a juvenile ossifying fibroma with special emphasis o n deposition of calcium crystals a n d formation of psammoma-like bodies. JFrom the

Juvenile Psammomatoid Ossifying Fibroma (JPOF) of Maxilla—a Rare Entity

“…On gross examination, the tumor is described as yellowish, white and gritty [12] as seen in our case.…”

“…These particles vary in appearance, but usually have a central basophilic area and a peripheral eosinophilic fringe [11]. Ultrastructurally, Psammoma-like bodies in PsJOF were found to possess a dark rim of crystals from which small spicules and needle like crystalloids project toward the periphery [12]. Cystic degeneration and aneurysmal bone cyst formation has been reported in some cases.…”

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

“…Juvenile ossifying fibroma, however, has also been employed as a diagnostic label for a lesion occurring predominantly in the paranasal sinuses and histologically characterized by the presence of a fibroblastic stroma containing small ossicles resembling psammoma bodies (17)(18)(19)(20)(21)(22). Psammo-osteoid-fibroma (23), psammomatoid desmo-osteoblastoma (14,15) and psammomatoid ossifying fibroma (24,25) are the other designations for this putative entity.…”

Cranial juvenile psammomatoid ossifying fibroma: case report

“…Recurrence after partial or incomplete resection is common, ranging from 30% to 56%. [1][2][3][4]7 Lesions with significant cortical destruction and periosteal elevation have an increased risk of recurrence. Resection requires tumor-free margins for the preservation of important adjacent structures as much as possible.…”