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A swelling of the maxilla: a case report and differential diagnosis.

Bhargava P, Khan S, Sharma R, Agwani K, Gupta S - J Korean Assoc Oral Maxillofac Surg (2014)

Bottom Line: Although ossifying fibromas have principally been found in the jaw, they have also been reported in the frontal, ethmoid, sphenoid, and temporal bones, as well as the orbit and anterior cranial fossa.Ossifying fibromas affecting the jaw exhibit variable behaviors ranging from slow growth to occasionally aggressive local destruction.In the present article, we discuss a differential diagnosis considered for maxillary swellings and report a rare case of ossifying fibroma occurring in the maxilla.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Medicine and Radiology, NIMS Dental College and Hospital, NIMS University, Jaipur, India.

ABSTRACT
Ossifying fibromas are benign fibro-osseous tumors of mesenchymal origin. Although ossifying fibromas have principally been found in the jaw, they have also been reported in the frontal, ethmoid, sphenoid, and temporal bones, as well as the orbit and anterior cranial fossa. Ossifying fibromas affecting the jaw exhibit variable behaviors ranging from slow growth to occasionally aggressive local destruction. In the present article, we discuss a differential diagnosis considered for maxillary swellings and report a rare case of ossifying fibroma occurring in the maxilla.

No MeSH data available.


Related in: MedlinePlus

Gross specimen from the lesion.
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Figure 6: Gross specimen from the lesion.

Mentions: Orthopantomograph was advised and revealed an area of radiolucency at the periapical regions of 28 and 27 extending distal of 26, which was suggestive of a periapical abscess at 27 and 28. There was a bony overgrowth in a maxillary tuberosity region showing increased marrow spaces with a fine, wispy, trabecular pattern.(Fig. 3) An axial section from computed tomography at the mid root level of the maxillary arch showed a hyper dense shadow measuring 23.9×13.0 mm extending distal from 28 and involving the tuberosity region. The Hounsfield unit of the lesion was slightly lower (112-240) than the normal trabecular cancellous pattern (326-390), indicating that normal bone was replaced by fibrous connective tissue suggestive of a fibro osseous lesion. The presence of a hypo dense shadow indicated alveolar bone loss at the periapical area and was suggestive of a periapical abscess at the root stump of 28. Erosion of the buccal cortical plate was also evident.(Fig. 4) An incisional biopsy was done, and the specimen was sent for histopathological examination. The microscopic exam revealed non-keratinised stratified squamous epithelium and peripheral fibroblastic proliferation held tightly in the osteoblastic structures with imperfect ossification and regular trabeculae and fibrous connective tissue in certain places. Encased osteocytes were scattered within the operative specimen. The underlying connective tissue showed collagen fiber bundles, bony trabeculae, extravasated red blood cells, anastamosing trabecular bone with benign fibroblastic proliferation, and islands of bone within fibroblastic stroma.(Figs. 5, 6) Based on the clinical, radiological, and histopathological features, a final diagnosis of OF was made. The patient was scheduled for surgical resection of the lesion and kept on a regular follow-up schedule.


A swelling of the maxilla: a case report and differential diagnosis.

Bhargava P, Khan S, Sharma R, Agwani K, Gupta S - J Korean Assoc Oral Maxillofac Surg (2014)

Gross specimen from the lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4279968&req=5

Figure 6: Gross specimen from the lesion.
Mentions: Orthopantomograph was advised and revealed an area of radiolucency at the periapical regions of 28 and 27 extending distal of 26, which was suggestive of a periapical abscess at 27 and 28. There was a bony overgrowth in a maxillary tuberosity region showing increased marrow spaces with a fine, wispy, trabecular pattern.(Fig. 3) An axial section from computed tomography at the mid root level of the maxillary arch showed a hyper dense shadow measuring 23.9×13.0 mm extending distal from 28 and involving the tuberosity region. The Hounsfield unit of the lesion was slightly lower (112-240) than the normal trabecular cancellous pattern (326-390), indicating that normal bone was replaced by fibrous connective tissue suggestive of a fibro osseous lesion. The presence of a hypo dense shadow indicated alveolar bone loss at the periapical area and was suggestive of a periapical abscess at the root stump of 28. Erosion of the buccal cortical plate was also evident.(Fig. 4) An incisional biopsy was done, and the specimen was sent for histopathological examination. The microscopic exam revealed non-keratinised stratified squamous epithelium and peripheral fibroblastic proliferation held tightly in the osteoblastic structures with imperfect ossification and regular trabeculae and fibrous connective tissue in certain places. Encased osteocytes were scattered within the operative specimen. The underlying connective tissue showed collagen fiber bundles, bony trabeculae, extravasated red blood cells, anastamosing trabecular bone with benign fibroblastic proliferation, and islands of bone within fibroblastic stroma.(Figs. 5, 6) Based on the clinical, radiological, and histopathological features, a final diagnosis of OF was made. The patient was scheduled for surgical resection of the lesion and kept on a regular follow-up schedule.

Bottom Line: Although ossifying fibromas have principally been found in the jaw, they have also been reported in the frontal, ethmoid, sphenoid, and temporal bones, as well as the orbit and anterior cranial fossa.Ossifying fibromas affecting the jaw exhibit variable behaviors ranging from slow growth to occasionally aggressive local destruction.In the present article, we discuss a differential diagnosis considered for maxillary swellings and report a rare case of ossifying fibroma occurring in the maxilla.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Medicine and Radiology, NIMS Dental College and Hospital, NIMS University, Jaipur, India.

ABSTRACT
Ossifying fibromas are benign fibro-osseous tumors of mesenchymal origin. Although ossifying fibromas have principally been found in the jaw, they have also been reported in the frontal, ethmoid, sphenoid, and temporal bones, as well as the orbit and anterior cranial fossa. Ossifying fibromas affecting the jaw exhibit variable behaviors ranging from slow growth to occasionally aggressive local destruction. In the present article, we discuss a differential diagnosis considered for maxillary swellings and report a rare case of ossifying fibroma occurring in the maxilla.

No MeSH data available.


Related in: MedlinePlus