Title: Fibro-osseous Lesions of Cranio-facial region: An Institutional Study
Authors: Singh Rakesh Kumar, Sinha Richi, Mishra Sarita Kumari
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.190
Abstract
Introduction: Fibro-osseous lesions are a diverse group of bone disorders with fibrous dysplasia and ossifying fibroma as the major entities. They are extremely slow growing tumors that share overlapping clinical, radiographic and histopathologic features and demonstrate a wide range of biological behaviour.
Aim: To evaluate the clinical characteristics and management of patients with fibro-osseous lesions of the cranio-facial region.
Patients and Method: All the patients presenting with the fibro-osseous lesions of the head and neck region in the department of Otorhinolaryngology of Indira Gandhi Institute of Medical Sciences from 2012 to 2015 were included in this study.
Results: A total of 10 patients were diagnosed with fibro-osseous lesions of cranio-facial region. Fibrous dysplasia was seen in 6 cases and ossifying fibroma in 4. 2 of the cases had extensive craniofacial involvement including maxilla, skull base with intracranial expansion. There was involvement of sphenoid in 3 cases, 4 cases involved maxilla and 7 cases had mandibular or the temporo-mandibular joint involvement. The most common presentation was a progressive painless swelling over face with facial asymmetry. All cases were managed surgically with complete or limited resection depending on the extent of disease and vigilant followup thereafter for any recurrence.
Conclusions: Fibro-osseous lesions are a group of slow growing benign tumors with overlapping clinical, radiological and microscopic features. However their disease course is so variable that the treatment needs to be individualized. Extensive treatment is preferred to prevent recurrence, we suggest a more conservative approach of maximum resection with minimum morbidity to be the goal of surgery for huge lesions.
Keywords: Maxillofacial, ossifying fibroma,fibrous dysplasia, mandible, cemento-ossifying.
References
- Abdulai AE, Gyasi RK. Iddarissu MI. Benign Fibroosseous lesions of the facial skeleton: Analysis of 52 cases seen at the Korle Bu teaching hospital. Ghana Med J 2004;38(3):96-100
- Ram R, Singhal A, Singhal P. (2012). Cemento-ossifying fibroma. Contemp Clin Dent, 3, 83-5
- Bahl R, Sandhu S, Gupta M. Benign fibro-osseous lesions of jaws – A Review. Int Dent J Stude Res. 2012;1(2):56-68
- Rajpal K, Agarwal R, Chhabra R, Bhattacharya M. Updated Classification Schemes for Fibro-Osseous Lesions of the Oral & Maxillofacial Region: A Review. IOSR Journal of Dental and Medical Sciences. 2014;13(2):99-103.
- Tawab HMA, Raafat SA, Naseem NT, Megahed AS. Retrospective study for diagnosis and management of fibro-osseous lesions affecting para nasal sinuses.PAN Arab Journal of Rhinology, 2013;3(1):9-17.
- Ogunsalu CO, Lewis A, Doonquah L, authors. Benign fibro-osseous lesions of the jaw bones in Jamaica: Analysis of 32 cases. Oral Dis. 2001;7:155–62.
- Langdon JD, Rapidis AD, Patel MF, authors. Ossifying Fibroma-one disease or six? An analysis of 39 fibro-osseous lesions of the jaws. Br J Oral Surg. 1976;14:1–11.
- Vankeviciute RA, Neverauskiene A, Lukosevicius E. Fibro-osseous lesions of craniofacial bones in children: case reports. Acta Medica Litu. 2013;20(2):93–101.
- Fibrousdysplasiaofbone.ArchivesofPathology1963;75:480-495.
- Suarez-Soto A, Baquero-Ruiz de la Hermosa MC, Minguez-Martínez I, Floría-García LM, Barea-Gámiz J, Delhom-Valero J, Risueño-Mata P. Management of fibro-osseous lesions of the craniofacial area. Presenta- tion of 19 cases and review of the literature. Med Oral Patol Oral Cir Bucal. 2013 May 1;18 (3):e479-85
- Toyosawa S, Yuki M, Kishino M, Ogawa Y, Ueda T, Murakami S, Konishi E, Iida S, Kogo M, Komori T, Tomita Y. Ossifying fibroma vs fibrous dysplasia of the jaw: molecular and immunological characterization. Mod Pathol. 2007;20:389–96.
- Lee J, Fitzgibbon E, Chen Y et al Clinical guidelines for the management of craniofacial fibrous dysplasia. Orphanet J Rare Dis 2012;7(Suppl 1):S2.
- Cholakova R, Kanasirska P, Kanasirski N, Chenchev Iv, Dinkova A. Fibrous dysplasia in the maxillomandibular region – Case report. J IMAB - Annu Proc (Scientific Papers) 2010;16(book 4)
- Sinha R, Singh RK, Devi S, Kumar S, Singh A, Kumar R. JUVENILE AGGRESSIVE CEMENTO-OSSIFYING FIBROMA OF MANDIBLE: A RARE CASE REPORT. International Journal Of Advances In Case Reports, 2015;2(15):952-954.
- M de Andrade, YTC Silva-Sousa, MFT Marques, et al. Ossifying Fibroma of the Jaws: A Clinicopathological Case Series Study. Brazilian Dental Journal. 2013;24:662–66.