Introduction: Fibrous-osseous lesions of the jaws are difficult to diagnose precisely until excised biopsy results are found, so they might be confused with malignant lesions. This clinical study focused on the diagnostic aids of lesions that demonstrate different clinical, radiologic, and histologi...
Introduction: Fibrous-osseous lesions of the jaws are difficult to diagnose precisely until excised biopsy results are found, so they might be confused with malignant lesions. This clinical study focused on the diagnostic aids of lesions that demonstrate different clinical, radiologic, and histological findings. Materials and Methods: A total of 16 patients with benign fibrous-osseous lesions on the jaws (6 fibrous dysplasias, 6 ossifying fibromas, 3 cemental dysplasias, and one osteoblastoma) were reviewed. Nine patients with malignant fibrous-osseous lesions (8 osteosarcomas and one Ewing's sarcoma) were also retrospectively reviewed. Results: Osteosarcoma patients complained of facial swelling and tooth mobility. The radiographic findings showed the irregular resorption of cortical bone and periosteal reactions. Histological features included cellular pleomorphism and atypical mitosis. An Ewing's sarcoma patient complained of tooth mobility and facial swelling. Onion-skin appearance and irregular expansile marginal bony radiolucency were seen in the radiography. Fibrous dysplasia patients complained of facial swelling and asymmetry. The radiographic features were mostly ground-glass radiopacity. Histological findings showed a bony trabeculae pattern surrounded by fibrous ground substances. Ossifying fibroma patients complained of buccal swelling and jaw pains, showing expanded cortical radiolucent lesions with a radiopaque margin. Histological findings were revealed as cellular fibrous stroma with immature woven bones. In cemental dysplasia, most of their lesions were found in a routine dental exam. Well-circumscribed radiopaque lesions were observed in the radiography, and cementum-like ossicles with fibrous stroma were seen in the microscopy. An osteoblastoma patient complained of jaw pain and facial swelling. Radiographic findings were mottled, dense radiopacity with osteolytic margin. Trabeculae of the osteoid with a vascular network and numerous osteoblasts with woven bone were predominantly found in the microscopy. Conclusion: Our study showed similar results as other studies. We suggest the clinical parameters of diagnosis and treatment for malignant and benign fibrous-osseous lesions of the jaws.
Introduction: Fibrous-osseous lesions of the jaws are difficult to diagnose precisely until excised biopsy results are found, so they might be confused with malignant lesions. This clinical study focused on the diagnostic aids of lesions that demonstrate different clinical, radiologic, and histological findings. Materials and Methods: A total of 16 patients with benign fibrous-osseous lesions on the jaws (6 fibrous dysplasias, 6 ossifying fibromas, 3 cemental dysplasias, and one osteoblastoma) were reviewed. Nine patients with malignant fibrous-osseous lesions (8 osteosarcomas and one Ewing's sarcoma) were also retrospectively reviewed. Results: Osteosarcoma patients complained of facial swelling and tooth mobility. The radiographic findings showed the irregular resorption of cortical bone and periosteal reactions. Histological features included cellular pleomorphism and atypical mitosis. An Ewing's sarcoma patient complained of tooth mobility and facial swelling. Onion-skin appearance and irregular expansile marginal bony radiolucency were seen in the radiography. Fibrous dysplasia patients complained of facial swelling and asymmetry. The radiographic features were mostly ground-glass radiopacity. Histological findings showed a bony trabeculae pattern surrounded by fibrous ground substances. Ossifying fibroma patients complained of buccal swelling and jaw pains, showing expanded cortical radiolucent lesions with a radiopaque margin. Histological findings were revealed as cellular fibrous stroma with immature woven bones. In cemental dysplasia, most of their lesions were found in a routine dental exam. Well-circumscribed radiopaque lesions were observed in the radiography, and cementum-like ossicles with fibrous stroma were seen in the microscopy. An osteoblastoma patient complained of jaw pain and facial swelling. Radiographic findings were mottled, dense radiopacity with osteolytic margin. Trabeculae of the osteoid with a vascular network and numerous osteoblasts with woven bone were predominantly found in the microscopy. Conclusion: Our study showed similar results as other studies. We suggest the clinical parameters of diagnosis and treatment for malignant and benign fibrous-osseous lesions of the jaws.
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제안 방법
Iliac bone graft was done after the surgery, with the patient showing no evidence of recurrence for 2 year follow-up check.
Patients with osteosarcoma came to the hospital with chief complaints of swelling and tooth mobility. The radiological findings were irregular resorption of bone margins and periosteal reaction. The histological observation showed cellular pleomorphism, atypical mitosis, and separation of osteoid tissue by cellular fibrous stroma.
Patients with ossifying fibroma had swelling and pain. The radiological findings were radiolucency with sclerotic bone margins showing buccal and lingual cortical bone expansion, with the histological findings revealing the aspect of immature bony trabeculae spreading into a fibrous stroma. Patients with cemental dysplasia showed the limited radiolucent lesion in the bone marrow of the mandible with the welldefined border in the radiography.
This clinical study on benign fibrous-osseous lesions classified the lesions more simply according to Waldron's modified classification14 as fibrous dysplasia, ossifying fibroma, periapical cemental dysplasia and osteoblastoma, and cementoblastoma and considered each disease's clinical aspect and radiological and histological findings.
대상 데이터
Unlike general fibrous-osseouslesions, it has its distinct clinical symptom, and it may be observed in the maxilla. In this clinical study, one patient, a male in his/her 60s, came to the hospital with complaint of pain on both posterior mandible. The lesion showed the mixed radiopacity and radiolucency.
A total of 16 patients were diagnosed as benign fibrous-osseous lesion, and age distribution of patients was from the second to seventh decades with little difference in sex. The chief complaints of the patients were facial swelling with occasional jaw pains, and predilection site was mostly the posterior mandible. The lesions were classified as fibrous dysplasia, ossifying fibroma, cemental dysplasia, and osteoblastoma.
성능/효과
2. A total of 16 patients were diagnosed as benign fibrous-osseous lesions, 6 of which had fibrous dysplasia, 6 with ossifying fibroma, 3 with cemental dysplasia, and 1 with osteoblastoma.
Second, the histological malignancy of osteosarcoma in long bone reaches 85%, whereas the one in the head and neck is 56-79%.
The histological findings showed a syncytial appearance with poorly defined cell outline and cytoplasmic glycogen and vimentinpositive tumor.
Radiological findings were radiopacity showing osteolytic borders. The histological findings showed an interconnected form of bony trabeculae with osteoid in the fibrovascular stroma and osteoblasts.
Second, the histological malignancy of osteosarcoma in long bone reaches 85%, whereas the one in the head and neck is 56-79%. Third, the response of osteosarcoma in the head and neck to neoadjuvant chemotherapy is below 25%. Among our clinical cases, 5 cases with surgery were osteoblastic type, and 2 cases were chondroblastic type.
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