[논문]Psammomatoid Juvenile Ossifying Fibroma of the Maxilla Misdiagnosed as Fibrous Dysplasia: A Clinicopathologic Case Report

Jong-Ho Kim; Jiwon Kang; Seong-ik Kim; Byung Jun Kim

doi:10.1055/s-0042-1758468

Psammomatoid Juvenile Ossifying Fibroma of the Maxilla Misdiagnosed as Fibrous Dysplasia: A Clinicopathologic Case Report 원문보기

Archives of plastic surgery : APS, v.50 no.1, 2023년, pp.49 - 53

Jong-Ho Kim (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) , Jiwon Kang (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) , Seong-ik Kim (Department of Pathology, Seoul National University College of Medicine) , Byung Jun Kim (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Hospital)

Abstract ▼ AI-Helper

Juvenile ossifying fibroma (JOF) is a variant of the ossifying fibroma and includes two histopathological subtypes: trabecular and psammomatoid. Psammomatoid JOF (PJOF) in craniofacial structures should be distinguished from other fibro-osseous lesions, such as fibrous dysplasia (FD), considering the difference in the treatment protocols. Here, we present a rare case of PJOF that was initially misdiagnosed as a case of FD and emphasize the importance of considering JOF in the differential diagnosis of patients with craniofacial fibro-osseous lesions. A 4-year-old boy demonstrated progressive enlargement of the zygomaticomaxillary area on his left side for the last 6 months. The patient was diagnosed as a case of FD based on the clinical features and radiographic findings, and was operated considering the rapid progression. To achieve facial symmetry, contouring of the zygomatic bone and arch was performed. However, the patient demonstrated rapid enlargement at the 3-month postoperative follow-up. The decision was made to surgically remove the tumor due to visual field impairment. Intraoperatively, a rubbery mass, which was separated from the surrounding cortical bone, was identified and excised. The lesion was confirmed as PJOF by histopathological examination. The possibility of PJOF should not be ruled out in the differential diagnosis of patients with fibrous-osseous lesions. In the event of suspected PJOF, accurate diagnosis should be made through definitive biopsy.

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표/그림 (7)

그림 Fig. 1 Histologic findings (hematoxylin and eosin staining, x20) of the specimen obtained fromthe shaving procedure show irregular trabeculae of woven bone.
그림 Fig. 3 Intraoperative finding. A rubbery mass, which was separated from the surrounding cortical bone, was identified and excised.
그림 Fig. 4 Macroscopic specimen.
그림 Fig. 2 (A) Computed tomography (CT) scanning shows a 2.4 ×1.8 ×1.5cm-sized bony expansile lesion with predominantly homogeneous ground glass appearance and focal radiolucent area in the left zygoma. (B) CT scanning revealed rapid growth of the lesion, which was well-circumscribed and involved the left zygomaticomaxillary area.
그림 Fig. 5 Histologic findings (hematoxylin and eosin staining, x40) show cellular stroma with small psammoma-like bodies, indicated by the red arrow.
그림 Fig. 6 Postoperative follow-up computed tomography scan showed bony defect after removal of tumor and no sign of recurrence.
표 Table 1 Comparison of craniofacial PJOF and FD

참고문헌 (20)

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Psammomatoid Juvenile Ossifying Fibroma of the Maxilla Misdiagnosed as Fibrous Dysplasia: A Clinicopathologic Case Report 원문보기

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