Ossifying fibroma

A well demarcated and occasionally encapsulated neoplasm – containing varying amounts of calcified tissue resembling bone or cementum or both

Clinical: Asymptomatic swelling – causing facial asymmetry, mandible > maxilla

Radiology: A well defined unilocular lesion, may have a sclerotic border

Histology:

  • Encapsulated lesion – composed of cellular fibrous matrix + calcified material, which may be either cementum or bone
  • Osteoblasts are visible (but not osteoclasts)

Management: Enucleation, with good prognosis

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Juvenile ossifying fibroma

An aggressive variant of OF – seen in patients under 15

Common sites: Orbital, frontal bones & paranasal sinuses

Radiology: Varying degrees of radiolucency and opacity

Histology:

  • Cell rich stroma + spindle shaped cells
  • Scanty collagen + small strands of immature osteoid with some areas of woven bone

Management: Surgical enucleation, 30-58% recurrence

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