Juvenile active ossifying fibroma of the mandible: a report of 2 cases.
Juvenile active ossifying fibroma of the mandible: a report of 2 cases.
复制标题
青少年活动性下颌骨骨化纤维瘤2例报告.
DOI：
10.1053/joms.2001.21883
复制
发表时间：
2001
期刊：
影响因子：
--
通讯作者：
S. Syrjänen
中科院分区：
文献类型：
--
作者：
R. Leimola;K. Vähätalo;S. Syrjänen
颌面部纤维病变通常是临床医生和病理学家的诊断困境。良性纤维性病变的概念和标准是Waldron和giasanti1973年在回顾了60多例病例后提出的1,2。根据他们的说法，大多数所谓的颌骨“纤维性骨瘤”应该被认为是纤维性发育不良的例子他们还发现了一组不符合纤维发育不良标准的病变。这些病变包括不同比例的骨、骨质和纤维结缔组织。作者得出结论，这组病变最好被认为是由牙周韧带细胞引起的一系列过程，并有可能形成骨、骨质和纤维组织的组合他们认为只有一些病变是肿瘤性的，而其他病变是反应性的。世界卫生组织（WHO）对牙源性肿瘤的组织学分型将纤维性病变分为两大类：成骨性肿瘤和非肿瘤性骨病变成骨肿瘤包括骨水泥化纤维瘤根据世界卫生组织的分类，青少年活动性骨化纤维瘤（JAOF）一词用于主要影响15岁以下人群的活动性生长病变。JAOF由富含细胞的纤维组织组成，其中含有没有成骨细胞边缘的细胞样骨带，以及更典型的编织骨小梁。可见小的巨细胞灶，在某些部位可见大量与编织骨相关的破骨细胞。Waldron和giasanti1,2对JAOF这个术语持相当怀疑的态度。由于缺乏任何说明JAOF病理和预后的文献系列，他们无法评论JAOF与他们称为骨化性纤维瘤的病变可能或可能没有关系通常，肿瘤累及上颌骨、鼻窦、眶骨和额筛骨；然而，也有单独的下颌病变病例报道（表1）。在下颌骨，JAOF被认为是一种由牙周韧带未分化细胞发展而来的肿瘤，最常见于下颌前磨牙区。JAOF的典型组织学特征是间质细胞化和矿化颗粒的存在。硬组织的性质各不相同，从分散的小骨到编织的未成熟骨的不规则小梁，尽管板层骨也可能存在。肿瘤通常无症状，体积较大，表现出侵袭性行为，造成明显的骨破坏，并有复发的倾向。区分其他纤维性病变（即水泥化纤维瘤和纤维发育不良）主要是基于肿瘤钙化产物的性质。本文介绍了2例下颌骨JAOF分别在一个十几岁的女孩和男孩。
Maxillofacial fibrosseous lesions usually present a diagnostic dilemma for clinicians and pathologists. The concepts and criteria of benign fibrosseous lesions were presented in 1973 by Waldron and Giasanti1,2 after reviewing more than 60 cases. According to them, most of the so-called “fibrous osteomas” of the jaws should be considered examples of fibrous dysplasia.1 They also identified a group of lesions that did not fulfill the criteria of fibrous dysplasia. These lesions consisted of varying proportions of bone, cementum, and fibrous connective tissue. The authors concluded that this group of lesions are best considered a spectrum of processes arising from cells in the periodontal ligament and having the potential to form bone, cementum, and fibrous tissue in combination.2 They considered only some of the lesions neoplastic, whereas others appeared reactive in nature. The World Health Organization’s (WHO) histologic typing of odontogenic tumors groups the fibrosseous lesions into 2 main categories: osteogenic neoplasms and nonneoplastic bone lesions.3 Osteogenic neoplasms include cementossifying fibroma.3 According to the WHO classification, the term juvenile active ossifying fibroma (JAOF) is used for an actively growing lesion mainly affecting persons younger than age 15. JAOF consists of a cell-rich fibrous tissue containing bands of cellular osteoid without osteoblastic rimming together with trabeculae of more typical woven bone. Small foci of giant cells may be present, and in some parts, there may be abundant osteoclasts related to the woven bone. Waldron and Giasanti1,2 were rather skeptical as to the term JAOF. Because of the lack of any documented series illustrating the pathology and prognosis of JAOF, they were unable to comment on how JAOF might or might not relate to the lesions they called ossifying fibroma.1,2 Typically, the tumor involves the maxilla, paranasal sinuses, orbital, and frontoethmoid bones; however, single cases of mandibular lesions have also been reported (Table 1).4-7 In the mandible, JAOF is considered a neoplasm that develops from undifferentiated cells of the periodontal ligament, most often in the mandibular premolar-molar region. The typical histologic features for JAOF are stromal cellularity and the presence of mineralized particles. The nature of the hard tissue varies from scattered ossicles to irregular trabeculae of woven immature bone, although lamellar bone may also be present. The tumor is usually asymptomatic, achieving a large size, exhibiting aggressive behavior, producing significant osseous destruction, and having a tendency to recur. The distinction between other fibrosseous lesions (ie, cementifying fibroma and fibrous dysplasia) is mainly based on the nature of the calcified product of the tumor. This article presents 2 cases of mandibular JAOF in a teenage girl and boy, respectively.