J Korean Assoc Oral Maxillofac Surg.  2012 Feb;38(1):29-37. 10.5125/jkaoms.2012.38.1.29.

Clinical study of benign and malignant fibrous-osseous lesions of the jaws

• Lee JM
• Song WW
• Lee JY
• Hwang DS
• Kim YD
• Shin SH
• Chung IK
• Kim UK

• KMID: 1434376
• DOI: http://doi.org/10.5125/jkaoms.2012.38.1.29

Abstract

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.

Keyword

Fibrous-osseous lesions of the jaws; Fibrous dysplasia; Ossifying Fibroma; Ewing's sarcoma; Osteoblastoma

MeSH Terms

Biopsy
Fibroma, Ossifying
Humans
Jaw
Microscopy
Mitosis
Osteoblastoma
Osteoblasts
Osteosarcoma
Retrospective Studies
Sarcoma, Ewing
Tooth Mobility

Figure

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  Fig. 1 A-D. Osteosarcoma. E-H. Ewing's sarcoma (H&E staining, C: ×100, D: ×200, G: ×100, H: ×200).

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  Fig. 2 A, B. Fibrous Dysplasia. C, D. Ossifying Fibroma. E, F. Cemental Dysplasia. G, H. Osteoblastoma (H&E staining, B: ×100, D: ×100, F: ×100, H: ×100).

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