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Ossifying Fibromas of the Head and Neck Region: A Clinicopathological Study of 45 Cases

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Abstract

Ossifying fibromas of the head and neck region are classified as cemento-ossifying fibroma (COF) (odontogenic origin), and two types of juvenile ossifying fibromas: juvenile trabecular ossifying fibroma (JTOF), and juvenile psammomatous ossifying fibroma (JPOF). The potential for recurrence in JTOF and JPOF and the discovery of newer molecular signatures necessitates accurate histological classification. Over 12 years (2005–2017), a total of 45 patients with 51 tumours were retrieved and reviewed for clinic-pathological features from the archives of a tertiary care oncology centre. Of 45 cases, COF, JTOF and JPOF comprised 13 (28.9%), 11 (24.4%) and 18 (40%) cases respectively. Three cases were unclassifiable. M: F ratio was 1:3.3, 1.1:1, 2:1 for COF, JTOF and JPOF respectively with an age range of 6–66 years (mean: 24.6, median; 18.1 years). The most common site for COF was mandible, for JTOF was maxilla, and for JPOF was ethmoid sinus. One case of mixed JTOF and JPOF histology was seen. Aneurysmal bone cyst-like areas were seen in 26.6% of cases, most commonly in JPOF. Follow up was available in 23 cases, and ranged from 4 to 207 months. Three cases of JPOF had a recurrence and one patient with JTOF had residual disease after surgery. One case of COF demonstrated increased parathyroid hormone levels. COF, JTOF, and JPOF are clinically, radiologically and histologically distinct entities. Surgical resection is the mainstay of treatment. JPOF has a higher incidence of recurrence as compared to JTOF and COF and hence needs a more aggressive follow-up.

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Acknowledgements

We would like to extend our gratitude to Dr. Rajiv S. Desai (Professor & Head, Department of Oral & Maxillofacial Pathology, Nair Hospital Dental College, Mumbai) for his valuable suggestions to improve this manuscript.

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None of the authors have any relevant financial disclosures.

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Authors and Affiliations

  1. Department of Pathology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Mumbai, India

    Saurabh R. Nagar, Swapnil U. Rane & Asawari Patil

  2. Homi Bhabha National Institute, Mumbai, 400012, India

    Saurabh R. Nagar, Neha Mittal, Swapnil U. Rane, Munita Bal, Asawari Patil, Suman Kumar Ankathi & Shivakumar Thiagarajan

  3. Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, 400012, India

    Neha Mittal & Munita Bal

  4. Department of Radiology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, 400012, India

    Suman Kumar Ankathi

  5. Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, 400012, India

    Shivakumar Thiagarajan

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  1. Saurabh R. Nagar
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  2. Neha Mittal
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  3. Swapnil U. Rane
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  4. Munita Bal
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  7. Shivakumar Thiagarajan
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Contributions

SRN, NM, SUR: Study Concepts; SRN, NM: Study Design; SRN, NM, SUR, MB, AP, SKA, ST: Data Acquisition.

Corresponding author

Correspondence to Neha Mittal.

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All authors declare that they have no conflicts of interest.

Ethcial Approval

This is a retrospective observational study done in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. No additional procedures were performed on the participants as a part of this study. All received the standard of care for their condition and was as per the ethical standards.

Informed Consent

An informed consent has been obtained from all the study participants or their guardians (only in case of minors) for the treatment received by them, and for photographing and/or televising appropriate portions of their body and the use of this information and their histopathological material for medical, educational or scientific research (including publication) purposes after sufficient anonymization of patient particulars.

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Nagar, S.R., Mittal, N., Rane, S.U. et al. Ossifying Fibromas of the Head and Neck Region: A Clinicopathological Study of 45 Cases. Head and Neck Pathol 16, 248–256 (2022). https://doi.org/10.1007/s12105-021-01350-4

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  • DOI: https://doi.org/10.1007/s12105-021-01350-4

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