良性纤维骨病变是一组病理状况,其特征是用经历矿化的细胞纤维结缔组织代替正常骨。最常见的良性纤维骨病变类型包括纤维发育不良,骨化性纤维瘤,骨发育不良.然而,诊断这些病变可能具有挑战性,因为它们的临床重叠,放射学,和组织学特征,这会给外科医生带来诊断困境,放射科医生,和病理学家。一种罕见的良性纤维骨性病变是骨水泥骨化性纤维瘤(COF),这是一种影响颅面区域的良性纤维骨性肿瘤的确定形式,尤其是下巴(70%)。这里,我们介绍了一名61岁的上颌前区女性患者的COF病例。由于病变和健康骨骼之间有明确的区别,病灶采用保守性手术切除,然后进行刮宫和一期闭合。然而,由于COF与Paget病和纤维发育不良等其他纤维骨性病变具有重叠特征,因此其鉴别诊断对临床医生来说具有很大的挑战性。骨化性纤维瘤和纤维发育不良通常表现为组织病理学,临床,和放射学重叠。八个月后的术后随访是不可预测的,放射学照片显示额骨厚度增加,顶骨,上颌骨骨髓间隙闭塞,用棉绒/毛玻璃外观改变小梁图案,上颌窦空间缩小.在得出最终结论之前,必须对纤维骨病变进行适当的评估和诊断。颌面部骨骼中的骨化性纤维瘤并不常见,八个月后,复发率是罕见的。该病例强调了将COF作为颌面部纤维骨病变的鉴别诊断的重要性,以及正确评估和诊断以确定适当的治疗计划和预后的必要性。总之,良性纤维骨病变的诊断可能是具有挑战性的,由于它们的重叠特征,但早期诊断和正确评估对于成功的治疗结果至关重要.COF是一种罕见的良性纤维骨性病变,应将颌面部区域的其他纤维骨性病变视为鉴别诊断。在得出最终结论之前,应采取必要的步骤确认诊断。
Benign fibro-osseous lesions are a group of pathological conditions characterized by the replacement of normal bone with cellular fibrous connective tissue that undergoes mineralization. The most common types of benign fibro-osseous lesions include fibrous dysplasia, ossifying fibroma, and osseous dysplasia. However, diagnosing these lesions can be challenging due to their overlapping clinical, radiological, and histological features, which can cause a diagnostic dilemma for surgeons, radiologists, and pathologists. One rare type of benign fibro-osseous lesion is the cemento-ossifying fibroma (COF), which is a definitive form of a benign fibro-osseous tumor that affects the craniofacial region, particularly the jaws (70%). Here, we present a
case of COF in a 61-year-old female patient in the maxillary anterior region. Due to a clear distinction between the lesion and healthy bone, the lesion was treated with conservative surgical excision followed by curettage and primary closure. However, differential diagnosis of COF can be highly challenging for clinicians due to its overlapping features with other fibro-osseous lesions like Paget\'s disease and fibrous dysplasia. Ossifying fibroma and fibrous dysplasia often present a histopathological, clinical, and radiological overlap. The post-operative follow-up after eight months was unpredictable, with a radiological picture showing the increased thickness of the frontal bone, parietal bone, and maxilla with obliteration of marrow spaces, alteration of the trabecular pattern with a cotton wool/ground glass appearance, and reduced maxillary sinus space. Proper evaluation and diagnosis of fibro-osseous lesions are necessary before arriving at a final conclusion. Cemento-ossifying fibroma in the maxillofacial skeleton is uncommon, and after eight months, the recurrence rate is rare. This
case highlights the importance of considering COF as a differential diagnosis for fibro-osseous lesions in the maxillofacial region and the necessity for proper evaluation and diagnosis to determine the appropriate treatment plan and prognosis. In summary, the diagnosis of benign fibro-osseous lesions can be challenging due to their overlapping features, but early diagnosis and proper evaluation are essential for successful treatment outcomes. COF is a rare type of benign fibro-osseous lesion where other fibro-osseous lesions in the maxillofacial region should be considered as a differential diagnosis, and the necessary steps should be taken to confirm the diagnosis before arriving at a final conclusion.