• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권1호
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• pp.48-51
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• 2015

Cemento-ossifying fibromas are benign tumors, and, although cases of an aggressive type have been reported, no cases of cemento-ossifying fibroma transforming into osteosarcoma have been documented previously. Low-grade osteosarcoma is a rare type of primary bone tumor, representing 1%-2% of all osteosarcomas. A 45-year-old female patient was diagnosed with cemento-ossifying fibroma, treated with mass excision several times over a period of two years and eight months, and followed up. After biopsy gathered because of signs of recurrence, she was diagnosed with low-grade osteosarcoma. The patient underwent wide excision, segmental mandibulectomy, and reconstruction with fibula free flap. The aim of this report is to raise awareness of the possibility that cemento-ossifying fibroma can transform into osteosarcoma and of the consequent necessity for careful diagnosis and treatment planning.

• 치과방사선
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• 제21권2호
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• pp.261-273
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• 1991

This study was undertaken to document and better defined this condition to help clarify this clinical and radiographical appearances by the analysis of clinical and radiographical features of fibro-osseous lesions in the jaws. A study was made of a series of 128 cases with fibro-osseous lesions. The obtained results were as follows. 1. Fibrous dysplasia of the jaws occurred with equal predilection for males and females. But the females occurred in 68% of cemento-ossifying fibroma and 75% of periapical cemental dysplasia. 2. 43% of fibrous dysplasia and 32% of cemento-ossifying fibroma occurred in the 2nd decades and 33% of periapical cemental dysplasia in 5th decades. 3. 62% of fibrous dysplasia occurred in the maxilla, 73% of cemento-ossifying fibroma in mandible, 90% of periapical cemental dysplasia in mandible. 4. 98% of fibrous dysplasia occurred in premolar-molar region, 77% of cemento-ossifying fibroma in molar region, 68% of periapical cemental dysplasia in incisor region. 5. In serial radiographic features, mature stage were 55% of fibrous dysplasia, 45% of cemento-ossifying fibroma, 59% of periapical cemental dysplasia. 6. 87% of fibrous dysplasia had monostotic lesion, 67% of periapical cemental dysplasia had multiple lesions. 7. In fibrous dysplasia and cemento-ossifying fibroma, migration of tooth occurred in 61.7% and 36.4%, retention of tooth occurred in 4.3% and 9.1%, loss of lamina dura occurred in 6.4% and 9.1%, and root resorption had not occurred in fibrous dysplasia, but occurred in 18% of cemento-ossifying fibroma, displacement of mandibular canal occurred in 14.9% and 31.8%.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.297-308
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• 1989

저자동은 약 1년전 모 병원에서 하악과 상악에 각기 안모변형과 골팽창을 동반한 병소에 대해 수술을 재발한 치주인대에서 기인한 양성 섬유골성 병소를 치험하였으며 다음과 같은 결과를 얻었다. 1. 본증례 1은 32세 남자의 우측 하악 골체부에서 술후 약 1년만에 재발된 백악질골섬유종이었고 증례 2는 72세 여자의 상악 전치부에서 술후 약 5개월만에 재발소견을 보인 골섬유종이었다. 2. 방사선학적 소견에서 증례 1은 방사선 투과상의 병소내에 방사선불투과상의 석회화 물질이 함유된 혼합기의 상태였고 증례 2는 비교적 불명확한 경계를 가졌으나 방사선 투명대에 의해 치밀한 방사선 불투과상의 병소가 둘러싸여 있는 성숙기의 상태였다. 3. 조직병리학적 소견으로 두 증례 모두 조골세포의 부연이나 규칙적인 골소주 구조 및 기절내 세포성분의 증가를 관찰할 수 있었으나 증례 1에서는 골성분외에 백악질소적과 같은 석회화물질이 관찰되었고 증례 2에서는 층판골만이 관찰되어 증례 1은 백악질골섬유종, 증례 2는 골섬유종의 특징을 지닌 양성 섬유 골성 병소였다. 4. 재발된 병소이므로 증례 1은 하악 우측 제 1소구치부터 우각부까지 하악골 절제술과 장골 및 하치조신경 이식술을, 증례 2는 정상 인접골을 포함한 종물의 적출술을 시행하였다. 5. 술후 1년이 경과한 현재까지 정기적인 임상 및 방사선 검사결과 재발증상 없이 양호한 치유 경과를 보여주고 있다.

• 대한소아치과학회지
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• 제32권2호
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• pp.200-206
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• 2005

백악질 골화성 섬유종은 가장 흔히 발생하는 섬유 골성 병소(fibro-osseous lesion)로서, 경계가 분명하고, 느리게 성장하는 팽창성의 양성종양이다. 임상적으로 하악골의 소구치와 대구치 부위에서 발생하고, 여성에게서 2배 정도 호발하며, 주로 20대에서 30대 사이에서 발견된다. 백악질 골화성 섬유종은 섬유성 이형성증을 포함한 다른 섬유 골성 병소와 감별되어야 한다. 백악질 골화성 섬유종의 또 다른 형태인 유년형 골화성 섬유종은 15세 이하에서 발생하며, 빠르게 성장하고, 좀 더 골파괴적인 양상을 보인다. 치료는 병소의 크기 에 따른 절제술이고, 재발은 드물다고 알려져 있다. 본 증례는 우측 하악 견치의 미맹출을 주소로 내원한 12세 남자 어린이로, 백악질 골화성 섬유종으로 진단 후, 외과적 적출술을 시행하여 양호한 치유과정을 보이기에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.484-487
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• 2010

Cemento-ossifying fibroma is a true osteogenic neoplasm. It is also called as ossifying fibroma or cementify-ing fibroma. Small lesions seldom cause any symptoms and are detected only on radiographic examination. Large lesions result in a painless swelling of the involved bone. In radiographic features the lesion most often is well defined and unilocular. It may appear completely radiolucent, or more often varying degrees of rdiopacity. It is composed of fibrous tissue that contains a variable mixture of bony trabeculae,cementum-like spherules, or both. Treatment of most lesions generally is enucleation of tumor. However, some lesions which have grown large and destroyed considerable bone, may necessitate surgical resection and bone grafting. This case was the bony lesion that was found by accident in patient with mandibular left body and subcondylar fracture. In radiographic examination, there was a mixed radiolucent and radiopaque lesion in mandibular left body area with fracture line. We treated on mandibular left body and subcondylar fracture and enucleated the lesion on the left body area simultaneously. At surgical exploration, the lesion was well demarcated from the surrounding bone, thus permitting relatively easy separation of the tumor from its bony bed. In histopathologic examination, the lesion contained bony trabeculae and cementum-like spherules within a background of cellular fibrous connective tissue. It finally diagnosed as cemento-ossify-ing fibroma from the result of biopsy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.70-75
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• 2000

본과에서는 하악에서 발생한 거대한 백악질-골성 섬유종에서 원발병소부위에 대한 광범위한 외과적 적출술 및 후방 장골이식을 통해 환자의 심미적, 기능적 안정성을 이루었으며 이환치아의 발거와 함께 술후 악간고정을 통하여 얇아진 하악하연부의 병적골절을 방지하였다. 현재까지 병소의 재발은 없고 양호한 결과를 보이고 있으며 향후 보철수복과 함께 지속적인 평가를 요할 것으로 사료된다.

• 치과방사선
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• 제27권2호
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• pp.161-172
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• 1997

The purpose of this study was to know the proper diagnosis and to establish the treatment plan of cementifying and ossifying fibroma in the jaws through the clinical, raiological, and histopathologic considerations. The authors compared and analyzed the c1inicoradiologic features of the thirteen cases of cementifying and ossifying fibroma, diagnosed at the Dental college hospital in Yonsei university, Seoul, Korea, during the period from 1980 to 1995. The obtained results were as follows : 1. Cementifying and ossifying fibroma occured in the mean age, 44 years, ranged from 29 to 65 years and the male to female ratio was approximately 1:5. 2. Swelling was the most common frequent presenting complaints. Other reported symptoms included pain, tooth mobility and asymptom. 3. The frequency of the lesions was twelve cases in the mandible and one case in the maxilla. And eleven of thirteen cases were distributed on the premolar and molar region. 4. Radiologically, eight of thirteen cases were well defined lesions, five cases were relatively well defined lesions. And nine of thirteen cases were mixed lesions, three cases were radiopaque lesions, and only one case was purely radiolucenct lesion. 5. Histologically, seven of thirteen cases were classified ossifying fibroma, four cases were cemento-ossifying fibroma, and two cases were cementifying fibroma.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권1호
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• pp.158-164
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• 1990

저자는 20세 남자환자에게 발생한 섬유골성병소에 대한 문헌고찰과 더불어 섬유골성병소중 치주인대로부터 유래된 백아질골섬유종에 대해 En-bloc절제술과 결손부에 대해 이물성형재료인 $Pyrost^{\circledR}$이식을 시행한 뒤 현재까지 재발소견없이 양호한 치유상태를 보여 이에 보고하는 바이다.

• Imaging Science in Dentistry
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• 제40권1호
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• pp.53-58
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• 2010

Common radiographic appearances of ossifying fibroma (OF) are well demarcated margin, radiolucent or mixed lesion. Lesions for the radiographic differential diagnosis with OF include fibrous dysplasia, focal cemento-osseous dysplasia. Other confusing lesions might be the mixed lesions such as calcifying odontogenic cyst, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, and benign cementoblastoma. We reported three cases of OF in posterior mandible. These cases showed a little distinguished radiographic features of OF and diagnosed from a combination of clinical, radiographic, and histopathologic information. We need to further refine radiographic and histopathological features of OF and other confusing lesions with literatures review because some cases of these lesions are not easily differentiated radiographically and histopathologically.

• 대한구강악안면병리학회지
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• 제42권6호
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• pp.189-198
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• 2018

A 31 years old female had been suffered from a bony swelling in right premolar region of the mandible for 12 years, recently grown rapidly. A fistula tract developed on the right anterior mandibular border, but the lesion was relatively asymptomatic. In the radiological examination, the tumor mass was irregularly mixed with radiolucent and radiopaque areas, forming multiple cystic spaces. Under the diagnosis of calcifying odontogenic cyst, the mandibular mass was resected and examined pathologically. After decalcification, the dissected tumor mass showed multiple small cystic spaces and calcifying fibrous tissue, mimicking calcifying odontogenic cyst or ameloblastoma. Histological observation showed many calcifying cementoid materials and ossifying trabeculae. The cystic spaces were turned out to be dilated vascular channels lined by endothelial cells, containing plasma fluid. However, the main lesion was diagnosed as cemento-ossifying fibroma (COF), and the atypical vascular channels were greatly dilated and gradually expanded the whole tumor mass. The present COF was examined through immunohistochemical (IHC) array, and investigated for tumor cell characteristics, exhibiting abnormal ossification and aneurysmal cystic changes. IHC array disclosed that the tumor cells grew progressively in the lack of apoptosis, and that they showed lower expression of RUNX2 than BMP-2, RANKL, and OPG, and increases of protein expression in $HIF-1{\alpha}$, VEGF-A, and CMG2. These data suggested that the reduced expression of RUNX2, osteoblast differentiation factor, be relevant to abnormal ossification of COF, and that the consistent expressions of angiogenesis factors be relevant to de novo angiogenesis in COF, subsequently resulted in aneurysmal cystic changes.