RESUMEN
BACKGROUND: Juvenile psammomatoid ossifying fibroma (JPOF) is an uncommon benign fibro-osseous lesion that only rarely presents in the calvaria. OBSERVATIONS: The authors reported a case of JPOF in the left parietal bone of a 20-year-old patient and reviewed the 27 other cases of JPOF occurring in the calvaria as reported in the literature. LESSONS: JPOF rarely presents in the calvaria, and because diagnosis is a histopathologic one, clinicians should consider this entity when presented with a lytic, expansile mass on imaging. Little is known about the molecular mechanisms driving development of JPOF. MDM2 amplification may play a role, although this was not seen in the case presented herein.
RESUMEN
Juvenile ossifying fibroma (JOF) is a rare benign bone tumor that occurs most frequently in the craniofacial bones of children and young adults. There are few case reports that describe its involvement outside the craniofacial skeleton, especially within the spinal column. While JOF is classified as a benign lesion, it may be locally aggressive and demonstrate a high propensity for recurrence, even after resection. Definitive surgical management may be challenging in naive cases, but it is particularly challenging in recurrent cases and when extensive spinal reconstruction is warranted. In this report, the authors describe the diagnosis and surgical management of a 29-year-old man who presented with a large recurrent sacral trabecular-subtype JOF. A review of literature regarding JOFs, management of recurrent primary spinal tumors, and sacral reconstruction are discussed.
Asunto(s)
Fibroma Osificante/diagnóstico , Fibroma Osificante/cirugía , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/cirugía , Neoplasias de la Columna Vertebral/diagnóstico , Neoplasias de la Columna Vertebral/cirugía , Adulto , Diagnóstico Diferencial , Fibroma Osificante/patología , Humanos , Masculino , Recurrencia Local de Neoplasia/patología , Complicaciones Posoperatorias , Procedimientos de Cirugía Plástica , Sacro/diagnóstico por imagen , Sacro/patología , Sacro/cirugía , Neoplasias de la Columna Vertebral/patologíaRESUMEN
Juvenile psammomatoid ossifying fibroma (JPOF) is a fibroosseous tumor that arises in the craniofacial bones in young people. This lesion usually originates in the jaw, orbit, and ethmoid complex but can also be associated with the skull base and calvaria. Diagnosis must be made based on observing typical radiological and histopathological features. Although JPOF is a rare pathological entity, neurosurgeons must consider this odontogenic lesion in the differential diagnosis of skull masses given the lesion's aggressive behavior and locally invasive growth. Treatment must be gross-total resection. In the following article, the authors present a case of cranial JPOF and discuss various aspects of this entity.