Radiology of Juvenile ossifying fibroma, Adnan Rashid, MD

Adnan Rashid, MDDepartment of Diagnostic Radiology, SIMS/SHL

Radiology of Juvenile ossifying fibroma

Juvenile ossifying fibroma

Rare Benign locally aggressive tumor

Most common below age of 15yrs

Most common in males

Most common site Paranasal sinuses & orbits

Slowly evolving and asymptomatic tumors

No genetic association

Common radiologic modalities:

Radiograph: Panoramic PNSCT Plain Contrast enhanced (CECT)MRI T1WI, T2WI. Contrast (Gad-enhanced)

Panoramic radiograph (initially Radio-lucent)Extensive radio-opaque lesion with well-defined corticated border. Journal of International Oral Health 2014; 6(5):108-110

Paranasal view

Ill-defined radioopacity occupying the floor of the maxillary sinus

Contemp Clin Dent. 2012 Apr; 3(Suppl1): S45–S50.

CT Head & NeckPlain: Large expansile, soft tissue lesion with peripheral areas of calcification/ sclerosis, involving right maxillary sinus, causing balooning of the walls of sinus and out-pouching through the alveolar bone.

On CECT: The soft tissue component usually enhances 1.

MRIT1WI

intermediate to low signal focal regions of higher signal( fatty marrow in

ossified components)

T2WI: low signal

T1 WI+ Contrast (Gd): soft-tissue component may demonstrate some enhancement

MR Scan (T2)

-intermediate to low signal-focal regions of higher signal( fatty marrow in ossified components)

A Rare Case of Psammomatoid (Juvenile) Ossifying Fibroma of the Maxillary Sinus

Histologically two types:

Trabecular Psammomatoid

Small lesions can be conservatively treated by curretage and enucleation

Large and irregular shaped tumors with infiltrating sinuses can be treated by radical resection

Adjuvant interferon therapy for 1year for psammomatoid variant.

Recurrence rate is 30-58%

Follow up

Follow up of the patient will be done for three years

CT scan …….. Six monthly basis during first year.

THANK YOU!