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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.
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