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Clinical Problem Solving: Radiology
October 2007

Radiology Quiz Case 2—Diagnosis

Author Affiliations

Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Otolaryngol Head Neck Surg. 2007;133(10):1061. doi:10.1001/archotol.133.10.1061

Ossifying fibroma is rare fibro-osseous benign tumor that was first described in 1872 by Menzel, who considered it to be a form of osteoma.1 The term benign fibro-osseous lesion is used to describe a spectrum of lesions ranging from fibrous dysplasia to OF, including cementifying OF or cemento-OF, psammomatoid OF, psammomatoid fibroma, juvenile or young OF, and juvenile active OF. Other lesions in this category include benign osteoblastoma and aneurysmal bone cyst.2 The origin of OFs is not clearly known, but they are thought to develop from the periodontal roots or from primitive mesenchymal cells that are able to produce cementum in nonodontogenic tissues.3 They are 1.6 times more common in females, and the most common site is the mandible, accounting for 75% to 89% of the cases.4 Less commonly, the orbit, paranasal sinuses, anterior skull base, or maxilla have been involved.5 The presenting symptoms depend on the location of the tumor and may include nasal obstruction, ocular and neurologic disturbances, and signs of intracranial extension.