A CLINICO-PATHOLOGICAL AND HISTOCHEMICAL STUDY OF DIFFERENT VARIANTS OF MAXILLOFACIAL OSSIFYING FIBROMA

Abstract

Fibro-osseous lesions of maxillofacial bones comprise a diverse group of pathologic conditions whose subclassification is problematic. Among these lesions, ossifying fibroma (OF), the commonest in fibro-osseous lesions, promotes a substantial debate owing to the inexplicable range of its variants. Given that OF embraces lesions of fibrocellular tissue and mineralized material of varying appearances, this definition categorically include ossifying fibromyxoid tumor, osseous choristoma of the periodontium, ossifying variants of odontogenic fibroma and Nora’s lesion. This study enrolls ossifying fibromyxoid tumor as a variant of ossifying fibromas toward contrast the similarities and differences in terms of aggression, malignant potential, metastatic propensity, recurrence and histological similitude. It evaluates, clinically and histochemically (AgNOR stain), the aggression of different variants of ossifying fibroma; elucidates the nature of ossifying fibromyxoid tumor and correlate the findings with the contemporary surgical modalities of treatment. The study used AgNOR as a histochemical stain to measure the proliferation activity in contrast to clinicopathologic findings of 100 archival cases. Results provided measures for the MPC and MAF in the different variants. The AgNOR expression was the lowest in the normal mucosa. POF showed a very comparable picture of the normal mucosa. The cases of COF showed much higher measures while the highest score was obviously of OFMT. AgNOR stain was recommended to be routinely recruited as an adjunct diagnostic tool. OFs encompass variants of substantially diverse potential: reactive, benign and borderline malignant. Therefore, a new taxonomy should be considered in order to cope with such diversity.