Almeida Júnior Vildeman Rodrigues de, Dultra Joaquim de Almeida, Cerqueira Paloma Souza Gonçalves, Fernandes Tarcísio Oliveira Donato, Xavier Flávia Caló de Aquino, Dos Santos Jean Nunes, Henriques Águida Cristina Gomes
Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, BA, Brazil.
Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, BA, Brazil.
Int J Surg Case Rep. 2020;71:285-289. doi: 10.1016/j.ijscr.2020.05.025. Epub 2020 May 22.
Juvenile ossifying fibroma (JOF) is a controversial and uncommon lesion that has been distinguished from the larger group of ossifying fibromas because of distinct clinical features and some morphological peculiarities. Furthermore, JOF shows an aggressive biological behavior that has led researchers to consider it a benign neoplasm, resulting in its differential diagnosis with important benign and malignant bone neoplasms.
This study describes a case of synchronous presentation of JOF in the mandible and maxilla of a young patient. In addition, the literature was reviewed to identify clinical-pathologic features and possible factors that could help establish the correct diagnosis. A 26-year-old male patient presented simultaneously a lesion affecting the body, angle and ramus of the left mandible and another lesion in the left maxilla. Both lesions were well delimited and radiolucent, being unilocular in the maxilla and multilocular in the mandible. The mandibular lesion was partially resected and the maxillary lesion was submitted to curettage. The diagnosis was JOF.
A delay in seeking medical care and a late diagnosis can have serious consequences for the postoperative functional and esthetic outcome. Much care should be taken during establishment of this diagnosis since an equivocal diagnosis can have serious consequences for the patient in terms of treatment.
After 1 year, the patient shows no signs or symptoms of recurrence of the lesions and was referred for reconstructive surgery of the mandible. An early and correct diagnosis is necessary to permit the best therapeutic management.
青少年骨化性纤维瘤（JOF）是一种存在争议且不常见的病变，因其独特的临床特征和一些形态学特点，已从较大的骨化性纤维瘤群体中区分出来。此外，JOF表现出侵袭性生物学行为，这使得研究人员将其视为良性肿瘤，从而导致其与重要的良性和恶性骨肿瘤进行鉴别诊断。
本研究描述了一名年轻患者下颌骨和上颌骨同时出现JOF的病例。此外，还回顾了文献以确定有助于建立正确诊断的临床病理特征和可能因素。一名26岁男性患者同时出现累及左下颌骨体部、角部和升支的病变以及左上颌骨的另一个病变。两个病变边界清晰且呈透射性，上颌骨病变为单房性，下颌骨病变为多房性。下颌骨病变进行了部分切除，上颌骨病变进行了刮除术。诊断为JOF。
就医延迟和诊断较晚可能对术后功能和美观结果产生严重影响。在确立该诊断时应格外小心，因为模棱两可的诊断可能在治疗方面给患者带来严重后果。
1年后，患者未出现病变复发的迹象或症状，并被转诊进行下颌骨重建手术。早期正确诊断对于实现最佳治疗管理至关重要。
