Podcast
Questions and Answers
Which molecular tool is most useful to differentiate fibrous dysplasia from other fibro-osseous lesions?
Which molecular tool is most useful to differentiate fibrous dysplasia from other fibro-osseous lesions?
- X-ray
- CT scan
- GNAS1 mutations (correct)
- MRI
What is the clinical presentation of fibrous dysplasia?
What is the clinical presentation of fibrous dysplasia?
- Thickening of skull bones (correct)
- Facial symmetry
- Painful expansion of the affected area
- Normal skull base foramina
Which imaging modality is important for investigating fibro-osseous lesions?
Which imaging modality is important for investigating fibro-osseous lesions?
- MRI
- CT and CBCT (correct)
- PET scan
- Ultrasound
What is the most common fibrous dysplasia subtype encountered in the maxillofacial region?
What is the most common fibrous dysplasia subtype encountered in the maxillofacial region?
What is the genetic cause of fibrous dysplasia?
What is the genetic cause of fibrous dysplasia?
What are the radiographic features of early onset fibrous dysplasia lesions?
What are the radiographic features of early onset fibrous dysplasia lesions?
At what age is fibrous dysplasia commonly diagnosed?
At what age is fibrous dysplasia commonly diagnosed?
What is the characteristic feature of benign fibro-osseous lesions?
What is the characteristic feature of benign fibro-osseous lesions?
Which syndrome is a clinical subtype of fibrous dysplasia?
Which syndrome is a clinical subtype of fibrous dysplasia?
What is the pattern of involvement for craniofacial fibrous dysplasia?
What is the pattern of involvement for craniofacial fibrous dysplasia?
What is the key requirement for the diagnosis of benign fibro-osseous lesions?
What is the key requirement for the diagnosis of benign fibro-osseous lesions?
Where are cemento-ossifying fibromas (COF) primarily found?
Where are cemento-ossifying fibromas (COF) primarily found?
In which age group do COFs show aggressiveness and often cause displacement of teeth?
In which age group do COFs show aggressiveness and often cause displacement of teeth?
What is the peak age for the occurrence of COFs?
What is the peak age for the occurrence of COFs?
What is the preferred initial treatment option for COFs?
What is the preferred initial treatment option for COFs?
Where is Juvenile-Ossifying Fibroma (JOF) predominantly found?
Where is Juvenile-Ossifying Fibroma (JOF) predominantly found?
What is the characteristic feature of COFs on radiographs as the lesion matures?
What is the characteristic feature of COFs on radiographs as the lesion matures?
What is the recurrence rate of COFs?
What is the recurrence rate of COFs?
What is the more aggressive variant seen in younger age groups?
What is the more aggressive variant seen in younger age groups?
What is the preferred treatment option for lesions exhibiting aggressive behavior and recurrence?
What is the preferred treatment option for lesions exhibiting aggressive behavior and recurrence?
Who proposed a classification for fibro-osseous lesions in 1985?
Who proposed a classification for fibro-osseous lesions in 1985?
Which classification includes entities like ossifying fibroma and central giant cell granuloma?
Which classification includes entities like ossifying fibroma and central giant cell granuloma?
What is replaced by connective tissue and fibroblasts in fibro-osseous lesions?
What is replaced by connective tissue and fibroblasts in fibro-osseous lesions?
What is the basis for the final diagnosis of fibro-osseous lesions?
What is the basis for the final diagnosis of fibro-osseous lesions?
What reflects the spectrum of clinicopathological entities in fibro-osseous lesions?
What reflects the spectrum of clinicopathological entities in fibro-osseous lesions?
What is the most important factor for the final diagnosis of fibro-osseous lesions?
What is the most important factor for the final diagnosis of fibro-osseous lesions?
What is the typical presentation of fibrous dysplasia (FD)?
What is the typical presentation of fibrous dysplasia (FD)?
What is the histological appearance of fibrous dysplasia (FD)?
What is the histological appearance of fibrous dysplasia (FD)?
What factors determine the treatment for fibrous dysplasia?
What factors determine the treatment for fibrous dysplasia?
What are the categories under benign fibro-osseous lesions (BFOL)?
What are the categories under benign fibro-osseous lesions (BFOL)?
When is optic canal decompression advised?
When is optic canal decompression advised?
What is the role of non-surgical treatment in fibrous dysplasia?
What is the role of non-surgical treatment in fibrous dysplasia?
What needs to be differentiated from fibrous dysplasia?
What needs to be differentiated from fibrous dysplasia?
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Study Notes
Fibro-Osseous Lesions of the Craniofacial Complex: Clinical Features, Treatment, and Prognosis
- Fibrous dysplasia (FD) typically presents with slow growth and may stabilize over time, surgical treatment is indicated for functional deficits or significant cosmetic deformity
- Histologically, FD shows irregularly shaped trabeculae of immature woven bone dispersed in cellular fibroblastic stroma, with bone trabeculae evolving directly from the stroma
- Treatment for FD is based on patient's age, presence of cosmetic and functional deficits, and growth rate, options include observation, conservative surgical recontouring, or radical surgical resection and reconstruction
- Sclerosing osteomyelitis is a differential diagnosis for FD, and its pathology report may show varied results under the benign fibro-osseous lesion (BFOL) spectrum
- Inflammatory reactive processes containing focal sclerosing osteomyelitis and proliferative periostitis are categorized under BFOL
- Differential diagnosis of sclerosing osteomyelitis can be challenging, as seen in a case with initial FD diagnosis but pathology report showing sclerosing osteomyelitis
- Trabecular pattern alterations are evident in cases of sclerosing osteomyelitis, and surgical intervention may be necessary for significant involvement
- Chen's treatment scheme offers guidance for the approach to lesions based on their extent and location within different craniofacial zones
- Optic canal decompression is advised for patients with orbital dysplasia and decreasing visual acuity, and early treatment is recommended for progressive sensory disturbances in craniofacial dysplasia
- Non-surgical treatment has a limited role in fibrous dysplasia, with radiotherapy contraindicated and steroids, calcitonin, and pamidronate showing some promise in reducing symptoms
- Fibrous dysplasia needs to be differentiated from other fibro-osseous lesions like cemento-ossifying fibroma (COF) and diffuse-sclerosing osteomyelitis of the mandible
- COF, previously included under BFOLs, is now accepted as odontogenic in origin and has a new classification, with variants including cemento-ossifying fibroma, juvenile trabecular-ossifying fibroma, and juvenile psammomatoid-ossifying fibroma
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