Comparison of proliferative potential in variants of ossifying fibroma (OF) of craniofacial complex

• SAVITA PRASHANT WAGH,  
• MANDAKINi Mandale,  
• Jayanti Humbe,  
• VAISHALI ANIL NANDKHEDKAR,  
• POONAM RAJENDRA ZANWAR,*  
• Nidhi Kaushal

Abstract

Introduction: Fibro-osseous lesions (FOL) refers to a poorly defined diverse group of lesions affecting the jaws and craniofacial complex. This spectrum of lesions includes fibrous dysplasia, cement-osseous dysplasia and two histological variants of ossifying fibroma - Juvenile trabecular ossifying fibroma (JTrOF) and psammamatoid ossifying fibroma (PsOF). JTrOF tends to occur in younger individuals with mean age of 15 years. In contrast the PsOF variant affects a wider age range with mean age 20 years and has a propensity for extragnathic locations (sinus, orbital bone). Despite benign neoplasms, both the variants are characterized by rapid growth, potential for local invasiveness and a tendency to recur. According to the literature, the recurrence rate of JTrOF is about 20% where as PsOF is from 30-56%. Diagnosis is based on histopathology and imaging of the lesion. Early diagnosis allows for the resection of a smaller lesion , reducing the chance of damage to nearby structures. Various biomarkers such as oncogenes CDK4, MDM2, p53 and α-SMA have been investigated in bone pathology to predict biological behaviour of these lesions for precise treatment planning. Aim: Comparison of proliferative potential in JTrOF , PsOF and OF of craniofacial complex using CDK4 and pHH3 . Material and Methods: Immunohistochemical expression of CDK4 and pHH3 will be assessed in histopathological diagnosed cases of juvenile trabecular ossifying fibroma , psammamatoid ossifying fibroma and conventional ossifying fibroma . Results and Conclusion: The immunohistochemical expression of CDK4 was 100% in JTrOF and PsOF and 60% in OF .The expression of pHH3 was weak and focal in JTrOF and PsOF and also weak in OF. This study reveals the genetic mechanism involved in pathogenesis of aggressive variant of OF

Keywords

Ossifying fibroma, juvenile ossifying fibroma,PHH3 CDK4