Ossifizierendes Fibrom

nicht verwechseln mit: nicht ossifizierendes Fibrom

Ossifying fibromas are benign bone lesions that should be differentiated from non-ossifying fibromas and fibrous dysplasiaOsteofibrous dysplasia is considered as a separate pathological entity in view of its different presentation and treatment, although histopathologically similar to ossifying fibroma.


These lesions are most frequently encountered in young children (often <10 years).



They comprise haphazardly distributed lamellated bony spicules on a background of fibrous stroma. Despite being benign, they can be locally aggressive. Immunohistochemical staining of lesions shows positive keratin cells in the majority of the cases.

  • lower extremity
    • tibia: most frequent site (90% of the time); there is a predilection for the anterior tibial cortex
    • femur: occurs in a diaphysial location
  • mandible and maxilla: these are examples of cementum-poor cemento-ossifying fibromas (see WHO classification scheme for odontogenic tumors)
  • sinonasal: expansile lesions with peripheral ossification and central lucency

Radiographic features

Plain radiograph and CT
  • well-circumscribed lesion
  • evidence of intracortical osteolysis with a characteristic sclerotic band (osteoblastic rimming)
  • moderate cortical expansion
  • homogeneous lesion matrix

Reported signal characteristics include

  • T1: low signal
  • T2: iso-high signal
  • T1 C+ (Gd): typically shows enhancement

Treatment and prognosis

Tend to regress over time. For locally aggressive lesions, surgical resection is often curative although recurrence has been reported.


Differential diagnosis

Imaging differential considerations include

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