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Low-grade osteosarcoma arising from cemento-ossifying fibroma: a case report
Yong Bin Lee1, Nam-Kyoo Kim2, Jae-Young Kim3
1Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea.
Summary
Cemento-ossifying fibromas, typically benign, can rarely transform into low-grade osteosarcoma. This case highlights the importance of vigilant diagnosis and management for these rare bone tumors.
Area of Science:
- Oral and Maxillofacial Surgery
- Oncology
- Pathology
Background:
- Cemento-ossifying fibromas (COFs) are benign jaw tumors, rarely exhibiting aggressive behavior.
- Transformation of COFs into malignant neoplasms, specifically osteosarcoma, has not been previously documented.
- Low-grade osteosarcoma is an uncommon primary bone malignancy, accounting for 1-2% of all osteosarcomas.
Observation:
- A 45-year-old female presented with recurrent cemento-ossifying fibroma over 2 years and 8 months.
- Biopsy of the recurrent lesion revealed a transformation into low-grade osteosarcoma.
- The patient required extensive surgical intervention, including segmental mandibulectomy and fibula free flap reconstruction.
Findings:
- This case presents the first documented instance of cemento-ossifying fibroma transforming into osteosarcoma.
- The transformation occurred in a recurrent lesion previously diagnosed as benign.
- The resulting malignancy was a rare low-grade osteosarcoma.
Implications:
- Raises awareness of the potential malignant transformation of cemento-ossifying fibromas.
- Emphasizes the critical need for meticulous histopathological evaluation of recurrent or atypical COF lesions.
- Underscores the importance of careful treatment planning and long-term follow-up for COF patients to detect any malignant changes early.
