FUSOCELLULAR NEOPLASM OF THE JAW: A CHALLENGE FOR DIAGNOSIS AND TREATMENT

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2020-09, Vol.130 (3), p.e126-e126
• Main Authors: SASSI, LAURINDO MOACIR, DISSENHA, JOSE LUIS, GUEBUR, MARIA ISABELA, ZANFERRARI, FERNANDO L., SCHUSSEL, JULINANA L., STRAMANDINOLI-ZANICOTTI, ROBERTA T., QUADROS, MARCIO VINICIUS HURCZULACK
• Format: Article
• Language: English
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2020.04.078

A female, 21 years old, type-I diabetic, presented with right pre-auricular pain and limited jaw function. Discrete facial asymmetry and swelling were noted. Panoramic radiograph showed a mixed, expansive, multilocular lesion in the right mandibular ramus about 6 cm wide and undefined margins. After incisional bone biopsy, anatomopathologic study revealed a fusocellular neoplasm with osteoid deposition. Immunohistochemistry showed a Ki-67 proliferative index of about 20% with positive ALFA acute myeloid leukemia, vimentin, and CD-34 markers. S-100 and desmin markers were negative. Hypothesis for the diagnosis was ossifying fibroma or low-grade osteosarcoma. After biopsy, the patient had increased pain and swelling. Aggressive treatment through surgical resection and immediate reconstruction with a microvascular free fibula flap was indicated. Final diagnosis after resection was ossifying fibroma. The patient remains disease-free after 6 months. Fibro-osseous lesion diagnoses are often challenging, and aggressive treatment may be indicated when low-grade malignant disease is suspected.