Juvenile Ossifying Fibroma
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This is a companion case to the solitary fibrous
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tumor that was demonstrated earlier.
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Here we have a mass which is in an extra-axial
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location and is invading the top of the orbit.
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We note that it is relatively low in signal intensity on T1-weighted scans.
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It's also low in signal intensity on the T2-weighted scan.
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And yet it shows avid contrast enhancement.
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So this has imaging features very much
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like the solitary fibrous tumor.
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The differential diagnosis here would
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include a calcified meningioma,
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which would also be an extra-axial lesion that
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may have, for example, this CSF cleft sign.
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However, this lesion is from the bone and that is best
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demonstrated on the coronal imaging.
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On this coronal image, one can see that the
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lesion is infiltrating the orbital roof and has
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a component which is in the extra-axial
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compartment of the brain but is also growing into the orbit.
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This case went to surgery and this was a
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juvenile ossifying fibroma. Unfortunately,
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many of these fibrous lesions can be quite
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tricky and have similar signal intensity characteristics.
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So the solitary fibrous tumor and the juvenile
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ossifying fibroma in this case had the identical imaging features.
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The solitary fibrous tumor has malignant potential.
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The juvenile ossifying fibroma does not.
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
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