Osteofibrous dysplasia (ossifying fibroma of long bones). A report of four cases and review of the literature.

Osteofibrous dysplasia (ossifying fibroma of long bones) is a rare fibroosseous lesion. Only about 64 cases have been reported in the English literature. It is most commonly found in the tibia and fibula of a child ten years of age or younger. Of the four cases reported in this study, however, only one patient was younger than ten years of age. In two cases, the lesions were unusually located in the radius and ulna respectively. The other two cases had the usual tibial involvement. The last case had two recurrences after curettage before the patient was ten years of age. The other three patients who were treated after the age of 18 years had uneventful healing, one after wide resection and two after curettage. Extensive histologic examination and immunostaining for keratin were performed in all cases. No epithelioid cells were found. Because of a high recurrence rate after curettage, the treatment of this disease in a child should be conservative if the diagnosis is confirmed by biopsy. Only curettage with bone grafting is necessary for those patients older than 15 years of age with symptomatic lesions.