Clinical Pathological Features and Cytokeratin Expression Patterns of Osteofibrous Dysplasia in Children

OBJECTIVE: To investigate the clinicopathological features and cytokeratin (CK) expression patterns of osteofibrous dysplasia (OFD) in children. METHODS: A total of 49 cases of OFD confirmed by the Department of Pathology, Anhui Provincial Children's Hospital from 2008 to 2025 were collected. Their clinicopathological data, CK expression, and follow-up information were analyzed. RESULTS: The male-to-female ratio is approximately 4:3. The age ranges from 9 months to 13 years. It is more commonly observed in the tibia and fibula. Imaging examinations mainly reveal irregular bone destruction and cortical thinning. Histologically, it manifests as fibrous-osseous lesions. CK immunohistochemical staining was positive in 29 cases (29/49, 59.1%) and negative in the remaining cases. Follow-up indicated no recurrence or malignant transformation. CONCLUSION: OFD is a fibro-osseous lesion that commonly occurs in children. Immunohistochemistry often reveals CK expression, typically in individual cells, and it must be distinguished from conditions like osteofibrous dysplasia-like adamantinoma.