Desmoplastic fibroma of the jaws: Surgical management and review of the literature

Abstract

Desmoplastic fibroma of the jaws is a rare and locally aggressive tumor that has a high rate of recurrence. The cellularity, extent of the tumor, and completeness of the local excision may be factors in its tendency to recur. We reviewed the literature in an attempt to determine if there was any correlation between the histologic features of a desmoplastic fibroma, or the surgical procedure utilized, and the tumor's recurrence. From the information gathered, it was found that a more cellular desmoplastic fibroma or inadequate surgical procedure may be factors that contribute to the recurrence of the tumor. A case report of desmoplastic fibroma of the mandible in a 9-year-old child is presented. The tumor, which displayed areas of moderate cellularity, was resected via a partial hemimandibulectomy. There has been no recurrence to date (46 months).

Multifocal desmoplastic fibromas of the mandible

“…2,11,12 Increased cellularity seems to be associated with an increased tendency for recurrence. 15,16 Both the lack of a capsule and the infiltrative nature of this lesion are hallmarks of desmoplastic fibroma; these features can pose a diagnostic challenge. Absence of osteoid as well as prominent collagenization help distinguish this lesion from other fibrous lesions of bone, which include benign neoplasms such as nonossifying fibroma and odontogenic fibroma.…”

“…However, tumors treated with local excision or enucleation recur approximately 20% to 40% of the time, whereas those treated with curettage alone have a recurrence rate of up to 70%. 9,12,[14][15][16][17][18] There have been reports in the literature of multifocal desmoplastic fibromas involving the extremities. These cases typically involve a single anatomic region and suggest that the proliferative alteration of the involved connective tissue is a local phenomenon.…”

Desmoplastic fibroma of the mandible: report of a case

“…Most clinicians, however, seem to prefer surgical resection as the treatment of choice [13, 14]. A recurrence rate of 20–42% is reported in lesions [13, 15, 16]. In the present case, although a more conservative approach was adopted there has been no sign of recurrence after 3 years.…”

“…No osteoid or osseous metaplasia is apparent in desmoplastic fibroma, thus differentiating it from fibrous dysplasia [2], also the predominately woven bone and more irregularly shaped trabeculae seen in fibrous dysplasia is missing in desmoplastic fibroma [6]. Surgical treatment by thorough curettage is usually sufficient for small mandibular lesions [10], but because curettage is associated with high recurrence rates, when the lesion is aggressive and extends into adjacent soft tissue, wider surgical excision is recommended [10, 13]. Most clinicians, however, seem to prefer surgical resection as the treatment of choice [13, 14].…”

Gnathic Desmoplastic Fibroma Mimicking a Dentigerous Cyst: A Case Report

“…Desmoplastic fibroma of the jaw presents in the same manner as its counter part in long bones. The age incidence being first, second, and third decade with no predilection for any sex [9], whereas the dentigerous cyst is by far the most common non-inflammatory cyst of the oral region [10].…”