Ossifying Fibroma in the Maxilla and Mandible: A Case Report With a Brief Literature Review

Abstract

Fibro-osseous lesions in the jaw bones include fibrous dysplasia, ossifying fibroma (OF), cemento-ossifying fibroma, florid osseous dysplasia, and focal osseous dysplasia. OF is the most common fibro-osseous tumor that presents as a slow-growing well-encapsulated benign neoplasm composed of varying amounts of bone or cement-like tissue in a fibrous stroma well-demarcated from the adjacent normal bone. OF is most common in the jaw bones, with a predilection for the mandible. OF usually occur as solitary lesions and rarely as multiple lesions in a patient. We present clinical and radiologic features, histopathology, and surgical management of a rare case with large synchronous OFs in the mandible and maxilla and a brief review of the literature.

Cemento-Ossifying Fibroma of the Mandible: A Case Report

“…Typically, growth arises concentrically apically to the molars and premolars above the mandibular canal. Both the skin or mucosa covering the bone and its cortical bone plates maintain their integrity intact [ 4 ].…”

“…COFs typically have an expansile mass that is round or oval in shape, smooth, well-defined, and bordered by cortices. They grow centrifugally, expanding uniformly in all directions to give the appearance of a well-defined round mass [ 4 ]. In a small number of cases, additional radiological characteristics like root resorption, tooth displacement, and erosion of the mandible's inferior border may also be observed.…”

“…Precontrast T1-weighted MRI images exhibit intensities akin to brain gray matter, while T2-weighted sequences show intermediate to low intensities. Following gadolinium injection, the lesion is enhanced [ 4 ].…”

“…This combination is often referred to as psammoma bodies. COF has a cellular connective tissue with mineralized material and osteoblastic rimming visible on the surface under a microscope [ 4 ].…”

“…Conventional COF presents as slow-growing, while juvenile COF grows quickly [ 3 ]. It is thought to originate from multipotent mesenchymal cells in the periodontal ligament area, which can create fibrous tissue, cementum, and lamellar bone [ 4 , 5 ].…”