Bilateral maxillary odontogenic fibroma: a case of rare occurrence

Abstract

Aim: To report the case of a patient diagnosed with bilateral odontogenic fibroma in the maxilla that was surgically removed. Clinical conduct: A 32-year-old female patient was referred to the Santa Casa de Montes Claros Hospital for the removal of a lesion in the maxilla. Intraoral examination revealed a mixed lesion in the maxilla, bilaterally, with a suspected odontogenic tumor. Cone beam computed tomography showed an expansive lesion in the posterior region of the right and left maxilla, extending to the palatine and zygomatic processes. An incisional biopsy was performed and revealed the proliferation of spindle cells amid collagenized stroma, with the presence of mitoses and foci of concentric calcification, accompanied by lacerated bone trabeculae and fibroconnective tissue with edema, which were compatible with the diagnosis of odontogenic fibroma. During removal, the lesion detached easily and it was necessary to remove a premolar corresponding to the area involved, which presented advanced mobility due to loss of support, followed by adequate cleaning of the surgical site. Results: After the surgery to remove the lesion, the patient remained under clinical follow-up to evaluate the evolution of the case as well as its possible complications. Conclusion: This case highlights the importance of a careful clinical, imaging, and histopathological approach to lesions in the maxilla, for correct diagnosis and referral of the patient for appropriate treatment.