Cemento-Ossifying Fibroma of the Mandible: A Case Report Including Its Imaging and Histopathological Features

Abstract

Cemento-ossifying fibroma is the uncommon benign fibro-osseous lesion of the craniofacial skeleton. The origin of this lesion has been traced to the periodontal ligament since the cells can form cement, lamellar bone, or fibrous tissue. The lesion most often occurs in the jaws, especially the mandible. Most lesions are small and incidentally found. Larger lesions cause facial asymmetry or functional impairment. The lesion is more common in females. Of the craniofacial bones, the mandible is the most commonly affected site, with the lesion typically inferior to the premolars and molars. From a radiological perspective, some lesions can be exceptionally radiopaque, or some well-defined with mixed or unilocular radiolucency. A 23-year-old female presented with a swelling in the right mandibular region, radiographs revealed a mixed radiopaque – radiolucent lesion showing a centrifugal expansion. Computed tomography revealed a mixed predominantly opaque expansile lesion with massive buccolingual expansion. Complete excision of the lesion was performed and histopathology findings confirmed it as Cemento-Ossifying Fibroma. Through this case report we want to signify the importance of diagnosis, consecutive therapy after clinical and radiographic findings, as such lesions continue expanding and may lead to a severe medical complication. The knowledge of the different types of radiological findings is important. The unique radiographic appearance of the lesion, in this case, can be beneficial to help clinicians understand. Due to the good delimitation of the lesion surgical removal and curettage is the treatment of choice. Complete surgical resection of the lesion is essential to achieve good results in terms of health and recurrence.