Desmoplastic Fibroma: a benign neoplasm mimicking a malignancy

Abstract

A four-year-old African male patient presented to our clinic with a two-month history of a fi rm, warm lesion involving the right side of his face. The lesion presented as a bleeding papillary mass in the 85/46 region that extended to the floor of the mouth, causing displacement of the tongue (Figure 1A-B). Upon cone-beam computed tomography (CBCT) examination, an expansile homogenous intermediate density lesion was noted with complete destruction of the bucco-lingual cortical bone. Discernible extensions were identified in the anteroposterior plane from the region of the 84 to the posterior mandible involving the right corpus, developing 46, angle and ramus but spared the condyle and coronoid processes. The lesion extended inferiorly below the epiglottis and showed a reduction of the hypopharynx. Marked bucco-lingual expansion with soft tissue swelling was noted (Figure 2A-D). An incisional biopsy was performed under general anaesthesia, and histological examination rendered a diagnosis of desmoplastic fi broma (DF).