Huge cemento-ossifying fibroma of the mandible

Abstract

Cemento-ossifying fibroma is relatively rare, benign non-odontogenic tumour of the jaws, considered as subdivision of fibro-osseous lesions. The usual age of occurrence is between 20 and 40 years. Female to male ratio 5:1, usual site is the posterior mandible. The aim of this report to present the clinical and radiological features and management of 32 years old female Libyan patient who presented with giant swelling, asymptomatic in the left mandible with duration of 5 years, histopathology report confirm clinical diagnosis. Cemento-ossifying fibroma (COF) is a bone producing, slow growing asymptomatic, well-demarcated, benign lesion of the jaws. Typically affects female between age 20 and 40 years old, in the premolar-molar area, causing a painless swelling, slow, expansile growth. Periodontal ligament contains both bone and cementum. 3 Longobardi G. et al. Extra osseous cemento-ossifying Fibroma of cheek. Schol Res Exch. 2009; 2009 (Article ID: 493190) Google Scholar The pathogenesis of extraosseous COF, where there is no periodontal tissue as suggested by Cakir and Karadayi is from embryonic nests and ectopic periodontal membrane as suggested by Brademann et al., 6 Bertand B. Eloy P. et al. Juvenile aggressive cement-ossifying fibroma: case report and review of literature. Laryngoscope. 1994; 103: 1385-1390 Google Scholar cytogenetic studies are limited. Depending on the stage of maturation, cemento-ossifying fibroma can be radiolucent, mixed variety to completely radio-opaque. Histopathologically, it appear as well-circumscribed, occasionally encapsulated with various amount of bony trabeculae/cementum formation in a fibrous stroma. 9 Kramer I.R.H. Pindburg J. et al. Histological typing of odontogenic tumors. 2nd ed. Springer-Verlag, Berlin1992: 27-28 Google Scholar