The central odontogenic fibroma: How difficult can be making a preliminary diagnosis

R Pippi,M Santoro,R Patini

doi:10.4317/jced.52795

R Pippi, M Santoro + Show 1 more

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https://doi.org/10.4317/jced.52795

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Abstract

Central odontogenic fibroma (COF) is a rare benign odontogenic tumor derived from the dental ectomesenchymal tissues. A 16-year-old Caucasian female patient was referred by her dentist for a radiolucent asymptomatic area associated with the crown of the impacted lower right third molar. A preliminary diagnosis of a follicular cyst was supposed. The lesion was surgically removed under general anesthesia together with the impacted tooth. The microscopic diagnosis of the excised tissue revealed an odontogenic fibroma. No clinical or radiographic signs of recurrence were found five years after surgical excision. Despite the various differential diagnoses of homogeneous unilocular and well delimited radiolucencies of the jaws, enucleation with peripheral curettage, without any other pre-operative imaging exams or biopsies, can be considered as the treatment of choice. Key words:Differential diagnosis, impacted third molar, radiographic imaging, microscopic diagnosis, odontogenic fibroma.

Highlights

The central odontogenic fibroma (COF) is an uncommon odontogenic tumor whose typing is controversial both clinically and histologically [1]
The clinical and radiographic diagnosis of COF has been reported not to be always easy and the tumor should be differentiated from many other lesions of the jaws such as keratocystic odontontogenic tumor, ameloblastoma, odontogenic myxoma, ameloblastic fibroma, calcifying odontogenic cyst, dentigerous cyst since it could appear as a well-defined radio-transparent area associated with the crown of an impacted tooth
The central odontogenic fibroma is an uncommon tumor which clinically appears as an asymptomatic welldefined osteolytic lesion and which rarely can be locally aggressive, with dental displacement and rhizolysis

Summary

Introduction

The central odontogenic fibroma (COF) is an uncommon odontogenic tumor whose typing is controversial both clinically and histologically [1]. The clinical and radiographic diagnosis of COF has been reported not to be always easy and the tumor should be differentiated from many other lesions of the jaws such as keratocystic odontontogenic tumor, ameloblastoma, odontogenic myxoma, ameloblastic fibroma, calcifying odontogenic cyst, dentigerous cyst since it could appear as a well-defined radio-transparent area associated with the crown of an impacted tooth. Microscopic examination showed a cellular loose connective tissue with epithelial cell aggregates showing the typical morphological characteristics of the enamel organ These aspects were compatible with the diagnosis of the simple type of odontogenic fibroma (Fig. 2). All fragments were fixed with 10% buffered formalin and microscopically

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