Cemento-ossifying fibroma

Case contributed by Henry Knipe


Jaw swelling.

Patient Data

Age: 30 years
Gender: Female

Mildly heterogeneous sclerotic expansile lesion involving the body of the right mandible, which is related to the roots of 4.4 to 4.8 (these do not appear eroded). No separate tooth components. Cortical thinning without disruption. Narrow zone of transition. No associated soft tissue mass. No cervical lymphadenopathy. Remainder of the imaged suprahyoid neck is unremarkable. 

The patient proceeded to mandibular biopsy. 


MICROSCOPIC DESCRIPTION: Multiple fragments of compact bone with attached cellular fibroblastic tissue composed of disorganized spindle and epithelioid cells with focal ossification. No necrosis or mitotic activity is identified. The features extend to the biopsy edges.

DIAGNOSIS: Right mandible bone biopsies: Features favoring ossifying fibroma. Radiological correlation recommended.

Case Discussion

There is variable terminology of these lesions, known commonly as cemento-ossifying fibroma or just as ossifying fibromas. These are rare lesions of the mandible, less commonly occurring in the maxilla. Overall, the imaging appearances are of a benign lesion with differential diagnosis including fibrous dysplasia. 

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