Presentation
History of surgical excision of mandibular lesion 10 years ago. Now recurrent jaw swelling.
Patient Data
Left mandibular body expansile bony lesion showing mixed lytic and sclerotic texture. No periosteal reaction, cortical disruption, or extra-osseous soft tissue components. Extracted related left lower 2nd premolar and the three molar teeth.
The lesion was biopsied.
Histopathology report
Examination of H&E stained sections revealed a connective tissue lesion showing numerous bone trabeculae and calcifications, embedded in hypercellular stroma. Few giant cells were detected. Reactive bone was observed at the peri[hery of the lesion.
Diagnosis: ossifying fibroma.
Case Discussion
Cemento-ossifying fibromas are rare, benign neoplasms that usually arise from the mandible or maxilla. They most often occur from the tooth-bearing areas of jaws. They initially appear lytic and gradually develop increasing calcifications/ossifications as they mature. They tend to expand bones, yet with no cortical breach.
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