Presentation
Lump under the chin.
Patient Data
A non-contrast paranasal sinus examination reveals a well-demarcated expansile lesion with lucent areas within the right mandible, extending to the symphysis menti. No cortical breech is noted, and the teeth are intact.
Case Discussion
Cemento-ossifying fibroma is a fibro-osseous neoplasm that originates from the mandible and maxilla, deriving from multipotent blast cells of the periodontium 1. Clinically, it manifests as a slow-growing jaw mass, more commonly affecting females, with a predilection for the mandibular premolar region 1.
The imaging characteristics of cemento-ossifying fibromas vary based on the degree of mineralisation. In the early stages, they appear as radiolucent lesions, progressively maturing into homogenous lesions 2. A key imaging feature is the centrifugal growth, resulting in a round mass. Notably, cortical breech is typically absent, although cortical thinning is often encountered 2.
For lesions in the maxilla, a characteristic feature is the upward bowing of the maxillary sinus, while mandibular lesions cause inferior bowing of the lower border of the mandible 3,4.
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