Presentation
The patient attended the dental surgical clinic for painless hard swelling along the lower mandible. Right mandibular abnormality prompted CT to be undertaken.
Patient Data
The right mandibular body (para-symphysis menti) is the seat of a fairly defined intra-osseous expansile lesion of dense sclerotic center surrounded by a radiolucent halo with a contour bulge
The lesion is seen related to crowns of lower incisors and right canine, with preserved overlying teeth and no cortical breaching nor fracture line seen.
Another note is made of small periapical cyst related to left lower 1st premolar tooth.
Right maxillary antrum basal polyp /retention cyst is incidentally seen.
Hypertrophied bilateral nasal turbinates.
Histopathology report
Macroscopic: Specimen received in formalin with patient identification and file number and labeled the mandibular lesion consists of multiple pieces of hard bony tissue, decalcified and embedded in a cassette.
Microscopic: Sections show narrowly curved, misshapen (fish hook) trabeculae of bone in a moderately cellular fibrous matrix as well as bone trabeculae and few giant cells, No evidence of necrosis or malignancy.
However, specimens show also few enamel matrix, mineralized dentin, and dental bulb that would be attributed to cut out of nearby tooth.
Diagnosis: Mandibular lesion, excision biopsy. Ossifying fibroma. No evidence of malignancy.
Case Discussion
Cemento-ossifying fibromas are rare, benign neoplasms that usually arise from maxillofacial bones mainly the mandible or maxilla. They most often occur from the tooth-bearing areas of jaws. They appear firstly as lytic lesions and gradually develop increasing calcifications/ossifications within their substances as they mature. They tend to expand bones, yet with no cortical breach or destructive maneuver.
Unable to process the form. Check for errors and try again.