Eversole fibro osseous lesions are a diverse group of processes that are characterized by replacement of. Microscopically it showed both bone and cementum component in a fibrous connective tissue stroma fig. Cementifying fibroma, fibroosseous lesion, jaw tumor. A clinical, radiographic, histologic and follow up study of 18 cases of ossifying fibroma involving the mandible and maxilla was performed. Extensive presentation of central ossifying fibroma. A definitive diagnosis is thus established upon also considering the clinical and radiological findings. In the 2005 who histological classification of odontogenic tumors, this tumor is referred to as ossifying fibroma but in this article, the term cementoossifying tumor is used to differentiate from peripherally occurring ossifying fibromas other synonyms of cementoossifying fibroma besides ossifying fibroma include 7. However, there is a general consensus that the conventional ossifying fibroma originates in the periodontal ligament of the toothbearing areas of the jaws and is of odontogenic origin. Central lesion of bone with variable fibrous proliferation of round, polyhedral or spindly cells and calcifications. The trend to reuse of in preference to cof would appear to have been started by brannon and fowler, 3 and continued by reichart and philipsen. The definitive diagnosis of these lesions requires integration of its clinical, radiological and histological features. It is derived from cells of the periodontal ligament and is usually classified as a reactive hyperplasia but sometimes as a benign neoplasm. Cementoossifying fibroma radiology reference article. Fibroosseous lesions include a large group of pathologic processes in which normal bone is replaced by fibrous tissue containing variable amounts of mineralised material.
Peripheral ossifying fibroma, also known as ossifying fibrous epulis, is a gingival nodule which is composed of a cellular fibroblastic connective tissue stroma which is associated with the formation of randomly dispersed foci of mineralised products, which consists of bone, cementumlike tissue, or a dystrophic calcification. The freetext terms used were cementoossifying fibroma, ossifying fibroma and cementifying fibroma. Jul 22, 2019 histopathology revealed microscopic diagnosis of cementifying fibroma and thus a final diagnosis of cementifying fibroma was given. Ossifying fibroma nos showing areas of fibrous stroma with a storiform pattern. This bone tumor consists of highly cellular, fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum, or both. Cementifying fibroma definition of cementifying fibroma. Shipra arora et al treatment of peripheral ossifying fibroma. Jul 14, 2016 cementoossifying fibroma cof is a distinct form of a benign fibroosseous tumor, affecting predominantly the craniofacial region. Mandibular cementifying fibroma and cementoblastoma 5478 int j clin exp med 2017. Cementoossifying fibroma radiology cytology histopathology. Cementifying fibroma definition of cementifying fibroma by medical dictionary s.
Incisional biopsy was taken and the diagnosis was confirmed by histopathology as cementoossifying fibroma. The ability to electronically send cytopathology images around the world for a definitive second opinion is a practical example of the power of e. Brannon and fowler in 2001 appear to have started the trend to use ossifying fibroma instead of cementifying ossifying fibroma and this was continued by reichart et al. Fibroosseous lesions refer to a collection of nonneoplastic intraosseous lesions that replace normal bone and consist of a cellular fibrous connective tissue within which nonfunctional osseous structures form. Central ossifying fibroma is a benign slowgrowing tumor of mesenchymal origin and it tends to occur in the second and third decades of life, with predilection for women and for the mandibular premolar and molar areas. It is very closely related to other fibroosseous lesions like fibrous dysplasia, cemental periapical dysplasia and other calcifying odontogenic cysts and tumour. It comprises fibrous tissue containing a variable quantity of mineralized material resembling bone andor cement, whence the term cementoossifying. In the world health organization international classification of tumors of domestic animals, among the tumors formed in the bones of the upper alimentary system and in bones and joints, osteoma, ossifying fibroma, myxoma, and chondroma are classified as benign, while osteosarcoma, chondrosarcoma, and multilobular bone tumor are classified as malignant 3, 9. The current case of bilateral cemento ossifying fibroma of mandible is reported because of its rarity and the paucity of information concerning them in the dental literature. Eversole fibro osseous lesions are a diverse group of processes that are characterized by. Typically seen in the mid30s age group, women being twice as frequently affected as men. Peripheral cementoossifying fibroma pcof accounts for 3. Intraoral ossifying fibromas have been described in the literature since the late 1940s. Specific fibromas include nonossifying fibroma, found in the large long bones.
Cementifying fibroma, fibroosseous lesion, jaw tumor introduction the concept of fibroosseous lesions of bone has evolved over the last several decades and now includes two major entities. Therefore, we diagnosed it as an ossifying fibroma. Cementoossifying fibroma of the mandible sciencedirect. Cementifying fibroma clinical characteristics, histological features and correlation article pdf available in srpski arhiv za celokupno lekarstvo 6suppl. Pdf cementifying fibroma clinical characteristics, histological. Central cementoossifying fibroma behaves like, a benign bone neoplasm. Ossifying fibroma nos a irregular osteoid rimmed by osteoblasts and a fibrous stroma. Due to considerable similarity of features, definitive diagnosis of these lesions requires an accurate correlation of the clinical, radiographic and histopathological findings.
Extensive presentation of central ossifying fibroma treated. Treatment of peripheral ossifying fibroma using er,cr. Oral fibroma, typically referred to as simply fibroma, is a very common benign lesion in oral pathology. Case 2 a 23yearold female reported with a painless slowgrowing. It is also known as focal fibrous hyperplasia, peripheral fibroma, peripheral ossifying fibroma, fibroid epulis old term, and fibroepithelial polyp. Cementoossifying fibroma cof is considered by most as relatively rare, benign. Differences in behavior and management according to age, location, radiographic appearance and histopathology were not evident. Cementoossifying fibroma, mandible, histopathology. Ossifying cementifying fibroma pleomorphic adenoma. The tumor was subsequently confirmed as a juvenile trabecular variant of cementifying fibroma on histopathology on a surgical excision in london, united kingdom. Peripheral ossifying fibroma a clinical and histological evaluation of 51 cases p. Occasionally treated by curettage enucleation, this conservative.
The clinical and radiographic features of ossifying fibroma are the same as for cementifying fibroma and it is not a separate entity. The most recent edition of the classification of odontogenic tumours produced by the world health organization who 1 has replaced the second editions 2 cementoossifying fibroma cof with ossifying fibroma of. To our knowledge, this is the first report of this tumor in a rabbit. What is peripheral ossifying fibroma peripheral ossifying fibroma is a benign swelling of the gum, most commonly seen in teenagers and young adults. Cementoossifying fibroma is a benign fibroosseous maxillary. It has been suggested that the origin of these tumour is odontogenic or from periodontal ligament. Ossifying fibroma always presents well defined margins.
In addition, the cementoossifying fibroma often shows variations in clinical, radiographic, and histopathologic features, hence require different treatment options. Cementoossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cementossifying dysplasia. Discrete mass that is well delineated from surrounding bone, no encapsulation, tanwhite, rubbery cut surface, firm to gritty. Several sections of the sample must be carefully examined, since. Ameloblastoma occurs in the posterior part of the mandible, multilocular appearance and it may cause paraesthesia of lip. The freetext ossifying fibroma was already an entry term or recognized synonym of the above mesh. Cementoossifying fibroma is a benign osteogenic tumor with membranous ossification. The peripheral ossifying fibroma pof has been defined by a variety of terms such as ossifying fibrous epulis, calcifying fibroblastic granuloma and peripheral cementifying fibroma that have reflected partly the type of calcifications apparent histologically. Due to its clinical and histopathological similarities, some pofs are believed to develop initially as a pyogenic granuloma that. She was then advised complete excision of the frontal sinus tumor but was unable to comply because of personal and financial reasons. Giant ossifying fibroma of the philippine journal of. Histopathological characteristics of an ossifying fibroma. Cementifying fibroma is considered as a benign, osseous tumour, which arises from the periodontal ligament and is composed of varying amounts of cementum, bone and fibrous tissue.
Here we present a case of 18year old female having slow growing painless swelling on left side of mandible over 2year period. Central cementoossifying fibroma is a fibroosseous lesion causing slow expansion of the involved bone and is usually manifested after attaining significant growth. In the latest who classification of 2005, the term cementifying ossifying fibroma was replaced with ossifying fibroma reichart et al. Cementoossifying fibroma of the jaw bmj case reports. There was considerable confusion in the terminology used in the literature until it was distinguished. Classification charles a waldron in 1985 classified fibro osseous lesions into main groups on the basis of clinical behavior, histopathology and radiographic findings. Case report open access central cementifying fibroma of. Histopathology revealed microscopic diagnosis of cementifying fibroma and thus a final diagnosis of cementifying fibroma was given. Peripheral ossifying fibroma pof is usually a fibroma of the gingival which shows areas of calcification or ossification. Department of oral and maxillofacial surgery, 1department of. It therefore involves exclusively the maxillofacial bones 1, 2. Department of pathology, burdwan medical college, india. It is commonly found in patients under 25, more often so in women.
Cementifying fibroma definition of cementifying fibroma by. Clinically, it is a large asymptomatic tumor of aggressive appearance, with possible tooth displacement. Ossifying fibroma cementoma is a tumor of mesenchymal origin which represents about 1% of odontogenic tumors. There were several reports on cementifying fibroma combined with odontoma in the same mandible 9, 10, but cementifying fibroma coexisted with cementoblastoma were not found.
Histopathology revealed microscopic diagnosis of cementifying. Cementoossifying fibroma was initially classified by the world health organization who as a fibroosseous neoplasm. Diagonosed by cytological and radiological correlation. Report of two cases international journal of laser dentistry, septemberdecember 20. In some instances, this entity has been divided into cementifying fibroma and ossifying fibroma depending on the relative amounts of the tumors constituent tissues. It is often encapsulated and predominantly located in the mandible, and presents as a slowgrowing lesion, but may cause deformity if left untreated. Peripheral ossifying fibroma a clinical and histological.
Method the authors report 10 cases of cementifying fibroma diagnosed at the institute of pathology, school of medicine, university of belgrade. Shipra arora et al treatment of peripheral ossifying. Equine ossifying fibroma is characterized by development in the mandible, but was formed in the maxilla in this case. Adyanthaya peoples journal of scientific research 11 vol. Due to their clinical and histopathological similarities, some pcofs are believed to develop fibrous maturation and. Cementoossifying fibroma of the jaw journal unair universitas. This lesions commonly seen in women in 3rd and 4th decade of life. The lesion is considered part of an ossifying fibroma, but that. Surgical enucleation with curettage of the lesion of the patient mentioned in this case report. Usually in the jaw region the lesions are found mostly in the tooth bearing area. Central cementifying fibroma is a bony tumor, which is believed to be derived from the cells of the periodontal ligament.
Cementoossifying fibroma ossifying fibroma pathology outlines. Cementoossifying fibroma a case report omics international. Trabecular and psammomatoid patterns, myxomatous matrix. Case report bilateral cemento ossifying fibroma of mandible. Cementoossifying fibroma is a benign growth, considered to originate from the periodontal ligament. On histology, the mass was composed of trabecular bonelike structures due to the proliferation and aggregation of fibroblasts. Ossifying fibroma in a miniature rex rabbit oryctolagus.