A case of cementoossifying fibroma involving the right mandible is described in a 30 yearold female patient. It is agreed that the terms ossifying fibroma, cementoossifying fibroma and cementifying fibroma describe the same pathologic process,15. This paper highlights the diverse clinical and histopathological presentations of peripheral ossifying fibroma through three cases encountered. Appropriate management, to achieve local control and prevent. This bone tumor consists of highly cellular, fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum, or both. Cementoossifying fibroma is a benign fibroosseous maxillary tumor. There have been occurrences in other bones, most commonly the tibia. We described a case of central cementoossifying fibroma involving the right mandible of a thirtyfivefemale patient by presenting its clinical, radiographic, and. The concept of fibroosseous lesions of bone has evolved over the last several decades and now includes two major entities. Cementoossifying fibroma cof is a distinct form of a benign fibroosseous tumor, affecting predominantly the craniofacial region. Ossifying fibroma free download as powerpoint presentation.
The cementoossifying fibroma is classified as a fibroosseous lesion of the jaws. The swelling was bony hard, nontender with no fluctuation on manual palpation. Cemento ossifying fibroma is a benign, non odontogenic tumour of the jaw, a subdivision of. As mentioned in chapter 7, all lesions designated by the terms listed above were formerly classified as cementomas. In 1872 menzel described ossifying fibroma but in 1927 montgomery was the one who gave a terminology to it1, in1972 peripheral fibroma term was coined by eversole and rovin2. A case of cementoossifying fibroma involving the left mandible is described in a 35 year old female patient. It has been suggested that the origin of these tumour is odontogenic or from periodontal ligament. When the bone predominated, ossifying fibroma was assigned. New concepts and controversies have arisen over the past 10 to 15 years regarding classification and diagnostic criteria. A 72yearold patient was referred for a subclinical lesion of the. Osteofibrous dysplasia is considered as a separate pathological entity in view of its different presentation and treatment, although histopathologically similar to ossifying fibroma. This lesions commonly seen in women in 3rd and 4th decade of life.
In the second who classification in 1992, benign fibroosseous lesions in the maxillo facial region were separated into two groups, osteogenic neoplasm and nonneoplastic bone lesions. High power histopathological picture showing lamellar bone with osteoblastic rimming and psammomatouslike nodules and calcifications in the fibrous stroma haematoxylineosin x larger lesions with size over 80 mm in their greatest diameter have been termed as giant ossifying fibroma. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. Uncategorized volume 4, issue 4 octoberdecember, 2014 peripheral ossifying fibroma. Usually in the jaw region the lesions are found mostly in the tooth bearing area. When curvilinear trabeculae or spheroidal calcifications were encountered, the lesion was often referred to as cementifying fibroma.
Cementoossifying fibroma is a relative rare lesion considered as an osteogenic tumor nonodontogenic with variable expressiveness. However, the term cementifying ossifying fibroma was reduced to ossifying fibroma in the new who classification in 2005. Differential diagnoses should also include neoplastic growths due to the occurrence and similar. It usually arises from the inter dental papillae1 and represents upto 2% of all lesions that are biopsied. Cementoossifying fibroma more c, thakkar k, asrani m indian j. They are noncancerous and do not spread to other areas of the body. Pdf introduction cementifying fibroma cf is a fibroosseous lesion which produces cementum.
Pdf cementoossifying fibromas cofs are benign lesions affecting. In histological examination, the image stained with hematoxylin and eosin showed dif. Orthopaedic institute for children nonossifying fibroma. Cemento ossifying fibroma pdf cementoossifying fibroma is classified as an osteogenic tumor, defined as a well differentiated tumor, occasionally encapsulated, comprising fibrous skip to content wonderful australia. The who classifies cementoossifying fibroma as a fibroosseous neoplasm, included among the nonodontogenic tumors, derived from the mesenchymal blast cells of the periodontal ligament, and with a potential to form fibrous tissue, cement and bone, or a combination of such elements. Case report open access central cementifying fibroma of. Central ossifying fibromas are more common in the mandible around premolars and molars. Cementoossifying fibroma presenting as a mass of the. Many names have been used to describe this lesion osteofibroma, fibroosteoma, cementifying fibroma secondary to the tumors cell of origin. Peripheral ossifying fibroma is a focal, reactive, nonneoplastic tumorlike growth of the soft tissue that often arises from the interdental papilla 1. Peripheral ossifying fibroma pof is a lesion of the gingival tissues representing up to 2% of all oral lesions that are biopsied. Ossifying fibroma an overview sciencedirect topics. Pdf cementoossifying fibroma is an unusual benign nonodontogenic fibroosseous tumor that is limited to the jaws and facial bones. A nof is a result from failure of the bone to properly close at its outer shell.
Pdf cementifying fibroma clinical characteristics, histological. World health organization has recognized peripheral odontogenic fibroma as a. Case report mandibular cementifying fibroma and cementoblastoma. A nonossifying fibroma nof is one of the most common benign bone tumors found in 30 to 40% of children between 820 years of age. Hyperparathyroidism jaw tumor syndrome head neck pathol 2014. Jul 22, 2019 amaryl lids to download pdf you need some things, like my website and the name of the file. The authors discuss the pathogenesis and radiological signs guiding the choice of diagnostic and therapeutic methods.
Cementoossifying fibroma radiology reference article. The peripheral ossifying fibroma pof is a reactive gingival overgrowth occurring frequently in the anterior maxilla. Cementifying fibroma definition of cementifying fibroma by medical dictionary s. Cementoossifying fibromas are benign tumors, and, although cases of an aggressive type have been reported, no cases of cementoossifying fibroma. Journal of radiology case reports extension into left orbit via inferior orbital fiss orbital proptosis fig.
Lehrer, md, new orleans the he term ossifying fibroma is applied to a localized fibroosseous dysplasia encountered in the bones of the face and skull which presents clinically and radiographically as a monostotic expansile lesion. Amaryl lids to download pdf you need some things, like my website and the name of the file. Cementifying fibroma definition of cementifying fibroma by. Cemento ossifying fibromas cofs are benign lesions affecting the jaws. Lowgrade osteosarcoma arising from cementoossifying fibroma. The mass wa remodelling the alveolar process of left maxilla f no intracranial extension was noted. The tumour had replaced one half of the body of the mandible. Pdf cementifying fibroma of the frontoethmoid complex. Cementoossifying fibroma of the mandible sciencedirect. 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. Cementoossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cementossifying dysplasia. Ossifying fibroma of is a rare benign tumor of the jawbones consisting of fibrous connective tissue with sites of calcifications resembling bone andor cement12,26. It is defined as a welldemarcated and occasionally encapsulated. A total of 80 patients who were diagnosed either as cementifying fibroma cf, of and cementoossifying fibroma cof of the jaws from the files of the oral pathology department of the university of the witwatersrand dental school were retrieved.
The tumor caused displacement of first right premolar with disappearing of its lamina dura. Cementifying fibroma is designated as a benign form of fibroosseous lesions with well circumscribed, slow growing and sharply defined margins. Ossifying fibroma of is a slowgrowing, benign lesion of bone most commonly associated with the jaws. Mandibular cementifying fibroma and cementoblastoma 5478 int j clin exp med 2017. Multicentric peripheral ossifying fibroma request pdf. Cementoossifying fibroma was initially classified by the world health organization who as a fibroosseous neoplasm. Most of the lesions typically show slow and often expansile growth. Extensive presentation of central ossifying fibroma treated. They are included in the group of mesodermal odontogenic. The term cementifying fibroma was originally applied to the lesion of the mandibular incisor teeth now referred to as periapical cemental dysplasia pindborg and hjortinghansen 1974. Case report, australian dental journal on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Largely unknown for sporadic ossifying fibroma can rarely show syndromic inherited association. Today, however, the term cementoossifying fibroma is widely used because both osseous and cemental tissues are seen commonly in a single lesion. Cementoossifying fibroma more c, thakkar k, asrani m.
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. Jan 14, 20 the concept of fibroosseous lesions of bone has evolved over the last several decades and now includes two major entities. Peripheral odontogenic fibroma is an uncommon neoplasm that is believed to arise from odontogenic epithelial rests in periodontal ligament or attached gingiva itself. Central cementifying fibroma is a bony tumor, which is believed to be derived from the cells of the periodontal ligament.
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. Other synonyms of cementoossifying fibroma besides ossifying fibroma include 7. The term cementifying fibroma has sometimes been used to describe ossifying fibromas in which cementum is prorninent, often in the form of irregular particles termed cementicles. Fibroma, ossifying definition of fibroma, ossifying by. However, among the new theories and contentions, there is now essential agreement that the osseous dysplasias represent a single disease process, while the socalled juvenile active.
Peripheral ossifying fibroma pof is one of the several common reactive hyperplastic inflammatory lesions of the gingiva. It is very closely related to other fibroosseous lesions like fibrous dysplasia, cemental periapical dysplasia and other calcifying odontogenic cysts and tumour. Sep 01, 2019 the tumor caused displacement of first right premolar with disappearing of its lamina dura. The histological pattern of these lesions varies with the stages. Cementoossifying fibroma is a rare benign tumor most often discovered incidentally. Aug 28, 2019 a case of cementoossifying fibroma involving the right mandible is described in a 30 yearold female patient. Eversole fibro osseous lesions are a diverse group of processes that are characterized by. Cementifying fibromas are benign osteogenic neoplasms originating from the periodontal ligament, and composed of fibrous tissue, amounts of. Cementifying ossifying fibroma belonged to the osteogenic group of. 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. 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. Central cementifying fibroma of maxilla request pdf. Cementoossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fi brous dysplasia and cementossifying dysplasia 1. Mandibular cementifying fibroma and cementoblastoma 5477 int j clin exp med 2017.
A case report shivjot chhina, ajit singh rathore, puneet ahuja abstract introduction. Cementoossifying fibromas cofs are benign lesions affecting the jaws. Peripheral ossifying fibroma has to be differentiated from traumatic fibroma, peripheral giant cell granuloma, pyogenic granuloma, and peripheral odontogenic fibroma. We use cookies to offer you a better experience, personalize content, tailor advertising, provide social media features, and better understand the use of our services. Central cementoossifying fibroma behaves like, a benign bone neoplasm. Department of oral medicine, diagnosis and radiology, k. It is more likely to affect women in their third and fourth decades. When bone was predominated, ossifying fibroma was assigned. The ossifying and cementifying fibromas are differentiated by their clinical, radiological, and histological findings. Cementifying fibroma clinical characteristics, histological features and correlation article pdf available in srpski arhiv za celokupno lekarstvo 6suppl. The peripheral ossifying fibroma pof is a relatively uncommon reactive lesion of the gingiva, associated with mineralization and derived from the periodontal ligament cells 6. They tend to persist or increase in size as the child grows but decrease in size or close once growth ends. It is most commonly seen between the third and fourth deca des of life 26, and is more frequent in women than in men 4. Central ossifying fibroma is a benign neoplasm that may arise from the fibroblasts of the periodontal ligaments.
Fibro osseous lesions classifications, pathophysiology. A 36 year old female with giant cementifying fibroma is presented. The pathological examination confirmed the ossifying fibroma. Surgical enucleation with curettage of the lesion of the patient mentioned in this case report. Ossifying fibromas are benign bone lesions that should be differentiated from nonossifying fibromas and fibrous dysplasia. It represents upto 2% of all lesions that are biopsied. Occasionally treated by curettage enucleation, this conservative. Pdf cementoossifying fibromas are rare fibroosseous benign neoplasms that affect the jaws. Cementifying fibroma article about cementifying fibroma by. Here we present a case of 18year old female having slow growing painless swelling on left side of mandible over 2year period. 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. The varying clinical presentations of peripheral ossifying.
Other terms used to describe this lesion include peripheral cementifying fibroma. It originates in the cells of the periodontal ligament and is more common in children and young adults. Peripheral ossifying fibroma is a gingival growth, usually arising from interdental papilla and occurring frequently in the anterior maxilla. Cementifying fibroma definition of cementifying fibroma. Other terms used in reference to pof are peripheral cementifying fibroma, peripheral fibroma with cementogenesis, peripheral fibroma with osteogenesis, peripheral fibroma with calcification, calcified or ossified fibrous epulis, and calcified fibroblastic granuloma. Peripheral cementoossifying fibroma is a relatively rare tumour classified between fibroosseous lesions. Request pdf central cementifying fibroma of maxilla central cementifying fibroma is a bony tumor, which is believed to be derived from the cells of the periodontal ligament. Multifocal multiquadrant expansile cementoossifying fibroma lesions of the jaws which can be massive extragnathic skeletal abnormalities variably described as osteopenia, osteogenesis imperfecta, fragile and brittle bone disease that lead to multiple fractures, bowing and cortical thickening of the tubular bone. Ossifying fibroma of the orbital roof its distinction from blistering or intraosseous meningioma harold z. Central cementoossifying fibroma is a fibroosseous lesion causing slow expansion of the involved bone and is usually manifested after attaining significant growth.
Slow and progressive, cementoossifying fibroma is a rare benign tumor that reaches the maxilla and more frequently the mandible. Almost all cases of ossifying and cementifying fibromas reported previously occur as a solitary lesion. Fibroosseous neoplasms of uncertain or detectable relationship to those arising in the periodontal ligament a. The differential diagnosis for a localized gingival overgrowth is shown in table 1 5, 7, 11,15,16. Aarthinisha sree balaji dental college and hospital, bharath university, chennai, india abstract. Ct scan findings revealed a bony expansion due to a huge multiloculated mass with varying density figure 3. Cementoossifying fibroma of paranasal sinus presenting acutely as orbital cellulitis khanna et al. Central cementoossifying fibromas of the mandible are common. Clinically, it is a large asymptomatic tumor of aggressive appearance, with possible tooth displacement. Other terms used to describe this lesion include peripheral cementifying fibroma, peripheral fibroma with cementogenesis, peripheral fibroma with osteogenesis, peripheral fibroma with calcification, calcified or ossified fibrous epulis and calcified fibroblastic granuloma.
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