Imaging Sci Dent.  2019 Sep;49(3):229-234. 10.5624/isd.2019.49.3.229.

Diagnostic considerations in central odontogenic fibroma of the maxilla: 2 case reports

• Seo YK
• Kang JH
• Lee SR
• Choi YS
• Hwang EH
• Oh SH

• KMID: 2458372
• DOI: http://doi.org/10.5624/isd.2019.49.3.229

Abstract

Central odontogenic fibroma (COF) is defined as a fibroblastic odontogenic tumor characterized by varying density of the tooth epithelium. It is an extremely rare benign neoplasm that occurs in the maxilla and the mandible; only a few reports of COF are available in the literature. Diagnosis of the lesion based only on the radiological features of COF is difficult due to variation in the findings regarding this condition. This report describes 2 clinical cases of middle-aged women with COF. Clinical examination revealed palatal mucosal depression; additionally, oral examination, as well as panoramic radiographs, intraoral radiographs, and computed tomography scans, revealed severe root resorption. This report highlights the clinical and radiological imaging features of COF, with the goal of enabling straightforward differential diagnosis of the lesion by the clinician and thereby appropriate treatment of the patient.

Keyword

Benign Tumor; Diagnosis, Differential; Myxofibroma; Odontogenic Tumors

MeSH Terms

Depression
Diagnosis
Diagnosis, Differential
Diagnosis, Oral
Epithelium
Female
Fibroblasts
Fibroma*
Humans
Mandible
Maxilla*
Odontogenic Tumors
Root Resorption
Tooth

Figure

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  Fig. 1 Case 1. Oral examination shows soft-tissue depression of the upper left lateral incisor and the canine palatal area. Signs of inflammation, such as edema, fluctuation, or redness, are absent.

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  Fig. 2 Case 1. A. A panoramic radiograph shows a radiolucent area with a poorly-defined margin extending from the upper left lateral incisor to the area of the first premolar. B. A periapical radiograph reveals prominent root resorption of the involved teeth.

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  Fig. 3 Case 1. A. A sagittal cone-beam computed tomographic (CBCT) image shows radiolucent osteolysis with an irregular border extending from the upper left lateral incisor to the region of the first premolar, as well as external root resorption of the involved teeth. B and C. The coronal (B) and axial (C) CBCT images show the cortical bone on the labial side with preservation of the thin margin. Palatal soft-tissue depression is observed as a radiolucent shadow (arrows).

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  Fig. 4 Case 1. Scattered islands or chords of odontogenic epithelium are observed in the connective tissue. A. Hematoxylin-eosin staining (original magnification, ×40). B. Hematoxylin-eosin staining (original magnification, ×200).

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  Fig. 5 Case 2. A panoramic radiograph shows a unilocular radiolucent lesion with a well-defined margin extending from the upper left canine to the first premolar region, as well as external root resorption of the first premolar.

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  Fig. 6 Case 2. A. A sagittal cone-beam computed tomographic (CBCT) image shows a unilocular radiolucent lesion with a well-demarcated margin, as well as significant external root resorption of the involved tooth. B and C. Coronal (B) and axial (C) CBCT views show a well-preserved cortical outline of the labial bone. On the palatal side, the shadow of the soft-tissue depression indicates a density similar to that of air (arrows).

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  Fig. 7 Case 2. Islands of odontogenic epithelium are observed in the fibrous connective tissue. A. Hematoxylin-eosin staining (original magnification, ×100). B. Hematoxylin-eosin staining (original magnification, ×200).

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