J Korean Assoc Oral Maxillofac Surg.  2024 Oct;50(5):292-296. 10.5125/jkaoms.2024.50.5.292.

Peripheral ossifying fibroma arising from the maxillary bucco-palatal gingiva in an elderly male patient: a rare case report

• An SY
• Kim CM
• Sung CH
• Kim CH

• KMID: 2560825
• DOI: http://doi.org/10.5125/jkaoms.2024.50.5.292

Abstract

Peripheral ossifying fibroma (POF) is a benign tumor characterized by dystrophic calcification or ossification within the gingiva, primarily affecting the anterior maxilla of females and young adults. Its pathogenesis is unclear but linked to local irritants such as trauma, biofilm, dental calculus, and poorly fitting prostheses. In this study, a 63-year-old male presented at Dankook University Dental Hospital with a large nodular lesion on the left maxillary bucco-palatal gingiva. Preoperative imaging, including panoramic radiography and cone-beam computed tomography, was performed. Surgical excision and histological examination confirmed POF with specific morphological characteristics, including mineralized tissue with varied deposition patterns, mature and immature bone, cementum-like tissue, and dystrophic calcification. In conclusion, POF is a rare oral tumor, more common in younger females, typically presenting asymptomatically on the anterior maxilla. Histopathological analysis is crucial for diagnosis. Standard treatment involves conservative local resection, but recurrence rates range from 8% to 20%, necessitating continuous follow-up. This report aims to enhance understanding of POF by presenting a rare case of a large POF in the maxillary posterior bucco-palatal gingiva of an elderly male.

Keyword

Ossifying fibroma; Gingiva; Neoplasms; Maxilla; Pathology

Figure

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  Fig. 1 Pre-operation panoramic view. Partial alveolar bone resorption was observed in the area of the upper left teeth (#24-#26), along with radiopaque particles that resemble dental calculus (red circle).

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  Fig. 2 Pre-operation cone beam computed tomography images. A. Axial view of peripheral ossifying fibroma (POF). Radiopaque calcified mass inside the lesion is observed (red arrows). B, C. Coronal view of POF. Note the sclerotic rim formation surrounding calcifications within the mass (red arrows).

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  Fig. 3 Clinical views during operation. A. A nodular and sessile base lesion in upper left gingiva, exhibiting erythematous areas on the buccal aspect and some ulcerative lesion on the palatal surface. B. After excision of the peripheral ossifying fibroma and teeth (#24-#26) closely related to the lesion. C. Application of fibrin sealant after sutures. D. Excised lesion measured 5.0×2.5 cm.

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  Fig. 4 Post-operation panoramic view. Postoperative view after removal of the peripheral ossifying fibroma and extraction of teeth #24-#26 (red circle).

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  Fig. 5 Histopathological findings. A. Immature osteoid with irregular mineralization and cellular stroma (H&E staining, ×40). B. Cementum-like material in fibrous connective tissue stroma (note the red arrows; H&E staining, ×100). C. Moderately cellular with active, proliferating fibroblast, dense fibrous stroma, with foci of calcified spherules corresponding to irregular bony trabeculae (H&E staining, ×200).

Reference

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