Cementifying fibroma arising in the maxilla and the mandible: Report of a case

Abstract

A very rare case of cementifying fibroma, which arose in the maxilla and the mandible, was reported. The patient, who was a 27-year-old man, had indolent bone-like hard diffuse swellings from the buccal to palatal site of 6-1 region and in the mucobuccal fold of 6-3 region. Each overlying mucosa was intact. Radiographic examination revealed diffuse mottled radiopaque lesions in the entire right maxillary sinus and relatively well defined radiolucent lesion of egg in size containing cloud-like radiopaque shadows in the body of mandible for 6-3 region.
The lesions were diagnosed as polyostotic fibrous dysplasia from the clinical course and findings, and palliative removal, that was, partial resection or curettage of the lesions was performed under general anesthesia.
Macroscopic findings of the lesions were tumorous, light greyish color, smooth surface and comparatively elastic hard in consistency. Soft X-ray photograph of removed lesions showed existence of calcareous substances which varied in shape and size.
Microscopically, the tumorous lesion consisted of dense fibromatous tissues with numerous round cementicle-like calcareous substances and irregularly shaped cementum-like hard tissues varying in size. Tumor cells were generally spindle-shaped. No bone tissue was seen in the tumor. Therefore, the tumor was histopathologically diagnosed as cementifying fibroma.
It is necessary that discussion on differential diagnosis of this tumor from similar diseases is based on a close correlation of the present history to clinical and radiograhic findings. But, clinically it seems very difficult to discriminate among cementifying fibroma, fibrous dysplasia and ossifying fibroma and these diseases should be histologically diagnosed in the end.