Central odontogenic fibroma in mandible: case report

Abstract

Objective: The present study aims to report a case of central odontogenic fibroma (COF) located in the mandible and to discuss aspects related to etiopathogenesis, clinicopathological features, differential diagnosis and treatment of the lesion. Case report: A 60-year-old female patient was referred for evaluation of a painless swelling in the mandible. Cone beam computed tomography revealed a unilocular hypodense lesion, with hyperdense foci, associated with the unerupted tooth #38. Under the diagnostic hypothesis of calcifying epithelial odontogenic tumor, an incisional biopsy was performed. Microscopic examination revealed moderately cellular fibrous connective tissue, with predominance of densely packed collagen fibers. In areas of the connective tissue, islands and strands of apparently inactive odontogenic epithelium were observed. Based on these findings, the diagnosis of COF was established. The treatment consisted of enucleation of the lesion and curettage of the peripheral bone, with extraction of the associated teeth. No sign of recurrence was observed after 14 months of follow-up. Conclusion: In general, the prognosis for patients with COF is considered good. Nonetheless, reports of recurrence 9 years after surgical treatment make long-term follow-up of patients diagnosed with this neoplasm mandatory.