Diagnostico e terapêutica de fibroma cemento-ossificante: relato de caso

Abstract

Cemento-ossifying fibroma is a benign and rare fibro-osseous lesion of the jaws, composed of fibrous tissue, which contains a variable mixture of bone trabeculae, cementum-like spherules, or both. It affects different age groups, but with greater involvement in the third and fourth decade of life. There is a predilection for females, with the mandible being more affected than the maxilla. It presents slow and painless growth that, when reaching large proportions, results in facial asymmetry. Radiographically, it appears as a unilocular lesion with well-defined sclerotic margins, which may be radiolucent with varying degrees of radiopacity inside. Histologically, bone trabeculae and globules of permeated cement-like material are seen against a background of fibrous connective tissue. Based on clinical, radiographic and histopathological data, a cemento-ossifying fibroma was concluded. Therapy will depend on the severity of each case. The present work aims to report the case of a 20-year-old patient with an asymptomatic swelling in the posterior region of the mandible. Clinically, there was an increase in intra and extra-oral volume in the region of the left mandibular body. The CT scan showed a hypodense multilocular lesion with hyperdensity variations within the lesion. An incisional biopsy was performed and microscopic analysis showed fragments composed of dense connective tissue permeated by areas of deposition of bone matrix in globules and short trabeculae. Diagnosis of central ossifying fibroma. The treatment of choice was partial segmental resection, with short, medium and long-term postoperative follow-up.