A 32 year old female presented to an oral surgeon with slight buccal expansion of the mandible. Radiographs revealed a lesion causing divergence of the apices of the two lower left bicuspids. The tumor was well-delineated, exhibited inferior cortical expansion and showed evidence of patchy deposits of calcifications.
Differential Diagnosis:
- Cementifying or Ossifying Fibroma
- Calcifying Odontogenic Cyst
- Calcifying Epithelial Odontogenic Tumor
The round appearance, inferior cortical expansion and presence of hard deposits favor a diagnosis of cementifying or ossifying fibroma although other calcifying lesions should be considered.
Histology:
Slide 1 (low power, H&E). This slide shows variously sized calcified deposits (you can not tell whether it is bone or cementum at this power) with a cellular connective tissue background.
Slide 2 (high power, H&E). The hard material contains osteocytes and appears to be bone. These bone trabeculae are bordered by scattered osteoblasts. The supporting connective tissue is cellular and contains uniform basophilic nuclei.
Diagnosis: Ossifying Fibroma
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