Ossifying fibroma of the maxilla: A case report with literature review

Abstract

Ossifying fibroma is a benign fibro-osseous lesion arising from the periodontal ligament cells. The lesion may progressively enlarge with the mass affecting the mandible or maxilla, resulting in facial deformities and tooth displacement despite its benign nature. Here, we presented a case of an 18-year-old female with ossifying fibroma in the maxilla extending to the maxillary sinus, infraorbital area, and skull base, resulting in considerable facial asymmetry. Since the primary treatment of ossifying fibroma is surgical resection, it is essential to determine the areas where the lesion has expanded, where a 3-dimensional computed tomography scan could play a critical role in providing such information. A complete surgical excision and histopathologic examination in treating this patient are crucial, made possible by a meticulous preoperative radio imaging technique.

Keywords: Fibro-osseous lesion; Maxilla; Ossifying fibroma.

Fig. 1

Ossifying fibroma. (A) The intraoral picture shows a lump in the right maxillary region, (b) orthopantomography.

Fig. 2

Ossifying fibroma. (A) Intraoral inspection shows a slow-growing lesion of the right maxilla. (B) Noncontrast axial CT image demonstrates extensive bone expansion with intact cortex and corticomedullary differentiation of the right maxilla to alveolar process with a clear margin, (C) noncontrast coronal CT image and (D) noncontrast sagittal CT image demonstrates diffuse radiopaque lesion with a mixed bone density characteristic filling the maxillary region extending to the infraorbital and lateral nasal.

Fig. 3

Ossifying fibroma (A, B). Incisional biopsy for histopathologic diagnosis. The histopathologic image suggests ossifying fibroma, H&E section (C) 100× and (D) 400× original magnification.

Fig. 4

(A-E) Ossifying fibroma. CT scan with 3-dimensional formatted images of the maxilla shows mixed density, well-circumscribed bone extending to the right maxillary and sphenoid sinus, right sphenoid bone, and pterygoid bone into alveolar processes.