Imaging Sci Dent.  2015 Jun;45(2):109-115. 10.5624/isd.2015.45.2.109.

Central odontogenic fibroma (simple type) in a four-year-old boy: atypical cone-beam computed tomographic appearance with periosteal reaction

• Anbiaee N
• Ebrahimnejad H
• Sanaei A

• KMID: 2054213
• DOI: http://doi.org/10.5624/isd.2015.45.2.109

Abstract

Central odontogenic fibroma (COF) is a rare benign tumor that accounts for 0.1% of all odontogenic tumors. A case of COF (simple type) of the mandible in a four-year-old boy is described in this report. The patient showed asymptomatic swelling in the right inferior border of the lower jaw for one week. A panoramic radiograph showed a poorly-defined destructive unilocular radiolucent area. Cone-beam computed tomography showed expansion and perforation of the adjacent cortical bone plates. A periosteal reaction with the Codman triangle pattern was clearly visible in the buccal cortex. Since the tumor had destroyed a considerable amount of bone, surgical resection was performed. No recurrence was noted.

Keyword

Fibroma; Odontogenic Tumors; Cone-Beam Computed Tomography

MeSH Terms

Bone Plates
Cone-Beam Computed Tomography
Fibroma*
Humans
Jaw
Male
Mandible
Odontogenic Tumors
Recurrence

Figure

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  Fig. 1 A panoramic radiograph shows a poorly-defined radiolucent lesion in the posterior mandibular region, perforating the inferior mandibular cortex.

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  Fig. 2 Axial cone-beam computed tomography images show lingual expansion and perforation of the buccal and lingual cortical plates. Note the periosteal reaction (Codman triangle) in the buccal cortex (arrows).

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  Fig. 3 Panoramic (A) and cross-sectional (B) reformatted cone-beam computed tomography images show a multilocular lesion with some faint septae. The lesion has perforated the lingual, buccal, and inferior mandibular cortical plates, the cortical outlines of the follicles of the molars, and the inferior alveolar nerve canal. Periosteal new bone formation is seen in the buccal cortical plate (arrows).

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  Fig. 4 Plump fibroblasts (arrow) within a collagenous background. No epithelial remnants are found (H&E stain, 100×)

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  Fig. 5 Fibrous stroma with fibroblastic cells. Some myxoid changes (asterisks) in the stroma, normal bone trabecules containing osteocyte lacunae (arrowheads), and osteoblastic margins (arrows) are seen (H&E stain, 100×)

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  Fig. 6 Postoperative panoramic radiograph.

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  Fig. 7 One-month follow-up radiograph. The infected bone graft had been removed.

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  Fig. 8 A six-month follow-up panoramic radiograph shows the patient's stable condition with no recurrence.

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