Ossifying fibroma of the maxilla: A case series

Abstract

Background: Ossifying fibroma is a benign bone neoplasm considered as one of the fibro-osseous lesions of the jaws. It has highly cellular, fibrous tissue that contains varying amounts of calcified tissue, resembling bone, cementum, or both. More common in the second to fourth decades of life. It is believed to arise from the periodontal membrane. It has a predilection towards females. Found more in the mandible than maxilla. Radiographically, the lesions are either completely radiolucent, opaque (and surrounded by a radiolucent rim) or mixed, depending on the amount of calcification. Microscopically, ossifying fibroma presents as trabeculae of woven bone and/or lamellar bone and/or spherules of cementoid in a cellular fibrous connective tissue stroma. Treatment is generally by surgical excision (‘shelling out’). The initial asymptomatic nature of the lesion and low socio-economic status are possible reasons for the late presentation of the cases.

Objective: To present two cases of ossifying fibroma managed surgically under general anaesthesia in our department.

Methods: Surgical excision under general anesthesia

Findings: Each tumor measured more than 10cm by 10cm involving the right maxilla, hard palate, maxillary antrum, zygoma and floor of orbit. The post-operative periods were quite challenging but the patients recovered fully with mild disfigurement. The clinical, radiographical, surgical and histological findings are presented.

Conclusion: Ossifying fibromas are comparatively rare benign tumors of maxillofacial region. They could cause major facial disfigurement if left untreated for a long period. However, its typical encapsulated nature enables its complete removal even when massive. Long term follow up is advocated to detect any recurrence

 Keywords: Ossifying fibroma, Maxilla