Periapical cemento-ossifying fibroma: a case report

Cemento-ossifying fibroma (COF) mimicking a periapical chronic inflammatory lesion is rare. This report aimed to describe a case of periapical COF. A 22-year-old male patient was referred for the evaluation of a mandibular radiolucent lesion identified during a routine radiographic examination. Panoramic radiography revealed a well-defined unilocular radiolucent lesion in the periapical region of the left mandibular canine, and central and lateral incisors, which presented pulp vitality. The canine presented root resorption. Under local anesthesia, a conservative surgical treatment was performed, which consisted of the enucleation of the entire lesion. Microscopically, a richly cellular fibrous tissue, containing mineralized material with a basophilic sphere appearance, was observed, along with immature bone trabeculae surrounded by osteoblasts. Thus, the final diagnosis of COF was established. The patient is under clinical-radiographic follow-up, showing no signs of recurrence after 4 years. COF should be considered in the differential diagnosis of periapical radiolucent lesions. Cemento-ossifying fibroma (COF) mimicking a periapical chronic inflammatory lesion is rare. This report aimed to describe a case of periapical COF. A 22-year-old male patient was referred for the evaluation of a mandibular radiolucent lesion identified during a routine radiographic examination. Panoramic radiography revealed a well-defined unilocular radiolucent lesion in the periapical region of the left mandibular canine, and central and lateral incisors, which presented pulp vitality. The canine presented root resorption. Under local anesthesia, a conservative surgical treatment was performed, which consisted of the enucleation of the entire lesion. Microscopically, a richly cellular fibrous tissue, containing mineralized material with a basophilic sphere appearance, was observed, along with immature bone trabeculae surrounded by osteoblasts. Thus, the final diagnosis of COF was established. The patient is under clinical-radiographic follow-up, showing no signs of recurrence after 4 years. COF should be considered in the differential diagnosis of periapical radiolucent lesions.