School of Dental Medicine, University of Zagreb, Croatian Dental Society - Croatian Medical Association
Abstract
Cemento-osificirajući fibrom gornje čeljusti nije čest tumor. Među promjene s fibroznim i koštanim komponentama ubrajaju se fibrozna
displazija (FD), osificirajući fibrom (OF), cemento-osificirajući fibrom
(COF) i cementirajući fibrom (CF). Čini se da koštano-fibrozne promjene koje nisu FD potječu od parodontne membrane.
U radu je prikazan klinički slučaj mlade žene koja se javila radi
evaluacije tumora u desnom obrazu. Promjena je prvi puta uočena prije četiri godine i rasla je uglavnom prema van. Uklonjena je kirurški, Weber-Fergussonovim pristupom.
Liječničkim je pregledom uočeno povećanje gornje čeljusti i promjena usnoj šupljini, koja je gotovo izravnala jugogingivni žlijeb. Zubi su bili pomični i pomaknuti sa svog mjesta. Vizualizacijskim se tehnikama prikazala masa mekog tkiva u gornjem dijelu desne maksile, koja se probijala u desni maksilarni sinus. Diferencijalnodijagnostički, u obzir su dolazili fibrozna displazija, osteoidni osteom, osteoblastom, kronični sklerozirajući osteomijelitis, ameloblastom, planocelularni karcinom maksilarnoga sinusa, kalcificirajući epitelni odontogeni tumor (Pindborgov tumor) i kalcificirajuća odontogena cista (Gorlinova cista). Histološki je potvrđen cemento-osificirajući fibrom.
U prikazanom slučaju cemento-osificirajućeg fibroma, diferencijalna
dijagnostika zasnovana na kliničkim znacima i konvencionalnim radiografskim pretragama dala je proturječne nalaze. Od ključne je važnosti bila histološka interpretacija, koja je omogućila i ispravno liječenje.Cementoossifying fibroma of the maxilla is an uncommon tumor.
Lesions with fibrous and osseous components include fibrous dysplasia (FD), ossifying fibroma (OF), cementoossifying fibroma (COF) and cementifying fibroma (CF). Fibro-osseous lesions other than FD seem to arise from the periodontal membrane.
We present a clinical case of a young woman referred for evaluation
of a mass in the right cheek. The mass had first appeared 4 years ago and was growing larger inwards. She was treated with surgical resection via a Weber-Fergusson approach.
The physical examination revealed a maxillary enlargement and an
inreaoral lesion which had almost effaced the jugogingival groove. The teeth were moveable and displaced. Imaging studies demonstrated a soft tissue mass in the superior right maxilla which invaded the right maxillary sinus. The differential diagnosis included fibrous dysplasia, osteoid osteoma, osteoblastoma, chronic sclerosing osteomyelitis, maeloblastoma, squamous cell carcinoma of the maxillary sinus, calcifying epithelial odontogenic tumor (Pindborg tumor) and calcifying odontogenic cyst (Gorlin cyst). Histology established a cementoossifying fibroma.
In our case of a cementoossifying fibroma, the differential diagnosis based on clinical manifestations and conventional radiographic studies was controversial. Histologic interpretation was critical, and led to correct treatment
