Fibroma Odontogénico Central de Mandíbula: Revisión de la Literatura a Propósito de un Caso / Central Odontogenic Fibroma of the Mandible: A Short Literature Review Apropos of a Case

RESUMEN: El fibroma odontogénico central (FOC) es una neoplasia benigna poco frecuente que representa alrededor del 1.5% de los tumores odontogénicos intraóseos. Su presentación es exclusiva de huesos maxilares. Tiene origen mesodérmico, pudiendo derivar del folículo dentario, ligamento periodontal y/o la papila dental. Tradicionalmente presenta dos variantes histológicas: un tipo que es pobre en epitelio y otro tipo que es rico en epitelio con focos de material calcificado. En la mayoría de los casos muestra un crecimiento lento y progresivo que produce expansión cortical con o sin sintomatología. Radiográficamente es común observar una imagen radiolúcida y unilocular, raramente se pueden exhibir lesiones multiloculares y/o de radiolucidez mixta. El tratamiento indicado en la mayoría de los casos es la enucleación del tumor. El siguiente reporte de caso describe las características clínicas, imageneológicas e histopatológicas de una lesión mandibular con diagnóstico de FOC y cuyo tratamiento realizado fue la enucleación del tumor.

ABSTRACT: Central odontogenic fibroma (COF) is a rare benign neoplasm that accounts for about 1.5% of intraosseous odontogenic tumors. Its presentation is exclusively in the maxillary bones. It has a mesodermal origin, being able to derive from the dental follicle, periodontal ligament and/or the dental papilla. Traditionally, it has two histological variants: one type that is poor in epithelium and another type that is rich in epithelium with foci of calcified material. In most cases it shows a slow and progressive growth that produces cortical expansion with or without symptomatology. Radiographically, it is common to observe a radiolucent and unilocular image, but rarely multilocular lesions and / or mixed radiolucency can be exhibited. The treatment indicated in most cases is the enucleation of the tumor. The following case report describes the clinical, imaging and histopathological characteristics of a mandibular lesion diagnosed with FOC and whose treatment was enucleation of the tumor.

Central odontogenic fibroma: Report of case with immunohistochemical study.

Objectives: To report a case of central odontogenic fibroma (COF) with immunohistochemical study. Clinical Presentation: We describe a case of epithelium‑rich type of COF in the posterior region of the mandible of a 39‑year‑old woman. Immunohistochemical examination showed the odontogenic epithelium to be positive for high‑molecular‑weight cytokeratins, vimentin and CD99, and negative for CAM5.2. The stroma contained some myofibroblasts and many fibroblast‑like cells positive for CD99. Conclusion: Our immunohistochemical findings, and especially the positive expression of vimentin from the epithelial cells of COF suggests that these cells are primordial. Last but not least, the presence of a relative small number of myofibroblasts in the stroma justifies the non‑aggressive behavior of the neoplasm and supports that a part of stromal collagen of COF is produced by these cells.

Central Odontogenic Fibroma in Anterior Maxilla: A Case Report

Central odontogenic fibroma is an extremely rare benign tumor, accounting for less than 0.1% of all odontogenic tumors. The most recent literature review that only 69 cases have so far been reported. This tumor has a slow persistent growth that results in painless cortical expansion clinically, and well defined unilocular or multilocular radiolucent lesion. Root resorption of associated teeth is common, and lesions located between the teeth often cause root divergence. There is occurring tendency to female more than male, and occurring in the mandible and in the maxilla with equal frequency. The treatment is surgical excision with no tendency to undergo malignant transformation. We report a case of central odontogenic fibroma in the maxilla of a 27-year male with literatures review.