Concluded Case

Central Ossifying Fibroma

Good Morning Everyone, Let's discuss this case today...!!! 10 years old female patient who reported with C/O painless swelling over the right lower 1/3rd of face since 5 to 6 months. Extraorally, gross facial symmetry evident on right side along with large solitary diffuse swelling involving right submandibular region & crossing midline. Intraorally there is single oval shaped submucosal whitish swelling present in madibular right vestibular region causing partial obliteration of vestibule. On palpation the swelling is bony hard, nontender with intact overlying mucosa. Mandibular occlusal radiograph reveals homogenous radiolucency with expansion of buccal & lingual cortical plates. OPG reveals mixed dentition with canine & premolars in formative stage, solitary radiolucency with thin sclerotic margins along with slight displacement of teeth. What should be the Provisional Diagnosis & Differential Diagnosis based on clinical and radiographical investigations??? kindly share your views. Thanks.

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Concluded answer
Diagnostic guidelines including complete hemogram, serum calcium, serum phosphorus, serum alkaline phosphatase were suggestive of no abnormalities. A clinical diagnosis of benign odontogenic tumor was made. Radiographically, the borders of the lesion were non-corticated, irregular but well defined and showed some amount of scalloping especially in the supero-lateral aspect. These findings led to a radiographic diagnosis of ossifying fibroma. With a working diagnosis of central ossifying fibroma, the patient was advised surgical excision of the lesion. The excised specimen was sent for histopathologic evaluation. Histological examination confirmed the diagnosis by revealing presence of immature bone trabeculae with entrapped osteocytes and lined by a dense rim of enlarged osteoblasts. The patient is under follow-up for last 6 months, and no recurrence has been reported yet.@Hrishikesh Bhowmick Sir, @Abhishek Dubey Sir, @Dr. Ankita Khare , @Dr. Kausar Yadwad , @Dr. Ashish Tiwari , @Dr. Divya Santolia Arya , @Dr. Satish Kumar , @Dr. Kute Ankush Sir, @Dr. Pk Jain Hrh Sir, @Dr. Asha Prakash Mohapatra
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Diagnostic guidelines including complete hemogram, serum calcium, serum phosphorus, serum alkaline phosphatase were suggestive of no abnormalities. A clinical diagnosis of benign odontogenic tumor was made. Radiographically, the borders of the lesion were non-corticated, irregular but well defined and showed some amount of scalloping especially in the supero-lateral aspect. These findings led to a radiographic diagnosis of ossifying fibroma. With a working diagnosis of central ossifying fibroma, the patient was advised surgical excision of the lesion. The excised specimen was sent for histopathologic evaluation. Histological examination confirmed the diagnosis by revealing presence of immature bone trabeculae with entrapped osteocytes and lined by a dense rim of enlarged osteoblasts. The patient is under follow-up for last 6 months, and no recurrence has been reported yet.@Hrishikesh Bhowmick Sir, @Abhishek Dubey Sir, @Dr. Ankita Khare , @Dr. Kausar Yadwad , @Dr. Ashish Tiwari , @Dr. Divya Santolia Arya , @Dr. Satish Kumar , @Dr. Kute Ankush Sir, @Dr. Pk Jain Hrh Sir, @Dr. Asha Prakash Mohapatra
Thank you Doc
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Intriguing Case Dr Salon Arora. P/D based on clinical and radiographic. examination dentigerous cyst, ameloblastoma, central giant cell grannuloma, osteosarcoma,Juvenile ossifying fibroma, fibroosseus dysplasia. After histopathological examination seems more of juvenile ossifying fibroma, cemento osseus dysplasia, cemento ossifying fibroma.
Thanks @Dr. Kausar Yadwad for your valuable opinion. Much appreciated...!!
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Looks more like an Odontogenic tumour rather than a cyst. D/D could be Ameloblastoma, Ossifying Fibroma, Myxoma, Osteosarcoma, fibrous dysplasia, etc. Incisional biopsy should be done as soon as possible to confirm the diagnosis and treatment plan, which will be most likely surgical imho.
Absolutely Sir... I agreed
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
Thank you so much.
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PD- Ameloblastoma DD- KOT, juvenile ossifying fibroma Based on clinical and radiographical representation, Ameloblastoma is suspected. Advice for incisional by.
Thank you mam for your valuable opinion.
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Fibrous dysplasia is wastebasket of FOL LET'S Dd it as Juvenile ossifying fibroma, cemonto dysplasia ameloblastoma. @Saloni Arora
Thanks for your opinion doc
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I would like to give a hint over here, it's a type of fibro-osseous lesion. Now let's discuss the provisional diagnosis and D/D.
Case of Hyperparathyroidism . Advice ,FNAC , Blood sugar F/R/PP , Thyroid functions test T3 ,T4 ,TSH .
Thank you doctor
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This case is incredible and very helpful for me.Thankyou @Dr. Saloni Arora
Thanks for appreciating @Dr. Ashish Tiwari ☺️
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IT'S A..CASE OF.. ? DENTAL PATHOLOGY.. ? CO../ COS.. / ID .. / COD ..
Right @Dr. Kute Ankush Sir
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