Central Cemento-Ossifying Fibroma in Maxilla: A Telltale- A Diagnostic Dilemma for Pathologist

Central Cemento-Ossifying Fibroma is a benign, non-odontogenic tumour affecting the jaws and other craniofacial bones. In a recent WHO classification, they were classified as fibro-osseous lesion and the term ‘cemento-ossifying fibroma’ was replaced with ‘ossifying fibroma’. These lesions are clinically invariably, encapsulated, painless slow growing mass; occasionally they may present as an aggressive form and can attain an enormous size resulting in facial deformity. It is known to occur more often in females than males, in the 3rd and 4th decade of life. The most common site of occurrence is mandibular premolar/molar region. Radiographically, it appears as unilocular or multilocular radiolucency along with flecks of radiopaque areas. Histologically, it is characterized by fibro-cellular connective tissue with calcifications. Surgical resection is the treatment of choice. This article presents an unusual case of cemento ossifying fibroma of the right maxilla in a 17 years old female patient, and also discusses the diagnostic dilemma for the pathologist to arrive at a diagnosis.