Table 1.
Differential diagnosis: Odondogenic fibroma and similar fibrous lesions of jaws.
| Features | Central odontogenic fibroma | Desmoplastic fibroma | Odontogenic myxoma | Ameloblastic fibroma | Adenomatoid odontogenic tumor |
|---|---|---|---|---|---|
| Origin | odontogenic ectomesenchyme | Fibroblastic/myofibroblastic | odontogenic ectomesenchyme | Odontogenic epithelium and odontogenic ectomesenchyme | Odontogenic epithelium |
| Pathology | Interwoven bundles of collagen embedding variable amount of scattered fibroblasts. Many nests and strands of inactive-looking OE** and calcifications can be found [1-3]. | Interlaced bundles and whorled aggregates of densely collagenous tissue containing uniform spindled and elongated fibroblasts/myofibroblasts [2]. | Stellate and spindle-shaped cells in a rich myxoid or mucoid stroma with few collagen fibrils. Few OE islands may be present [3,27]. | Branching and anastomosing proliferative OE with peripheral rim of columnar cells in a primitive connective tissue stroma without hard tooth formations [23]. | Variably sized solid nodules of cuboidal OE conspicuously with duct-like structures. Eosinophilic amorphous material called "tumor droplets" can be found [28,29]. |
| Presentation# | 1.5% of odontogenic tumors [4] Age: 34.9+19.6 [12] M:F *= 1:2.8 [12] Maxilla and mandible in equal proportions, being most affected posterior (73.5%) and anterior (73.5%) regions, respectively [5,11]. |
Less than 1% of bone tumors [21,30] Age: 15.1+12 [12,30] M:F = 1:1.2 [7,12] 15% may be painfull [21] Locally invasive and aggressive Almost mandible (84%), and in posterior portion of both jaws [21,30] |
3-20% of odontogenic tumors [4] Age: 31.3 [31] M:F = 1:2.3 [27] 25% may be painful [27] Locally invasive and aggressive Mandible (63%) at posterior region and maxilla at premolar region [31]. |
1.6% of odontogenic tumors [3] Age: 9.6 [23] M:F = 1.26:1 Expansive growth Mandible (80.5%) posterior (73.5%) [23]. |
1.7-7% of odontogenic tumors9, OMS Age:13.2 [28] M:F = 1:2.6 [28] The absence of a tooth is observed Maxilla (twice mandible) at anterior region (92.3%) [32] |
| Radiology | Well-defined radiolucency, unilocular in smaller (average of 2.2cm) and multilocular in larger (average of 4.2cm). Pinpoint calcifications may be present in 12% [3]. | Well-defined, almost multilocular radiolucency (76%), more likely to involve bone expansion and boundary destruction [21]. | Multilocular (60-80%) as "honeycomb", "soap bubble" or "tennis racket" aspect with well-defined borders. Lesions lower than 4.0 cm may be unilocular [22,27,31]. | Well-defined, uni/multilocular radiolucency, in most cases exhibiting a radiopaque boundary [23,24]. | unilocular radiolucency associated with the crown and often part of the root of an unerupted tooth, with displacement of neighbouring teeth [28] |
| Therapy/prognosis | Curettage/excellent | Surgical resection/tendency of recurrence [21] | Surgical resection/tendency of recurrence [22] | Surgical resection/tendency of recurrence; malignant transformation in 11.4% [23,25]. | Curettage/excellent [28,29,32] |
# All tumors generally depicted asymptomatic swellings. *M:F = Masculine:Feminine.**Odontogenic epithelium.