Large peripheral ossifying fibroma mimicking a malignant neoplasm

Abstract

Objective: the aim of the present paper is to report a large peripheral ossifying fibroma (POF) clinically mimicking a malignant neoplasm. Case report: a 35 yearold female was referred for evaluation of a 6,0 x 4,0 cm reddish partially ulcerated and bleeding exophytic swelling situated in the upper left gingiva and alveolar mucosa, lasting 3 months. Panoramic and occlusal radiographs showed no alterations and computed tomograph scans showed the presence of calcified foci inside the lesion. Clinical diagnosis was peripheral ossifying fibroma and bone-producing neoplasms, including osteosarcoma. An incisional biopsy under local anesthesia was performed and the 5 ?m HE-stained sections revealed a homogeneous proliferation of spindle cells associated with areas of calcified tissue and covered by partially-ulcerated surface epithelium. Conservative complete surgical removal of the lesion was performed and analysis of the surgical specimen confirmed the histological features from the initial biopsy and the diagnosis of peripheral ossifying fibroma. Clinical follow-up showed the area totally repaired and no evidence of local recurrence. Conclusion: malignant neoplasms can be eventually included in the differential diagnosis of oral reactive inflammatory conditions and histological analysis is essential for proper diagnosis and management.