Cemento-ossifying fibroma of jaws-correlation of clinical and pathological findings

Cemento-ossifying fibroma (COF) belongs to the group of bone-related lesions of the oral cavity. The aim of this study was refine its histologic features and to correlate histopathological picture and clinical behavior of the tumor. The quantity of bone spherules, their cellularity, the existence of hemorrhage, inflammation, and endochondral ossification in the stroma of the tumor were analyzed and correlated with patients main symptoms of ten patients with COF. All patients had swelling that lasted between 3 and 20 months (mean 10.4 months). Other clinical symptoms were facial asymmetry, eye bulb protrusion, and teeth displacement. The evolution of the tumor was longer in the mandible (12.3 months) than in maxilla (9.5 months). The main histomorphological diagnostic criterion for COF was psammoma-like structures. In lesions with longer case history, the number of "psammomatoid" bodies was greater. In lesions with shorter course of the disease, their number was lower and stromal hemorrhage and inflammation were presented. One patient had secondary superposition of aneurysmal bone cyst in the prime COF of mandible. Histological appearance of COF may be influenced by the tumor evolution. A siginificant correlation between the clinical course of the disease and histological parameters has been certified.