Desmoplastic fibroma of the mandible

Desmoplastic fibromas of the facial skeleton are the bony counterparts to the soft-tissue desmoid tumors and are almost exclusively confined to the mandible. The diagnosis should be considered whenever a rapidly increasing swelling with little functional disability is noted in the mandible. Historical, clinical, radiologic, and histologic findings must be correlated to establish the correct diagnosis. Every effort must be made to distinguish these lesions from well-differentiated fibrosarcomas. An illustrative case is presented. The treatment of desmoplastic fibromas affecting the facial skeleton should be conservative. Curettage is recommended for small tumors. Wide resections with reconstruction should be reserved for larger lesions and for those that have recurred after conservative treatment.