Cemento-osseous dysplasia with concomitant cemento-ossifying fibroma: a rare case report

Despite rare reports of hybrid tumors containing cemento-ossifying fibroma (COF), its association with florid cemento-osseous dysplasia (FCOD) is very rare. A 38-year-old female presented for treatment of an expansive, tumoral lesion extending from the right mandibular lateral incisor to the first molar. Clinical examination revealed a significant bulging of the vestibular and lingual mandible cortices. CT scans revealed a hypodense, unilocular lesion that was relatively well-demarcated. Also, multiple mixed hyperdense/hypodense lesions were observed in the alveolar process of the jaws. An incisional biopsy was performed, and the microscopic features, together with the clinic-radiologic evaluation, were consistent with the diagnosis of COF. The tumor was resected, and the histopathological analysis confirmed the diagnosis. In continuity with the tumor, trabeculae of osteocementoid material were observed, which were likely related to the FCOD noted in the CT scan. Clinical, surgical, radiologic, and microscopic features supported the final diagnosis of a hybrid lesion, exhibiting characteristics of both COF associated with FCOD. There are no signs of recurrence after two years of follow-up.