A destructive maxillary cemento-ossifying fibroma following maxillofacial trauma

The cemento-ossifying fibroma, a mesodermal type of non-odontogenic tumor, is rarely discussed in the otolaryngologic literature. It is a tumor that is seen more in blacks than in whites, appears largely in the elderly, is chiefly located in the mandibular molar or premolar area and is generally neither aggressive nor excessively destructive. The triggering mechanism for its derivation from aberrant periodontal membrane growth or development from endosteal fibrous tissue remains controversial. We report a case of cemento-ossifying fibroma in a 26-year-old Hispanic male which was located in the posterior portion of the maxilla which destroyed the maxillary bone, orbital floor, and the lateral wall of the nose. One year prior to discovery of the lesion the patient sustained severe facial trauma resulting in facial bone fractures. It may be speculated that the trauma sustained was the critical triggering factor allowing for unchecked growth and destruction associated with an otherwise non-aggressive tumor, which may have been present prior to the traumatic incident.