Desmoplastic Fibroma in maxilla: A Rare Case Report Case with Review of Literature

Introduction: Desmoplastic fibroma is a rare, benign, and locally aggressive, but non metastasizing, tumor with connective tissue origin. It usually presents during the first three decades of life and clinically presents as a slow growing, painless swelling. In the maxillofacial region, the posterior mandible is the most commonly involved site. Clinical and radiographic features often suggest the diagnosis of DF, but definite diagnosis can only be made by histopathological examination.Case Report: A ۲۰-year-old female patient referred to the Department of Oral and Maxillofacial surgery, Alborz University of Medical Sciences, with an expansive mass with pain in the left side of posterior for the past ۶ months. In extra-oral examination, clear asymmetry was observed. The panoramic view showed well defined radiolucent lesion in periapical area of left side of maxilla (Mesial area of first premolar to distal of third molar). According to radiographic view, odontogenic and bone lesions such as ameloblastoma and central giant cell granuloma were considered in differential diagnosis(Figure ۱). Incisional biopsy of the lesion was done under general anesthesia and sent for histopathological examination. Microscopic examination revealed a proliferation of uniform, spindle cells distributed in compact interlacing fascicles showing herring-bone pattern and also disorganized fashion. The fibroblasts are plump but not atypical with absent mitoses (Figure ۲). Based on clinical-radiographic and histopathologic features, desmoplastic fibroma was the final diagnosis. For treatment, an extensive segmental resection in addition to removal of involved surrounding soft tissues was done (Figure ۳). Postoperative follow-up, there was no evidence of recurrence.Discussion DF of bone is comparable with soft tissue fibromatosis or intraosseous counterpart of soft tissue fibromatosis. The most common symptom of DF of the jaw is presence of a painless swelling that causes facial asymmetry. Different treatment methods have been suggested for DF that are the source of controversy. Enucleation, curettage, resection, radiotherapy and chemotherapy are usual implemented treatment modalities. Most clinicians seem to favor surgical resection of the lesion with a wide margin, in order to avoid recurrence.

کلیدواژه ها:

Desmoplastic fibroma ، Maxilla ، Bone lesion ، Jaw