Cementifying fibroma - clinical characteristics, histological features and correlation

. Cementifying fibroma (CF) is a fibro-osseous lesion which produces cementum. OBJECTIVE. The aim of the current study was to further refine its clinical and histological features and to make clinico-pathological correlations. METHOD. The authors report 10 cases of cementifying fibroma diagnosed at the Institute of Pathology, School of Medicine, University of Belgrade, during 15 years (1995-2005). RESULTS. CF showed no sex predilection (5 males and 5 females). The youngest patient was a 14-year old male, and the oldest was a 54-year old female (the average years were 27.1). The maxilla was the most frequent site (80%). Only one patient had a lesion in the baseos cranii with invasion of sella turcica. All the patients reported history of pain and oedema lasting from 3 to 20 months (medium 10.4 months). Other clinical symptoms were: face assymetry, tooth dislocation and bulbus protrusion. The evolution of the tumour was longer and clinical course indolent in the patients with the mandibular localisation (mandible - 12.3 months, maxilla - 9.5 months). Clinical course and duration of history were in correlation with the histological feature of CF. The main histomorphological diagnostic criterion for CF was psammoma-like structures. Their number and mineralisation of bone spherules varied during the tumour maturation. In old lesions, the number of ?psammomatoid? bodies increased with long anamnesis. On the contrary, dramatic clinical symptoms were described in the CF with stromal haemorrhage and inflammation. We had one patient with secondary superposition of aneurysmal bone cyst in the prime CF. CONCLUSION. Differential diagnosis of cementifying fibroma and other fibro-osseous lesions of cranial bones by histological evaluation only is often difficult and asks for permanent cooperation between clinical doctors and pathologists.