Start practicing

Pathology · patient case question

Central ossifying fibroma is best distinguished from its peripheral counterpart by which feature?

Patient case: Cortical Expansion of the Posterior Mandible

demo: 34-year-old male

chief: “The outside of my jaw has been slowly swelling for about a year.”

history: Non-contributory. No pain, no paresthesia.

meds: None

findings: Occlusal radiograph shows buccal and lingual cortical expansion in the posterior mandible. Panoramic view shows a multilocular soap-bubble radiolucency. Clinical images and radiographs shown below.

  1. The central form occurs in the gingiva; the peripheral form occurs in bone
  2. The central form occurs within bone with a well-circumscribed radiolucency containing central ossification; the peripheral form occurs in the gingiva with no radiolucency or radiopacity
  3. The central form requires no treatment while the peripheral form requires resection
  4. Only the peripheral form has a juvenile aggressive variant
Show answer and explanation

Correct answer: B. The central form occurs within bone with a well-circumscribed radiolucency containing central ossification; the peripheral form occurs in the gingiva with no radiolucency or radiopacity

  • A. This reverses the definitions.
  • B. Correct. The central lesion sits within bone, typically between the premolar and molar regions of the mandible, as a well-circumscribed radiolucency with ossified product in the centre — similar in appearance to cementifying fibroma. The peripheral lesion is a soft tissue gingival mass with no radiographic bony change.
  • C. Both forms are treated by surgical excision.
  • D. The juvenile aggressive variant, with rapid growth, is described for the central lesion.

Practice Pathology questions Pathology study notes

More Pathology practice questions