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Table 1 Differential diagnosis: Odondogenic fibroma and similar fibrous lesions of jaws.

From: Central odontogenic fibroma: a case report with long-term follow-up

Features Central odontogenic fibroma Desmoplastic fibroma Odontogenic myxoma Ameloblastic fibroma Adenomatoid odontogenic tumor
Origin odontogenic ectomesenchyme Fibroblastic/myofibroblastic odontogenic ectomesenchyme Odontogenic epithelium and odontogenic ectomesenchyme Odontogenic epithelium
Pathology Interwoven bundles of collagen embedding variable amount of scattered fibroblasts. Many nests and strands of inactive-looking OE** and calcifications can be found [13]. Interlaced bundles and whorled aggregates of densely collagenous tissue containing uniform spindled and elongated fibroblasts/myofibroblasts [2]. Stellate and spindle-shaped cells in a rich myxoid or mucoid stroma with few collagen fibrils. Few OE islands may be present [3, 27]. Branching and anastomosing proliferative OE with peripheral rim of columnar cells in a primitive connective tissue stroma without hard tooth formations [23]. Variably sized solid nodules of cuboidal OE conspicuously with duct-like structures. Eosinophilic amorphous material called "tumor droplets" can be found [28, 29].
Presentation # 1.5% of odontogenic tumors [4] Age: 34.9+19.6 [12] M:F *= 1:2.8 [12] Maxilla and mandible in equal proportions, being most affected posterior (73.5%) and anterior (73.5%) regions, respectively [5, 11]. Less than 1% of bone tumors [21, 30] Age: 15.1+12 [12, 30] M:F = 1:1.2 [7, 12] 15% may be painfull [21] Locally invasive and aggressive Almost mandible (84%), and in posterior portion of both jaws [21, 30] 3-20% of odontogenic tumors [4] Age: 31.3 [31] M:F = 1:2.3 [27] 25% may be painful [27] Locally invasive and aggressive Mandible (63%) at posterior region and maxilla at premolar region [31]. 1.6% of odontogenic tumors [3] Age: 9.6 [23] M:F = 1.26:1 Expansive growth Mandible (80.5%) posterior (73.5%) [23]. 1.7-7% of odontogenic tumors9, OMS Age:13.2 [28] M:F = 1:2.6 [28] The absence of a tooth is observed Maxilla (twice mandible) at anterior region (92.3%) [32]
Radiology Well-defined radiolucency, unilocular in smaller (average of 2.2cm) and multilocular in larger (average of 4.2cm). Pinpoint calcifications may be present in 12% [3]. Well-defined, almost multilocular radiolucency (76%), more likely to involve bone expansion and boundary destruction [21]. Multilocular (60-80%) as "honeycomb", "soap bubble" or "tennis racket" aspect with well-defined borders. Lesions lower than 4.0 cm may be unilocular [22, 27, 31]. Well-defined, uni/multilocular radiolucency, in most cases exhibiting a radiopaque boundary [23, 24]. unilocular radiolucency associated with the crown and often part of the root of an unerupted tooth, with displacement of neighbouring teeth [28]
Therapy/prognosis Curettage/excellent Surgical resection/tendency of recurrence [21] Surgical resection/tendency of recurrence [22] Surgical resection/tendency of recurrence; malignant transformation in 11.4% [23, 25]. Curettage/excellent [28, 29, 32]
  1. # All tumors generally depicted asymptomatic swellings. *M:F = Masculine:Feminine.**Odontogenic epithelium.