Ossifying Fibromas of the Craniofacial Skeleton

Ossifying fibromas (OF) of the craniofacial skeleton, as described in WHO classification of odontogenic tumors (2005)(Barnes L 2005), are benign fibro-osseous neoplasms characterized by the replacement of normal bone by a fibrous cellular stroma containing foci of mineralized bone trabeculae and cementum-like material that vary in amount and appearance.(Brannon and Fowler 2001; El-Mofty 2002; Cruz, Alencar et al. 2008) The accurate nature and classification of OF has undergone considerable debate among pathologists, resulting in a confusing evolution of competing nomenclatures.(Brannon and Fowler 2001; Sarode, Sarode et al. 2011) Contemporary reviews have classified benign fibroosseous lesions of the craniofacial complex into neoplasms, developmental dysplastic lesions and inflammatory/reactive processes. [Table 1](Eversole, Su et al. 2008) In this reviews, subtypes vary with regard to behavior and propensity for recurrence after surgical excision. The definitive diagnosis can rarely be rendered on the basis of histopathological features alone and is usually dependent upon assessment of microscopic, clinical and imaging features together. This review will discuss the clinical, microscopic, radiological and therapeutic aspects of ossifying fibromas in this localization.