Abstract
A central odontogenic fibroma (COF) is a rare tumor of odontogenic origin with a diverse histopathology found in both the mandible and the maxilla. It can often be difficult to diagnose; therefore, it is necessary to evaluate the clinical, radiographic, and histopathological analyses of COF and co-relate them in a manner to make definitive diagnosis easier for the treating physician. Herein, we report and discuss the first known case of central odontogenic fibroma in Pakistan: a 16-year-old boy presenting as a hard bony painless swelling of the left mandibular region. It appeared as a large, well-defined unilocular radiolucency on the orthopantomogram, making it indistinguishable from other radiolucent tumors of the mandible. Histologically, the lesion consisted of nests of odontogenic epithelium in between the fibroblastic stroma, confirming a definitive diagnosis of COF. It was treated by conservative surgical excision followed by curettage and no postoperative complications were reported.