[Giant Ossifiant Fibrome Of The Mandibule In The Adolescent At The National Center D'odonto-Stomatologie Of Bamako].

Introduction: Fibroma ossificans are usually well-defined tumours, but are rarely encapsulated. The choice of radical or conservative treatment is a challenge for the maxillofacial surgeon. The aim of this case report was to describe the particularities of the management of a case of ossifying fibroma of the mandible.

Case report: The patient was a 17-year-old housewife with a history of caesarean section. She presented with a mandibular swelling that had been evolving for 6 years, with no other functional signs and no change in general condition. Exobuccal examination revealed a voluminous symphyseal swelling, covered by healthy-looking skin, with a bony consistency and forming part of the mandible. On endobuccal examination, there was a vestibular swelling extending from 36 to 45, covered by healthy-looking mucosa, with the absence of teeth 31, 32, 41, 42 and 43 and mobility of teeth 33 and 34. The hypothesis of a benign tumour of the mandible was raised. A maxillofacial CT scan revealed a heterogeneous image with local areas of hyperdensity and blowing of the external cortex. Treatment consisted of an interrupting mandibular resection via the vestibular approach, followed by transitional reconstruction using a stent graft. Histological examination of the surgical specimen revealed an ossifying fibroma. The outcome was favourable, with no recurrence after approximately 2 years.

Conclusion: Treatment of ossifying fibroids can often be mutilating. It is discussed according to the clinical and radiological characteristics of the lesion.