Treatment

Under intravenous anesthetic an incision was made over an intact buccal cortex. An incisional biopsy was performed and the tissue submitted for microscopic evaluation.

Excisional Biopsy

Histologic examination reveals multiple pieces of decalcified hard and soft tissue composed of a fibro-osseous lesion (Figure 3). The specimen is made up of cellular fibrous connective tissue stroma intermixed with calcified bone. The latter is at various stages of development and the trabeculae are of variable shapes and sizes (Figure 4). Osteoblastic rimming is absent in most parts (Figure 5). In many areas, the bony trabeculae show evidence of artifactual retraction from the connective tissue stroma (Figures 3 & 4).

Figure 3 Low power (x40) H & E histology shows a benign fibro-osseous lesion which is made up of strands of spindle-shaped fibroblasts focally forming bone. The bony trabeculae show evidence of artifactual retraction from the connective tissue stroma.

Figure 4 Higher power (x100) H & E histology shows a closer view of the benign fibro-osseous lesion which is made up of strands of spindle-shaped fibroblasts focally forming bone. The bony trabeculae show evidence of artifactual retraction from the connective tissue stroma. Also note the absence of osteoblastic rimming around the bony trabeculae.

Figure 5 Higher power (x200) H & E histology shows strands of spindle shaped cells surrounding bony trabeculae lacking osteoblastic rimming.