The occurrence of osseous, fibrous, and fibro-osseous lesions in the jaw bones might pose challenges for accurate diagnosis and the selection of the best therapeutic approach. Certain radiolucent, radiopaque, or mixed-origin lesions can look very similar to other bone lesions, because of the stages of their growth, calcification, maturation, and possible local factors affecting the lesion. Ossifying fibroma (OsF, OF) is a type of fibro-osseous lesion, whose radiological characteristics might sometimes be uncertain. It may appear on classic radiographs and cone beam computed tomography as a radiolucent/ radiopaque lesion with calcification bodies or a shape with a cloud-like appearance. The appearance is mostly related to the lesion’s maturation level, calcification stage, and number of fibrous elements. Diagnosis might be challenging. Its histopathological evaluation reveals a combination of mineralized and fibrous connective tissues in the mass. From a radiological point of view, because of the tumor’s various stages of bone remodeling, formation, and resorption, diagnosis might be troublesome. Different diagnoses should include cemento-osseous dysplasia, fibrous dysplasia, or cementoblastoma. A biopsy could provide an accurate histopathological examination, improving diagnosis and influencing later surgical approaches. Regardless of the final specimen evaluation, surgery is the treatment of choice. The authors would like to present the correlation between radiological and histopathological data in tumor treatment outcomes.
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