Peripheral ossifying fibromas: a series of 500 cases.

OBJECTIVE

To characterize the clinical and histopathologic features of peripheral ossifying fibromas (POFs).

STUDY

DESIGN

A retrospective search of the archives of our diagnostic oral pathology service was performed for POFs diagnosed from January 1, 2017 to September 1, 2025.

RESULTS

There were 500 POFs in 474 patients. The female-to-male ratio was 1.6:1, and the mean age was 35.6 years. The anterior maxilla was the most common location. The majority of lesions were pink to red in colour, with a pedunculated base. They were frequently ulcerated (69.8%). Possible local and systemic contributing factors were reported in 16.6% of POFs, including 17 pregnant patients. Pyogenic granuloma (PG) was the most common entity included in the clinical differential diagnosis. Recurrence was documented in 13.9% of patients.

CONCLUSIONS

To the best of our knowledge, this is the largest and most comprehensive series of POFs reported in the literature. Novel findings included POF development in pregnant patients, which is a setting classically associated with PGs. Additionally, we described a subset of recurrent POFs in which the histologic features of the initial excision specimen were not diagnostic for a POF. It is important for both clinicians and pathologists to be aware of these phenomena.