A Rare Presentation of Cemento-ossifying Fibroma with Inherent High Flow Vascular Malformation: A Wolf in Sheep’s Clothing

Abstract

Background: Cemento-ossifying fibroma (COF) is a rare subtype of benign fibro-osseous lesions predominantly affecting the craniofacial region. But tumor with combination of COF and vascular malformation has not been described in literature. Case: Following is the case of 14-year-old female patient with extensive COF of right maxilla encroaching orbit, maxillary antrum, nasal cavity, and zygoma. During course of careful investigations, embedded vascular malformation based on right maxillary and facial artery was diagnosed, in which aspiration cytology played crucial role. After confirmation by computed tomographic (CT) angiography, proper vascular control was gained by superselective embolization followed by surgical resection as definitive management. © The Association of Oral and Maxillofacial Surgeons of India 2025.