a 17-year - old male was referred to our hospital for evaluation of a painless swelling on the right cheek , which had been identified 3 or 4 months earlier . the extraoral examination showed swelling on the right cheek causing some facial asymmetry ( fig . 1 ) . the intraoral examination revealed a slight swelling on the right mandiblular ramus region , extending to the right retromolar area ( fig . the panoramic radiographic examination showed the presence of a multilocular radiolucency with partially ill - defined border between the right mandibular condyle and the distal root of the right mandibular third molar . since the radiolucency was not associated with the crown of the impacted third molar and seemed to involve the mandibular foramen , the first radiologic impression involved neural origin tumor along with more aggressive lesions such as desmoplastic fibroma , juvenile aggressive fibromatosis , or fibrosarcoma ( fig . ct examination showed an expansile solid ovoid slightly enhancing mass involving the right mandibular condyle and ramus , measuring around 3.53.2 cm giving the impression of an ameloblastoma ( figs . 4 - 6 ) . microscopic examination revealed a non - encapsulated tumor consisting of bland fibroblast cells with wavy cytoplasm . a few strands and nests of odontogenic epithelium were observed ( figs . 7 and 8) . based on the clinical , radiographic , and histopathologic findings , the definitive diagnosis was codf . according to covani et al,8 the codf was believed to originate from mesenchymal odontogenic tissue such as dental papilla , periodontal ligament , or dental follicle . considering the histogenesis of the lesion in the who classification,9 it has been suggested that the epithelium - poor type of codf is derived from the dental follicle , whereas the epithelium - rich type arises from the periodontal ligament . the peak incidence of codfs have been observed in the second decade of life and shows a female predilection.10 this lesion was originally thought to occur almost exclusively in the mandible , and was mostly found in the posterior mandible.11 clinically , codf manifests as a painless swelling and has a slow growth that results in cortical expansion.10,11 clinical symptoms such as pain and paresthesia are uncommon.12 radiologically , most cases of codfs are radiolucent , unilocular , and with well - defined borders similar to other radiolucent lesions such as traumatic bone cyst , ameloblastoma , odontogenic cysts , and central giant cell granulomas.13 araki et al14 reported that the diagnosis of codf by radiographic findings was extremely difficult , especially when the lesion was associated with a crown of the unerupted tooth that might resemble a dentigerous cyst . since the present case showed a multilocular radiolucent lesion involving ramus and even condylar process with partially ill - defined borders , the differential diagnosis involved a wide range of pathosis from benign lesions such as ameoloblastic fibroma , odontogenic myxoma to more aggressive lesions such as desmoplastic fibroma , juvenile aggressive fibromatosis or fibrosarcoma . the codf case reported by daniels10 was somewhat bigger in size , however it resembled a dentigerous cyst . handers et al3 reported that there were only two mandibular lesions among the 19 codf cases , and one of the mandibular lesions with a large multilocular radiolucency involving most of the ramus was similar to this case except for the fact that the margin was scalloped and showed well - defined buccal cortical expansion suggesting benign nature of the lesion . kaffe and buchner13 stated that the majority of codfs were unilocular radiolucent lesions with well - defined border , however they might also appear as multilocular lesions and might exhibit a mixed radiolucent - radiopaque appearance with poorly defined or diffused borders in rare cases . the great variability in radiologic appearance of the codfs means that it should be considered in the differential diagnosis of all radiolucencies found in the jaws .
central odontogenic fibroma is a rare odontogenic neoplasm that originates from odontogenic ectomesenchyme . here , a case of central odontogenic fibroma in a 17-year - old male 
 is reported . 
 since the present case showed a multilocular radiolucency with partially ill - defined border between the right mandibular condyle and the distal root of the right mandibular third molar , differential diagnosis involved a wide range of pathosis from benign lesions like ameoloblastic fibroma and odontogenic myxoma to more aggressive lesions such as desmoplastic fibroma , juvenile aggressive fibromatosis , or fibrosarcoma .