PMC3124289_01
The tumour in the right hard palate.
IJD2011-384578.001.jpg
PMC3124289_01_IJD2011-384578.001.jpg
fig1
Oral examination revealed a firm, painless mass located on the posterior hard palate, contiguous with the maxillary first molar (Figure 1).
(a) The tumour contained low-density and cemental regions. (b) CT showing penetration into the nasal cavity and maxillary sinus. (c) The tumour showed rapid expansion over 2 months.
IJD2011-384578.002.jpg
PMC3124289_01_IJD2011-384578.002.jpg
fig2
A computed tomography (CT) scan showed a 2.9 cm x 2.7 cm x 2.6 cm well-circumscribed mass involving the roots of the right maxillary first molar (Figure 2(a)). The tumour consisted of low-density cemental regions that penetrated into the nasal cavity and maxillary sinus (Figure 2(b)). Two months after the first visit to our hospital, the oral examination and CT showed rapid expansion (0.5 cm) of the tumour (Figure 2(c)).
(a) Nine years after surgery, the patient has a normal appearance although the right corner of the mouth is slightly higher than the left. (b) CT taken at 9-year followup, showing the defect in the maxilla and no recurrence of tumour.
IJD2011-384578.003.jpg
PMC3124289_01_IJD2011-384578.003.jpg
fig3
Nine years after the operation, the right corner of the patient's mouth was slightly higher than the left corner, because of scarring, but there have been no developmental disorders of the right maxillary region (Figure 3(a)), and the tumour has not recurred (Figure 3(b)).
(a) The tooth root was embedded in the tumour mass. (b) The periphery of the cementoblastoma showed numerous cementoblasts forming cementum-like mineralized tissue with basophilic reversal lines (H.E.).
IJD2011-384578.004.jpg
PMC3124289_01_IJD2011-384578.004.jpg
fig4
Macroscopically, the surgical specimen consisted of 3.5 x 3.3 x 3.0 cm, a rounded hard tissue mass confluent with the first molar tooth roots (Figure 4(a)). Microscopic examination revealed the tumour to be characterized by sheets of cementum-like tissue that contained a large number of basophilic reversal lines, surrounded by well-vascularised cellular connective tissue with abundant large cementoblasts (Figure 4(b)).