Calcifying aponeurotic fibroma with bone islands exhibiting hematopoiesis: a case report and review of the literature

Aponeurotic fibroma (AF) was originally described by Keasbey in 1953 as juvenile aponeurotic fibroma, most commonly occurring in the distal extremities. Initially described in children and adolescents, AF is now recognized to occur over a wide age range and at various anatomic sites. A variant of this lesion, termed calcifying aponeurotic fibroma (CAF) has been described. CAF is a slow-growing, solitary, and painless nodule often adherent to tendon, fascia, or periosteum. We report a patient who presented with a firm lobulated mass, portions of which were fixed to the left ascending mandibular ramus. The lesion represented a CAF arising juxtacortical to the mandible, with the calcified component composed of mature bone exhibiting focal areas of hematopoiesis. Additional reports of CAF occurring in the head and neck region are reviewed.