The presence of chronic renal disease (CRD) is a predisposing factor for the occurrence of soft and hard tissue lesions in the oral cavity. The cemento-ossifying fibroma (COF) is an uncommon benign fibroosseous lesion composed of fibrocellular component and calcified materials like cementum and woven bone. A 37-year-old female patient undergoing chronic haemodialysis reported to our institution with a complaint of slow growing, nontender swelling of mandible of 6-month duration. Computed tomography disclosed an ill-defined lesion showing thinning and expansion of buccal as well as lingual cortical plate with flecks of radiopacity in centre. Incision biopsy revealed histological characteristics consistent with cemento-ossifying fibroma. The lesion was excised under local anesthesia. The histopathological examination revealed irregularly shaped bone and cementum-like hard tissue calcifications contained within hypercellular fibrous tissue stroma, leading to a confirmation of the diagnosis of cemento-ossifying fibroma. This paper aims to provide light to the fact that the soft and hard tissues of the oral region may become susceptible to the development of pathological growths in case of some particular systemic conditions. 1. Introduction Chronic renal disease (CRD) can be defined as the progressive and irreversible decline in kidney functions and up to 90% of patients having renal insufficiency may present with oral signs and symptoms in soft and hard tissues either as a result of the disease itself or the treatment protocol [1]. Halitosis, altered taste and sensation, bone demineralization, loss of lamina dura, deep periodontal pockets, changes in saliva and poor oral hygiene are often associated with this condition, based on individual predisposition and the severity of the disease [1]. The knowledge of bone-related oral lesions in CRD patients is limited. Cemento-ossifying fibroma (COF) is a distinct form of benign fibroosseous lesions of the mandible and maxilla containing fibrous tissue and varying amounts of calcified tissue resembling bone, cementum, or both [2]. The pathologic nature of COF is not yet clearly understood. It is included under neoplastic group of fibro osseous lesions thought to arise from periodontal ligament [2]. The aim of this report is therefore to present a case of COF who was also suffering from CRD and describe clinical characteristics of these conditions. 2. Case Report A 37-year-old patient reported to outpatient department of our institution with a complaint of swelling of the lower jaw of six-month duration. There was
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