Case Report and Literature Review of Juvenile Ossifying Fibroma and Differentiating It from Other Fibro-Osseous Lesions of Jaws

Abstract

Juvenile ossifying fibromas (JOF) are rare, locally aggressive tumours with high potentials of recurrence, most commonly affecting children and young adults. Trabecular and psammomatoid types are the two distinctive variants found.The psammomatoid is a rare variant, affecting paranasal sinuses and orbits. It'saetiology remains unknown and it is characterized by substitution of normal bone by mineralized fibrous tissue. These lesions are usually asymptomatic, well defined clinically and radiologically amenable for enucleation. It is often confused with malignant condition because of its clinical behaviour. CT-scans and preoperative biopsy play an important role. It is distinguished from other fibro-osseous lesions primarily by its age of onset, clinical presentation and aggressive behavior. It is a well-demarcated lesion that differentiates it from fibrous dysplasia. The treatment of choice is a surgical resection.In specific locations, it poses a great treatment challenge so that early diagnosis and multidisciplinary treatment are crucial to improve the prognosis and delay clinical sequelae. Long term follow-up is necessary, considering the high recurrence nature of this tumour. Reported here is a case of a massive juvenile ossifying fibroma of the maxilla in a 26 years old female. A titanium mesh was used to reconstruct the facial contour and orbital floor after surgical resection of involved maxilla, achieving a satisfactory facial appearance.