Juvenile psammomatoid ossifying fibroma with fluid\u2013fluid levels: an unusual presentation

Linda Kalliath,Partheeban Balasundaram,Deepthi Padmanabhan,D Karthikeyan,Nataraj Pillai,Gokul Kripesh

doi:10.1186/s43055-021-00570-6

Linda Kalliath, Partheeban Balasundaram + Show 4 more

Open Access

https://doi.org/10.1186/s43055-021-00570-6

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Abstract

BackgroundJuvenile ossifying fibroma is an uncommon benign fibro-osseous tumor commonly involving the craniofacial skeleton of young patients with locally aggressive behavior and a high recurrence rate. Depending on the site of involvement it can present clinically as nasal obstruction, facial swelling, or proptosis.Case presentationHere we present a case of juvenile ossifying fibroma with an aneurysmal bone cyst component in the left nasal cavity in a 15-year-old boy who presented with gradually progressing left-sided nasal obstruction. Imaging findings were consistent with juvenile ossifying fibroma. Endoscopic resection of the tumor was done, and histopathological examination revealed it to be a psammomatoid variant of juvenile ossifying fibroma. Here we discuss its imaging findings, differential diagnosis, treatment options, and histopathological features.ConclusionDespite being a slow-growing benign tumor, early diagnosis and treatment are necessary due to its locally aggressive nature and invasion of adjacent structures. Complete surgical resection is the mainstay of treatment because of the high recurrence rate.

Highlights

ConclusionDespite being a slow-growing benign tumor, early diagnosis and treatment are necessary due to its locally aggressive nature and invasion of adjacent structures
Juvenile ossifying fibroma is an uncommon benign fibro-osseous tumor commonly involving the craniofacial skeleton of young patients with locally aggressive behavior and a high recurrence rate
Complete surgical resection is the mainstay of treatment because of the high recurrence rate

Summary

Conclusion

Juvenile ossifying fibroma despite being benign and slowgrowing behaves in a locally aggressive manner with the invasion of adjacent anatomical structures. The presence of a well-circumscribed lesion with a sclerotic rim and central less dense fibrous core and enhancement of the solid component should raise the suspicion of juvenile ossifying fibroma. Complete surgical resection is the mainstay of treatment because of the high risk of local recurrence which is found to be more aggressive than the primary

Background

Discussion