JUVENILE TRABECULAR OSSIFYING FIBROMA: CASE REPORT OF AN AGGRESSIVE FIBRO-OSSEOUS LESION

Abstract

Juvenile ossifying fibroma (JOF) is a benign bone-producing fibrous neoplasm of the skeleton. Clinically, children and adolescents are affected without preference for sex. There are 2 clinicopathologic variants, psammomatoid and trabecular (JTOF). JOF can be aggressive, suggesting a malignant neoplasm. A 26-year-old male patient with volumetric increasing of the mandible with a history of evolution of 2 months was referred for evaluation. Intraoral examination showed expansion of both bone cortical of the right mandibular body. Imaginological examinations evidenced a large osteolytic lesion with diffuse and nonsclerotic borders involving the right mandibular angle and body. Diagnostic hypotheses were ameloblastoma, fibrous dysplasia, central giant cell lesion, and JOF. Incisional biopsy was performed, which easily released lesional tissue. Microscopy showed fibrous stroma admixed with varying degrees of immature and mature osseous trabeculae. Final diagnosis was JTOF. The current case shows that strict clinicopathologic correlation is essential to differentiate JTOF from other bone-forming lesions. Juvenile ossifying fibroma (JOF) is a benign bone-producing fibrous neoplasm of the skeleton. Clinically, children and adolescents are affected without preference for sex. There are 2 clinicopathologic variants, psammomatoid and trabecular (JTOF). JOF can be aggressive, suggesting a malignant neoplasm. A 26-year-old male patient with volumetric increasing of the mandible with a history of evolution of 2 months was referred for evaluation. Intraoral examination showed expansion of both bone cortical of the right mandibular body. Imaginological examinations evidenced a large osteolytic lesion with diffuse and nonsclerotic borders involving the right mandibular angle and body. Diagnostic hypotheses were ameloblastoma, fibrous dysplasia, central giant cell lesion, and JOF. Incisional biopsy was performed, which easily released lesional tissue. Microscopy showed fibrous stroma admixed with varying degrees of immature and mature osseous trabeculae. Final diagnosis was JTOF. The current case shows that strict clinicopathologic correlation is essential to differentiate JTOF from other bone-forming lesions.