Abstract
Juvenile ossifying fibroma is a benign fibro-osseous lesion commonly affecting the extra-gnathic craniofacial skeleton of the young individuals. The psammomatoid and trabecular variants are its two histopathological subtypes having distinctive clinico-pathological characteristics. Secondary aneurysmal bone cysts are frequently reported to arise in the pre-existing fibro-osseous lesions but rarely reported in the psammmomatoid variant of the juvenile ossifying fibroma. Such hybrid lesions, especially massive in size, tend to exhibit a greater aggressive growth potential and higher recurrence rate and mandate complete surgical removal of the lesion along with a long-term follow-up. The objective of this case report was to present a rare incident of recurrent psammomatoid ossifying fibroma associated with a secondary aneurysmal bone cyst in the maxillary jaw bone of a young patient and review the similar published reports in the English literature.
Highlights
Benign fibro-osseous lesions (BFOLs) are characterized by a fibro-cellular stroma with varying degree of mineralized material leading to the replacement of physiological bone architecture with fibro-osseous tissue
To best of our knowledge, the present report is the seventh case of PsJOF with secondary aneurysmal bone cyst (ABC) and the first case to be reported in the maxillary jaw
Juvenile ossifying fibroma (JOF) is hypothesized to originate from the overproduction of the myxo-fibrous cellular stroma which is otherwise involved in the physiological growth of the septae in the paranasal sinuses as they enlarge and pneumatize
Summary
Benign fibro-osseous lesions (BFOLs) are characterized by a fibro-cellular stroma with varying degree of mineralized material leading to the replacement of physiological bone architecture with fibro-osseous tissue. ABC is described as an osteolytic lesion comprising of variable sized blood-filled spaces separated by connective tissue septa containing trabeculae of osteoid tissue and osteoclasts It can occur de novo or secondary to other existing bone lesions. The preliminary case history revealed that the patient had undergone surgical excision of a small swelling in the maxillary anterior region of the jaw 2 years back at a private hospital. The orthopantomogram revealed a ground glass appearance with ill-defined borders over the anterior region of the maxilla extending to the left quadrant The computed tomography scan showed an expansile lesion involving the alveolar arch of the left maxilla and extending into the pre-maxillary region and hard palate. Thereafter, the patient is in regular followup for past 3 years with no recurrence
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