Juvenile trabecular ossifying fibroma involving mandibular angle and ramus region

Abstract

Juvenile ossifying fibromas (JOFs) are the fibro-osseous lesions known to occur in children. Although benign, they are locally aggressive and are known to reoccur. They have two microscopic patterns; trabecular and psammomatoid. Here, we report a case of JOF in a 4-year old male patient who reported to our department with a chief complaint of swelling over the right side of the lower third of his face.

An unusual case report of a painless hard swelling in the angle of the mandible– An enigma in diagnosis

“…42% were radiolucent, 24% were radiopaque and 34% had mixed appearance. Three different patterns of radiographical borders were reported by Su et al 8 A defined lesion without a sclerotic border (40%), a well-defined lesion with a sclerotic border (45%), and a lesion with an ill-defined border (15%).Our case showed a well defined lesion with mixed radiographic appearance and periosteal reaction which can be misdiagnosed and mismanaged because of its rapidly progressive and osteolytic nature. There is no consensus on the treatment of JOF cases.…”

“…In the mandible, the angle and ramus are the most common sites of involvement. 8 In our case there is no history of trauma or tooth involvement. It was slow growing and mandible was affected.…”

“…The term ''Juvenile Ossifying fibroma'' was first used by Johnson in 1952 7 to describe aggressive forms of ossifying fibroma that occurred in the craniofacial bones of children It is known by a variety of terms, , juvenile aggressive ossifying fibroma, trabecular osteo desmoblastoma, Juvenile active ossifying fibroma, and active fibrous dysplasia. 8 It is a locally aggressive lesion and known to have recurrence rate from 30% to 58%, and these are generally seen at early stage and these are more aggressive than the primary lesions however malignant transformation has not been reported in literature so far. 9 This aggressive rate can be attributed to the increased rate of osteoblastic and osteoclastic activity in children but there are few cases of JOF reported in adults.…”