Juvenile Ossifying Fibroma - WHO Type

Juvenile ossifying fibroma is an uncommon clinical entity, its aggressive local behaviour and high recurrence rate mean that it is important to make an early diagnosis, apply the appropriate treatment and, especially, follow the patient up over the long term. In the current article we report a case of juvenile ossifying fibroma-WHO type in 12yr old patient which was clinical and histopathologically challenging as it was asymptomatic and at an unusual location.
Juvenile ossifying fibroma (JOF) term is used for a rare actively growing lesion that mainly affects individuals' younger than15 years of the age [1]. This lesion behaves in an aggressive fashion, reaching massive proportions with extensive cortical expansion. Over time, lesions with this morphology have been variously described as juvenile ossifying fibroma [2],active juvenile ossifying fibroma [3], aggressive ossifying fibroma [4], reticular desmo-osteoblastoma [5] or active fibrous dysplasia [6]. This lesion most commonly involves the paranasal sinuses and periorbital bones, where it may cause exopthalmous, proptosis, sinusitis and nasal symptoms. This rare tumor behaves in a more aggressive fashion than does ossifying fibroma, may be mistaken as low grade osteosarcoma, which may alter the treatment.

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